Details About Generic Salt ::  Vecuroni

Main Medicine Class:: Nondepolarizing neuromuscular blocker,muscle relaxant;Anesthetic adjunct   

(veh-CUE-row-nee-uhm BROE-mide)

Norcuron

Class: Nondepolarizing neuromuscular blocker/muscle relaxant;Anesthetic adjunct

 

Drugs Class ::

 Action Causes paralysis of skeletal muscles by binding competitively to cholinergic receptors on motor end-plate to antagonize action of acetylcholine, resulting in block of neuromuscular transmission.

Indications for Drugs ::

 Indications Adjunct to general anesthesia to facilitate endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.

Drug Dose ::

 Route/Dosage

ADULTS & CHILDREN > 10 YR: IV Initial dose: for inhalation 0.08 to 0.1 mg/kg. Reduce initial dose by 15% (0.06 to 0.85 mg/kg) if inhalation agents are already in use. If intubation is performed using succinylcholine, reduce initial dose to 0.04 to 0.06 mg/kg with inhalation anesthesia and 0.05–0.06 mg/kg with balanced anesthesia. Maintenance: IV bolus 0.01 to 0.015 mg/kg within 25 to 40 min of initial dose, then q 12 to 15 min. IV infusion: 1 mg/kg/min initially beginning 20 to 40 min after IV bolus. Titrate to desired clinical response. CHILDREN 1 TO 10 YR: IV Slightly higher initial doses and more frequent supplementation. INFANTS 7 WK TO 1 YR: IV Slightly lower doses and 1.5 times less frequent.

Contraindication ::

 Contraindications Hypersensitivity to vecuronium or bromides.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Infants are moderately more sensitive and take longer to recover. Not recommended in neonates; diluent contains benzyl alcohol (fatal-gasping syndrome). Elderly or debilitated patients: May experience delayed onset of action. Circulatory disease (eg, cardiovascular disease, elderly, edematous states): May cause delayed onset of action, do not increase dosage. Consciousness: Vecuronium has no known effect on consciousness, pain threshold, or cerebration. Accompany administration of this drug by adequate anesthesia. Electrolyte imbalance: Neuromuscular blockade may be altered depending on nature of imbalance. Hepatic/renal/biliary disease: Prolonged neuromuscular blockade may occur due to reduced elimination. Higher doses may be needed due to increased volume of distribution. Malignant hyperthermia: Monitor patient closely. Myasthenia gravis: Small doses may have profound effects; administer test dose in monitoring response to muscle relaxants. Severe obesity or neuromuscular disease: May pose airway or ventilation problems requiring special care before, during or after vecuronium.

PATIENT CARE CONSIDERATIONS

Drug Side Effects ::

 Adverse Reactions

RESP: Respiratory insufficiency; apnea. OTHER: Skeletal muscle weakness; profound and prolonged skeletal muscle paralysis.

Drug Mode of Action ::  

 Action Causes paralysis of skeletal muscles by binding competitively to cholinergic receptors on motor end-plate to antagonize action of acetylcholine, resulting in block of neuromuscular transmission.

Drug Interactions ::

 Interactions

Aminoglycosides, verapamil, inhalation anesthetics (eg, enflurane, isoflurane), lincosamides (eg, clindamycin, lincomycin), magnesium salts, polypeptide antibiotics (eg, bacitracin, polymyxin B): May enhance action of vecuronium (eg, respiratory depression). Hydantoins, carbamazepine: May cause vecuronium to have shorter duration or decreased effectiveness. Quinidine, quinine: Recurrent paralysis may occur with injection of quinidine during recovery from use of other muscle relaxants. Theophyllines: Dose-dependent reversal of neuromuscular blockade is possible. Thiopurines (eg, mercaptopurine): May decrease or reverse vecuronium action. Trimethaphan: May cause prolonged apnea.

Drug Assesment ::

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies.
• In patients with myasthenia gravis, perform test dose.
• Observe for histamine-release symptoms, bronchospasm, flushing, redness, hypotension, and tachycardia.
• Monitor respirations and be prepared to assist or control respiration.
• Monitor BP and pulse.
• Assess skeletal muscle tone.
• Monitor I & O.
• Check for urinary retention.
• Monitor carefully for signs of increased or decreased efficacy and pharmacologic activity (eg, muscle twitch response to peripheral nerve stimulation).

OVERDOSAGE: SIGNS & SYMPTOMS   Skeletal muscle weakness, neuromuscular block beyond time needed, hypotension, decreased respiratory reserve, low tidal volume, apnea

Drug Storage/Management ::

 Administration/Storage

• Administer IV only. Not for IM administration.
• Administer only if intubation, artificial respiration, oxygen, and reversal agents are immediately available.
• Reconstitute with 0.9% Sodium Chloride, 5% Dextrose, 5% Dextrose in Saline, Lactated Ringer’s Solution, or Sterile Water for Injection.
• May reconstitute with Bacteriostatic Water for Injection. However, when this diluent is used, solution contains benzyl alcohol and is contraindicated in newborns.
• Store unopened vial at room temperature. Protect from light.
• Following reconstitution, refrigerate. Use within 8 hr.
• Intended for single use only. Discard unused portions.

Drug Notes ::

 Patient/Family Education

• Explain to patient and family that patient will recover from anesthesia in 25 to 40 min.
• Inform patient and family that patient may have difficulty speaking when recovering postoperatively but that speech will improve as effects of medication wear off.
• Inform patient that postoperative urinary retention is possible.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.