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Nondepolarizing neuromuscular blocker/paralytic
Mechanism of action
Binds to the receptor for acetylcholine at the neuromuscular junction
induction or maintenance of paralysis after intubation to assist ventilations
Hypersensitivity, inability to control airway and support ventilations with oxygen and positive pressure, neuromuscular disease (myasthenia gravis), hepatic or renal failure.
apnea, weakness, salivation, PVCs, tachycardia; transient hypotension, increased BP, pain, burning at injection site.
Positive chronotropic drugs may potentiate tachycardia
Dosage and Administration
- Adult: 0.1mg/kg slow IV; repeat every 30-60 minutes PRN.
- Pediatric: 0.1mg/kg slow IV, IO
Duration of action
- onset: 30 seconds
- Peak effect: paralysis in 3-5 minutes
- Duration: 45-60 minutes
Pregnancy safety: not established. If Pt. is conscious, explain the effect of the medication before administration and always sedate the Pt. before using pancuronium. Intubation and ventilatory support must be readily available. Monitor the Pt. carefully. Effects may be reversed with neostagmine (prostigmin) 0.05 mg/kg and should be accompanied by atropine (0.5-1.2 mg IV). Pancuronium has no effect on consciousness or pain. Will not stop neuronal seizure activity. Pulse rate, cardiac output are increased. Decrease doses for Pts. with renal failure.
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