|
Pronunciation |
|
(ve
KYOO roe nee
um) |
|
|
U.S. Brand
Names |
|
Norcuron® |
|
|
Generic
Available |
|
No |
|
|
Synonyms |
|
ORG NC 45 |
|
|
Pharmacological Index |
|
Neuromuscular Blocker Agent, Nondepolarizing |
|
|
Use |
|
Adjunct to anesthesia, to facilitate intubation, and provide skeletal muscle
relaxation during surgery or mechanical ventilation |
|
|
Pregnancy Risk
Factor |
|
C |
|
|
Contraindications |
|
Known hypersensitivity to vecuronium |
|
|
Warnings/Precautions |
|
Use with caution in patients with hepatic impairment, neuromuscular disease,
myasthenia gravis, and the elderly; ventilation must be supported during
neuromuscular blockade |
|
|
Adverse
Reactions |
|
<1%: Tachycardia, flushing, edema, hypotension, circulatory collapse,
bradycardia, rash, itching, hypersensitivity reaction |
|
|
Overdosage/Toxicology |
|
Symptoms of overdose include prolonged skeletal muscle weakness and apnea
cardiovascular collapse
Use neostigmine, edrophonium, or pyridostigmine with atropine to antagonize
skeletal muscle relaxation; support of ventilation and the cardiovascular system
through mechanical means, fluids, and pressors may be necessary
|
|
|
Drug
Interactions |
|
Increased toxicity/effect with aminoglycosides, ketamine, magnesium sulfate,
verapamil, quinidine, clindamycin, furosemide |
|
|
Stability |
|
Stable for 5 days at room temperature when reconstituted with bacteriostatic
water; stable for 24 hours at room temperature when reconstituted with
preservative-free sterile water (avoid preservatives in neonates); do not mix
with alkaline drugs |
|
|
Mechanism of
Action |
|
Blocks acetylcholine from binding to receptors on motor endplate inhibiting
depolarization |
|
|
Pharmacodynamics/Kinetics |
|
Good intubation conditions within 2.5-3 minutes; maximum neuromuscular
blockade within 3-5 minutes
Elimination: Vecuronium bromide and its metabolite(s) appear to be excreted
principally in feces via biliary eliminations; the drug and its metabolite(s)
are also excreted in urine |
|
|
Usual Dosage |
|
I.V. (do not administer I.M.):
Children >1 year and Adults: Initial: 0.08-0.1 mg/kg/dose; maintenance:
0.05-0.1 mg/kg/every hour as needed; may be administered with caution as a
continuous infusion at 0.075 mg/kg/hour (concern has been raised of drug-induced
myopathies in ICU setting)
Note: Children (1-10 years) may require slightly higher initial doses
and slightly more frequent supplementation
Dosing adjustment in hepatic impairment: Dose reductions are
necessary in patients with liver disease |
|
|
Administration |
|
Dilute vial to a maximum concentration of 2 mg/mL and give by rapid direct
injection; for continuous infusion, dilute to a maximum concentration of 1
mg/mL |
|
|
Monitoring
Parameters |
|
Blood pressure, heart rate |
|
|
Nursing
Implications |
|
Does not alter the patient's state of consciousness; addition of sedation and
analgesia are recommended; dilute vial to a maximum concentration of 2 mg/mL and
administer by rapid direct injection; for continuous infusion, dilute to a
maximum concentration of 1 mg/mL |
|
|
Dosage Forms |
|
Powder for injection: 10 mg (5 mL, 10
mL) |
|
Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
|