Vecuronium

Aka: Vecuronium, Norcuron

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