pancuronium bromide
pancuronium bromide.JPG

CLINICAL USE

Non-depolarising muscle relaxant of long duration

DOSE IN NORMAL RENAL FUNCTION

Initial dose: 50–100 micrograms/kgIncremental dose:
  • 10 to 20     : micrograms/kg

    PHARMACOKINETICS

  • Molecular weight                           :732.7
  • %Protein binding                           :80–90
  • %Excreted unchanged in urine     : 40–60
  • Volume of distribution (L/kg)       :0.15–0.38
  • half-life – normal/ESRD (hrs)      :2/4.3–8.2

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Initial dose: 25–50 micrograms/kg Incremental dose: 5–10 micrograms/kg
  • <10           : Initial dose: 10–25 micrograms/kg Incremental dose: 2.5–5 micrograms/kg

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unknown dialysability. Dose as in GFR <10 mL/min
  • HD                     :Unknown dialysability. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Anaesthetics: enhanced muscle relaxant effect
  • Anti-arrhythmics: procainamide enhances muscle relaxant effect
  • Antibacterials: effect enhanced by aminoglycosides, clindamycin, polymyxins and piperacillinBotulinum toxin: neuromuscular block enhanced (risk of toxicity)

    ADMINISTRATION

    Reconstition

    Route

    IV

    Rate of Administration

    Bolus

    Comments

    OTHER INFORMATION

    Active metabolites accumulate in CKD 5; duration of action prolonged



    See how to identify renal failure stages according to GFR calculation

    See how to diagnose irreversible renal disease

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