Pancuronium

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General

Adult Dosing

Calculate based on ideal body weight

  • Intubation dose: bolus 0.06-0.1 mg/kg IV
  • Maintenance: 0.015-0.1 mg/kg IV q30-60min OR continuous infusion: 0.1 mg/kg/hr IV

Pediatric Dosing

  • Neonates
    • Load: 0.02 mg/kg IV
    • Maintenance: 0.05-0.1 mg/kg IV q0.5-4hr PRN
  • >1mo
    • Load: 0.04-0.1 mg/kg IV
    • Maintenance: 0.015-0.1 mg/kg IV q30-60min OR continual infusion: 0.1 mg/kg/hr IV

Special Populations

  • Pregnancy Rating: C
  • Lactation: Unknown
  • Renal Dosing
    • CrCl 10-50 mL/min: Administer 50% normal dose
    • CrCl <10 mL/min: Do not use
  • Hepatic Dosing: Use caution

Contraindications

  • Allergy to class/drug or bromides
  • Caution if:
    • Following opioid, sedative or anesthetic agent (additive/synergistic effects)
    • Poor renal perfusion or severe renal disease
    • Preexisting tachycardia
    • >25% TBSA burns
    • HyperMg, hypoK, hypoCa (increased sensitivity)

Adverse Reactions

Serious

  • Anaphylaxis
  • Tachycardia, dose related
  • Bronchospasm
  • Hypotension

Common

  • Tachycardia
  • Hypertension
  • Excessive salivation
  • Excessive sweating
  • Rash
  • Wheezing

Pharmacology

  • Half-life: 2h
  • Metabolism: primarily none
  • Excretion: Urinary
  • Mechanism of Action: Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist

See Also

References