Rocuronium: Difference between revisions
(Add dynamic SMW Indications by Condition table (auto-populated from disease pages via MedicationDose template)) |
(Switch SMW query from broadtable to table format for better layout with TOC) |
||
| (One intermediate revision by the same user not shown) | |||
| Line 66: | Line 66: | ||
|?Has Route=Route | |?Has Route=Route | ||
|?Has Population=Population | |?Has Population=Population | ||
|format= | |format=table | ||
|headers=plain | |headers=plain | ||
| | |mainlabel=- | ||
|sort=Has Indication | |sort=Has Indication | ||
|limit=50 | |limit=50 | ||
Latest revision as of 21:58, 20 March 2026
See critical care quick reference for drug doses by weight.
General
- Type: Neuromuscular blocker, Non-Depolarizing, Fast Onset, Intermediate Lasting
- Dosage Forms: IV
- Common Trade Names: Zemuron
Adult Dosing
RSI
- 0.6 to 1.2mg/kg IV (ideal body weight)
- Onset of action faster with higher dose
- One study suggests 2.0mg/kg may lead to optimal intubating conditions; however higher doses lead to longer duration of paralysis[1]
Maintenance Bolus Dosing
- 0.1 to 0.2mg/kg IV
Infusion
- 10 to 12 mcg/kg/min
Pediatric Dosing
See critical care quick reference for drug doses by weight.
RSI
- 0.6 to 1.2mg/kg IV (ideal body weight)
Maintenance Bolus Dosing
- 0.1 to 0.2mg/kg IV
Infusion
- 10 to 12 mcg/kg/min
Special Populations
- Pregnancy Rating: C
- Lactation: Infant risk cannot be ruled out
- Renal Dosing (half life approximately 1 hour longer if renal transplant patient)
- Adult
- Pediatric
- Hepatic Dosing (half life approximately 3 hours longer with liver dysfunction)
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
- Do not use without concurrent sedation
Adverse Reactions
Serious
Common
- Cardiovascular: hypertension (0.1% to 2%)
- Hypotension (0.1% to 2%)
- Tachycardia (1% to 5.3%)
- Dermatologic: Pain at injection site
- Respiratory: Increased pulmonary vascular resistance (24%)
Pharmacology
- Half-life: Variable by age, but anywhere from 30 minutes to 2 hours.
- Metabolism: Metabolite is 17-desacetyl-rocuronium
- Excretion: Primary route is fecal. Renal also.
- Mechanism of Action: Non-depolarizing neuromuscular blocking agent. Intermediate duration with dose dependant rapid to intermediate onset. Competes for cholinergic receptors at the motor end-plate. Acetylcholinesterase inhibitors like those found in organophosphates antagonize this action
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Rapid sequence intubation | 1.2 mg/kg | Paralytic (RSI dose) | IV | Adult |
| Rapid sequence intubation | 0.6 mg/kg | Paralytic (repeat) | IV | Adult |
See Also
- Critical care quick reference
- Reversal agent: Sugammadex
- Succinylcholine
Airway Pages
- Pre-intubation
- Induction
- Intubation
- Surgical airways
- Post-intubation
References
- ↑ Heier T, Caldwell JE. Rapid tracheal intubation with large-dose rocuronium: a probability-based approach. Anesth Analg. 2000 Jan;90(1):175-9. doi: 10.1097/00000539-200001000-00036. PMID: 10625000.