Neocuron Injection
Pancuronium Bromide
4mg
Neon Laboratories Ltd
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| Retail Price | 47.20 NPR |
Available as:
Indications
Neocuron Injection is used for:
Adjunct to GA for Endotracheal intubation and to provide skeletal muscle ralaxation.
Adult Dose
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
Child Dose
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
Renal Dose
Administration
Contra Indications
Anuria. Relatively contraindicated in conditions of reduced airway control. Lactation.
Precautions
Myasthenia gravis; severe electrolyte disorders; severe CV disease; pregnancy. Hepatic and renal function impairment. Hypothermia; jaundice; hypermagnesaemia, hypocalcaemia, hypokalaemia, hypoproteinaemia, acidosis, alkalosis, hypercalcemia. In obese patients, dose should be based on ideal body wt. Elderly; previous anaphylactic reactions to other neuromuscular-blocking agents. Burn patients (>30% of body) may be resistant to action for 5-70 days after injury. Demyelinating lesions, peripheral neuropathies, denervation, infection, muscle trauma, and DM may antagonise the neuromuscular blockade effects of drug. Neuromuscular diseases, acute intermittent porphyria, Eaton-Lambert syndrome. Maintain adequate airway and respiratory support during use.
Lactation: not known if excreted in breast milk; effect on nursing infant not known
Pregnancy-Lactation
Interactions
Neuroleptanalgaesia may decrease neuromuscular activity. Action may be prolonged and/or potentiated by aminoglycoside antibiotics, lithium, diazepam, lidocaine (high dose), quinidine, tetracyclines, propranolol, thiamine (high dose), parenteral magnesium sulphate, MAOIs, quinine, protamine, carbamazepine, donepezil and phenytoin (if pancuronium is given concurrently for <1 wk). Action may be decreased by neostigmine, edrophonium, high-dose or long term corticosteroids, adrenaline (may also potentiate effect), azathioprine, theophylline (high doses), clindamycin, nifedipine, piperacillin, polymixins, verapamil, procainamide. Furosemide may increase or decrease effects. TCAs may increase risk of arrhythmias and hypotension during anaesthesia.
Potentially Fatal: Potentiated by volatile anaesthetics (isoflurane and enflurane) and local anaesthetics. Prior admin of suxamethonium can increase the intensity of neuromuscular block. Concomitant use with digoxin may increase risk of serious cardiac arrhythmias.
Adverse Effects
Side effects of Pancuronium Bromide :
Tachycardia may occur due to vagal blockade and especially during light anaesthesia. May decrease intra-ocular pressure and induce miosis; excessive salivation; transient rashes and itching; wheezing; elevation in pulse rate, BP, cardiac output; erythema; burning sensation along vein; profound muscle weakness; bronchospasm; hypersensitivity reaction; acute quadriplegic myopathy syndrome, myositis ossificans.
Potentially Fatal: Rare anaphylactoid reactions; bradycardia, bronchospasm, hypotension and CV collapse; respiratory depression.
Mechanism of Action
Pancuronium bromide is a non-depolarising neuromuscular blocking agent with curarimimetic action through competitive blockade at the myoneural junction by binding with cholinergic receptor sites.
Note
Neocuron 4mg Injection manufactured by Neon Laboratories Ltd. Its generic name is Pancuronium Bromide. Neocuron is availble in Nepal.
Farmaco Nepal drug index information on Neocuron Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.