II. Precautions
- Used only in Anesthesia, emergency and Intensive Care
- Airway and Respiratory Control is critical after use
-
Paralytic Agents do not alter Level of Consciousness
- Must be used with sedation and analgesia
III. Indication
- Paralysis in Rapid Sequence Intubation
IV. Preparations
- Vecuronium 1 mg/ml after reconstituted with 10 ml saline or sterile water to 10 mg/10 ml
V. Mechanism
- Non-depolarizing Neuromuscular Blocking Agent
- Structurally similar to Pancuronium
- Same steroid nucleus
- Tertiary Nitrogen at position 2 is only difference
- Significantly different effects than Pancuronium
- Duration of action is half that of Pancuronium
- Hepatic excretion predominates
- Minimal cardiovascular effects
VI. Dose
- Initial Dose
- Vecuronium alone: 0.08 to 0.1 mg/kg IV
- Vecuronium after Succinylcholine: 0.04 to 0.06 mg/kg
- Maintenance dosing (if needed)
- Starts 25-40 minutes after initial dose
- Please see other references for maintenance dosing
- Reduce dosage in hepatic Impairment
- Do not use by intramuscular dosing
VII. Pharmacokinetics
- Onset: 1-2 minutes
- Maximal Neuromuscular Blockade by 3-5 minutes
- Duration: 30 minutes
- Primarily hepatic metabolism (only 20% via renal excretion)
VIII. References
- Miller in Katzung (1989) Pharmacology, p. 323-33
- Savarese in Miller (2000) Anesthesia, p. 412-90
- (2003) Lexicomp Drug database for Pocket PC