Clinical Pharmacology Details


PANCURONIUM BROMIDE


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Indications & Dose:

Neuromuscular blockade (long duration) during surgery and intubation



Adult: Initially 100 micrograms/kg, then 20 micrograms/kg as required


Neuromuscular blockade (long duration) during intensive care



Adult: Initially 100 micrograms/kg, initial dose is optional, then 60 micrograms/kg every 60–90 minutes


DOSES AT EXTREMES OF BODY-WEIGHT


To avoid excessive dosage in obese patients, dose should be calculated on the basis of ideal bodyweight. 

Contraindications:

Hypersensitivity.

Side Effects:

moderate rise of mean arterial pressure may occur. It decrease intraocular pressure and induce miosis. Localized reaction may occur. Transient fall in blood pressure, reduction in GI motility and tone, wheal-and-flare effects at site of injection.

Cautions:

can only be used in hospitals which possess suitable equipment and  it should be administered by fully qualified anaesthetist .


Administration of depolarizing drugs (suxamethonium) following a non depolarizing drug is not advisable. Do not mix with other solutions, hepatic impair-ment; reduce dose in renal impairment. 

Precautions:

Myasthenia gravis, renal, hepatic and pulmonary function impairment, biliary tract disease, severe obesity.


Pregnancy: Safety not established.


Breast-feeding: Use only if clearly indicated.


Old age: May be used in reduced dose

Interaction:

Drugs


Antibiotics: Aminogly-cosides, Tetracyclines, Bacitracin, Poly-myxin B, Clindamycin, Lincomycin and Colistin): Parenteral doses of these antibiotics used pre-operatively may produce unexpected prolongation of neuromuscular blockade.


Azathioprine: Causes reversal of neuro-muscular blocking effect of pancuronium.


Inhalation anaesthetics (Halothane, Enflurane, Isoflurane): Potentiation of neuromuscular blockade.


Magnesium Sulphate: Neuromuscular blockade of pancuronium enhanced.


Other neuromuscular blocking agents: (e.g. tubocuraine): Synergistic effect thought he blockade is not prolonged.


Quinine: Effects of pancuronium enhanced.


Succinylcholine:  Prior administration enhances the relaxant effect of pancuronium and its duration of action.


Theophylline: The effect of pancuronium may be reversed. Chances of cardiac arrhythmias. 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: