Vecuronium pharmacokinetics

Lebrault C, Berger JL, D Hollander AA, Gomeni R, Henzel D, Duvaldestin P. Pharmacokinetics and pharmacodynamics of vecuronium (ORG NC 45) in patients with cirrhosis. Anesthesiology 1985 62(5) 601-5. 

Lebrault C, Duvaldestin P, Henzel D, Chauvin M, Guesnon P. Pharmacokinetics and pharmacodynamics of vecuronium in patients with cholestasis. Br J Anaesth 1986 58(9) 983-7. 

Pharmacokinetics All agents are given parenterally. Drugs that are metabolized (eg, mivacurium, by plasma cholinesterase) or eliminated in the bile (eg, vecuronium) usually have shorter durations of action than those eliminated by the kidney (eg, doxacurium, pancuronium, tubocurarine). Atracurium clearance involves spontaneous breakdown (Hofmann elimination) to form laudanosine and other products is largely independent of hepatic or renal function. 

Soriano SG, Sullivan LJ, Venkatakrishnan K, Greenblatt DJ, Martyn JAJ. Pharmacokinetics and pharmacodynamics of vecuronium in children receiving phenytoin or carbamazepine for chronic anticonvulsant therapy, BrJAnaesth (2001) 86, 223-9. 

RD. Influence of chronic phenytoin administration on the pharmacokinetics and pharmaco-(fynamics of vecuronium. (1999) 83,183P-184P. 

Alloul K, Whalley DG, Shutway F, Ebrahim Z, Varin F. Pharmacokinetic origin of car-bamazepine-induced resistance to vecuronium neuromuscular blockade in anestiietized patients. Anesthesiology ( 996) 84,330-9. 

Rocuronium (Fig. 16.21) preserves the vecuronium trend of tertiary versus quaternary nitrogens, but with further modifications on the nitrogen substitutes. The dmg has a similar pharmacokinetic, duration of action, and toxicity profile to vecuronium but six times less potent. It has a fast onset of action (about 2 minutes). Recuronium is supplied as its bromide salt in multiple-dose vials containing volumes of 50 or 100 mL at a concentration of 10 mg/mL. 

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