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pancuronium (Rx)Brand and Other Names:Pavulon

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 1mg/mL
  • 2mg/mL
more...

General Anesthesia Adjunct/Cesarean Section

Load: 0.04-0.1 mg/kg IV 

Maintenance: 0.015-0.1 mg/kg IV q30-60min OR

Continuous infusion: 0.1 mg/kg/hr IV

Dose should be calculated based on ideal body weight

Monitoring of muscle twitch response to a peripheral nerve stimulator is advised

Endotracheal Intubation

Bolus dose 0.06-0.1 mg/kg  

Usually effective with in 2-3 minutes

Other Indications & Uses

Skeletal muscle relaxation during surgery, endotracheal intubation, mechanical ventilation

Dosage Forms & Strengths

injectable solution

  • 1mg/mL
  • 2mg/mL
more...

Neonates (<28 Days Old)

Load: 0.02 mg/kg IV 

Maintenance: 0.05-0.1 mg/kg IV q0.5-4hr PRN

>1 Month Old

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

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Interactions

Interaction Checker

pancuronium and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Slight elevation in pulse rate

            Elevations in blood pressure

            Excessive salivation

            Excessive sweating (in children)

            Transient rashes

            Wheezing

            Dose-related tachycardia

            Histamine release (bronchospasm/hypotension)

            CAUTION: adequate ventilatory support mandatory, may experience resistance with >25% TBSA burns, may experience incr sensitivity w/electrolyte disorders (hyperMg, hypoK, hypoCa)

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            Warnings

            Black Box Warnings

            The drug should be administered only by adequately trained individuals familiar with its actions, characteristics, and hazards

            Contraindications

            Lack of ventilatory support, neuromuscular disease

            Hypersensitive to drug &/or bromides

            Cautions

            Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent

            In pts with poor renal perfusion or severe renal disease, preexisting tachycardia

            Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk; effect on nursing infant not known

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Half-Life:

            2 hr (terminal phase)

            Renal dysfunction may incr half-life 50%

            Other Information

            Onset: 1-2 min

            Duration: 60 min

            Protein Bound: 87% (range: 77-91%)

            Metabolism: primarily none, some hepatic transformation to weakly active metabolite

            Excretion: unchanged in urine

            Little effect on intraocular/intracranial pressure

            Very rarely causes release of histamine (and hypotension, bronchospasm, flushing); more commonly causes dose-related tachycardia by blocking cardiac ACh receptors

            Mechanism of Action

            Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist

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            Administration

            IV Compatibilities

            Additive: ciprofloxacin, verapamil

            Syringe: caffeine, heparin

            Y-site: aminophylline, cefazolin, cefuroxime, cimetidine, dobutamine, dopamine, epinephrine, esmolol, etomidate, fenoldopam, fentanyl, fluconazole, gentamicin, heparin, Hextend, hydrocortisone, isoproterenol, levofloxacin, lorazepam, midazolam, milrinone, morphine, nitroglycerin, propofol (1 mg/mL), ranitidine, Na nitroprusside, trimethoprim/sulfamethoxazole, vancomycin

            IV Incompatibilities

            Y-site: diazepam, thiopental

            IV Preparation

            Solution: add to an empty Viaflex bag & infuse undiluted (2 mg/mL); however, if necessary, may be diluted in D5W, NS, or LR

            Continuous infusions may be given by using undiluted drug

            IV Administration

            Use controlled microinfusion device

            Storage

            Store at 2-8 C; stable at RT x 6mth

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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