Rocuronium: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
===[[RSI]]=== | ===[[RSI]]=== | ||
*0.6 to 1.2mg/kg IV ( | *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<ref>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.</ref> | |||
===Maintenance Bolus Dosing=== | ===Maintenance Bolus Dosing=== | ||
*0.1 to 0.2mg/kg IV | *0.1 to 0.2mg/kg IV | ||
| Line 16: | Line 19: | ||
''See [[critical care quick reference]] for drug doses by weight.'' | ''See [[critical care quick reference]] for drug doses by weight.'' | ||
===[[RSI]]=== | ===[[RSI]]=== | ||
*0.6 to 1.2mg/kg IV ( | *0.6 to 1.2mg/kg IV (ideal body weight) | ||
===Maintenance Bolus Dosing=== | ===Maintenance Bolus Dosing=== | ||
*0.1 to 0.2mg/kg IV | *0.1 to 0.2mg/kg IV | ||
| Line 34: | Line 37: | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Do not use without concurrent sedation | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
| Line 55: | Line 59: | ||
*[[Critical care quick reference]] | *[[Critical care quick reference]] | ||
*Reversal agent: [[Sugammadex]] | *Reversal agent: [[Sugammadex]] | ||
*[[Succinylcholine]] | |||
{{Template:Related Difficult Airway Pages}} | |||
==References== | ==References== | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Critical Care]] | |||
Latest revision as of 15:50, 29 April 2022
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
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.