Pancuronium Bromide

What it is used for

• General muscle relaxation
• Neuromuscular blockade during anaesthesia
• Muscle relaxation
• As a paralytic during mechanical ventilation
• General muscle relaxation
• Anesthesia maintenance adjunct (when inhalational agents result in severe hypotension)
• Neuromuscular blockade during anaesthesia

How it is given

Possible side effects

• Slight elevations in cardiac rate and blood pressure
• Hypersalivation (if not pretreated with an anticholinergic agent)
• Prolonged or profound muscular weakness
• Respiratory depression
• Histamine release with resultant hypersensitivity reaction (Very Rare)
• Tachycardia (due to vagolytic effect)
• Prolonged neuromuscular blockade
• Mild hypertension

Cautions & contraindications

• Known hypersensitivity to pancuronium or bromides
• Myasthenia gravis (extreme caution or contraindicated)
• Conscious or inadequately anaesthetized animals
• Lack of positive pressure ventilation facilities
• Lack of monitoring equipment (nerve stimulator)
• > **WARNING**: Pancuronium has **NO analgesic or sedative/anesthetic actions**. It must only be used in adequately anesthetized/sedated patients with full ventilatory support available. * **Extreme Caution**: Patients with myasthenia gravis (neuromuscular blocking agents should be used with extreme caution, if at all). * **Caution**: Renal dysfunction. Plasma half-lives are doubled in renal failure; atracurium may be a better choice for these patients. * **Caution**: Hepatic or biliary disease (lower doses may be necessary). * **Caution**: Patients where tachycardias may be deleterious (due to the drug's slight vagolytic effects).

Drug interactions

• Azathioprine: May reverse pancuronium's neuromuscular blocking effects
• Aminoglycosides (e.g., gentamicin): May enhance the neuromuscular blocking activity of pancuronium
• Calcium (IV): May reverse the effects of nondepolarizing neuromuscular blocking agents
• Lincosamides (e.g., clindamycin): May enhance the neuromuscular blocking activity of pancuronium
• Magnesium sulfate or HCl: May enhance the neuromuscular blocking activity of pancuronium
• Quinidine: May enhance the neuromuscular blocking activity of pancuronium
• Succinylcholine: May speed the onset of action and enhance the neuromuscular blocking actions of pancuronium. Do not give pancuronium until succinylcholine effects have subsided.
• Theophylline: May inhibit or reverse the neuromuscular blocking action of pancuronium and possibly induce arrhythmias
• Tricyclic Antidepressants (e.g., clomipramine, amitriptyline): Increased risk for cardiac arrhythmias when used with halothane anesthesia
• Volatile anaesthetics: Prolonged neuromuscular blockade

Frequently asked questions