Pancuronium Bromide

Pancuronium Bromide belongs to a group of medicines called muscle relaxants. It is used along with general anesthesia or sedatives to provide skeletal muscle relaxation during surgical procedures. It is also used to facilitate emergency airway management in patients in intensive care. Pancuronium Bromide is generally administered by a healthcare professional. You should not self-administer this medicine at home. The dose and duration will depend on what you are taking it for and how well it helps your symptoms. The medicine is generally well-tolerated with little or no side effects. However, it may cause injection site reactions (such as pain, redness, and swelling), rash, and allergic reactions in some people. If any of these side effects persist or get worse, you should let your doctor know. Your doctor may be able to suggest ways of preventing or reducing the symptoms. Before using it, you should let your doctor know if you have any medical conditions or disorders. You should also tell your doctor all the other medicines you are using or taking. Pregnant and breastfeeding women should consult their doctors before using this medicine. Pancuronium Bromide relaxes the muscles by blocking the impulses from the nerves.

• Skeletal mucle relaxation during surgery

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.

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 (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

Your doctor or nurse will give you this medicine. Kindly do not self administer.

Common: • Injection site reactions (pain, swelling, redness)

[NOT RELEVANT] Not relevant, as Pancuronium Bromide is intended for use in hospitalised patients.

Anuria. Relatively contraindicated in conditions of reduced airway control. Lactation.

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.

[CAUTION] Caution is advised when consuming alcohol with Pancuronium Bromide. Please consult your doctor.

[CONSULT YOUR DOCTOR] Pancuronium Bromide may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[SAFE IF PRESCRIBED] Pancuronium Bromide is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[CAUTION] Pancuronium Bromide should be used with caution in patients with kidney disease. Dose adjustment of Pancuronium Bromide may be needed. Please consult your doctor. [CAUTION] Pancuronium Bromide should be used with caution in patients with liver disease. Dose adjustment of Pancuronium Bromide may be needed. Please consult your doctor.

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