Pancuronium

General

• Type: Neuromuscular blocker
• Dosage Forms:
• Common Trade Names:

Adult Dosing

Calculate based on ideal body weight

• Intubation dose: bolus 0.06-0.1 mg/kg IV
• Maintenance: 0.015-0.1 mg/kg IV q30-60min OR continuous infusion: 0.1 mg/kg/hr IV

Pediatric Dosing

• Neonates
  • Load: 0.02 mg/kg IV
  • Maintenance: 0.05-0.1 mg/kg IV q0.5-4hr PRN
• >1mo
  • 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

Special Populations

• Pregnancy Rating: C
• Lactation: Unknown
• Renal Dosing
  • CrCl 10-50 mL/min: Administer 50% normal dose
  • CrCl <10 mL/min: Do not use
• Hepatic Dosing: Use caution

Contraindications

• Allergy to class/drug or bromides
• Caution if:
  • Following opioid, sedative or anesthetic agent (additive/synergistic effects)
  • Poor renal perfusion or severe renal disease
  • Preexisting tachycardia
  • >25% TBSA burns
  • HyperMg, hypoK, hypoCa (increased sensitivity)

Adverse Reactions

Serious

• Anaphylaxis
• Tachycardia, dose related
• Bronchospasm
• Hypotension

Common

• Tachycardia
• Hypertension
• Excessive salivation
• Excessive sweating
• Rash
• Wheezing

Pharmacology

• Half-life: 2h
• Metabolism: primarily none
• Excretion: Urinary
• Mechanism of Action: Non-depolarizing skeletal muscle relaxant; cholinergic receptor antagonist