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Class
Nondepolarizing neuromuscular blocker/paralytic
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Mechanism of action
Binds to the receptor for acetylcholine at the neuromuscular junction
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Indications
induction or maintenance of paralysis after intubation to assist ventilations
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Contraindications
Hypersensitivity, inability to control airway and support ventilations with oxygen and positive pressure, neuromuscular disease (myasthenia gravis), hepatic or renal failure.
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Adverse reactions
apnea, weakness, salivation, PVCs, tachycardia; transient hypotension, increased BP, pain, burning at injection site.
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Drug interactions
Positive chronotropic drugs may potentiate tachycardia
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How supplied
4mg/2mL ampule
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Dosage and Administration
- Adult: 0.1mg/kg slow IV; repeat every 30-60 minutes PRN.
- Pediatric: 0.1mg/kg slow IV, IO
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Duration of action
- onset: 30 seconds
- Peak effect: paralysis in 3-5 minutes
- Duration: 45-60 minutes
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Special considerations
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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