Vecuronium - Revision history

Cornel.Chiu at 16:10, 5 January 2023

2023-01-05T16:10:07Z

← Older revision		Revision as of 09:10, 5 January 2023
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	* 2-desmethyl derivative of pancuronium<ref name=":0" />		* 2-desmethyl derivative of pancuronium<ref name=":0" />
	*Supplied as crystalline particles that may be reconstituted with IV fluid<ref name=":1">{{Cite ~~web~~\|~~title~~=~~Login Selection~~ - ~~Lane Medical Library~~, ~~Stanford University Medical Center~~\|url=~~https~~://~~lane~~.~~stanford.edu~~/~~discoveryLoginPage.html?entityID~~=~~https%3A%2F%2Flane.stanford.edu%2Fshibboleth&return~~=~~https%3A%2F%2Flane.stanford.edu%2FShibboleth.sso%2FLogin%3FSAMLDS%3D1%26target%3Dss%253Amem%253Aafeae087fc51b2fb759e03714dfd19fe64f11fde03eebe29f6663b080e5d8858~~\|~~access~~-~~date=2023~~-01-05\|~~website~~=~~lane.stanford.edu~~}}</ref>		*Supplied as crystalline particles that may be reconstituted with IV fluid<ref name=":1">{{Cite book\|last=Nina.\|first=Gupta, Anita. Singh-Radcliff,\|url=http://worldcat.org/oclc/940638246\|title=Pharmacology in anesthesia practice\|date=2013\|publisher=Oxford University Press\|isbn=978-0-19-978267-3\|oclc=940638246}}</ref>

	==History<!-- Describe the historical development of the drug. -->==		==History<!-- Describe the historical development of the drug. -->==

Cornel.Chiu at 16:07, 5 January 2023

2023-01-05T16:07:51Z

← Older revision		Revision as of 09:07, 5 January 2023
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	{{Infobox drug reference		{{Infobox drug reference
	\| trade_names =		\| trade_names = Norcuron
	\| drug_class = Neuromuscular blocker		\| drug_class = Neuromuscular blocker
	\| drug_class_color = neuromuscular_blocker		\| drug_class_color = neuromuscular_blocker
	\| uses =		\| uses = Tracheal intubation, surgical relaxation, optimizing mechanical ventilation conditions, patients with ARDS
	\| contraindications =		\| contraindications = Known hypersensitivity
	\| routes = Intravenous		\| routes = Intravenous
	\| dosage =		\| dosage =
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	\| clearance =		\| clearance =
	\| halflife_elimination =		\| halflife_elimination =
	\| adverse_effects =		\| adverse_effects = Anaphylactic reaction
	\| metabolism =		\| metabolism = Liver, bile, and renal
	\| duration =		\| duration = 40
	\| time_onset =		\| time_onset =
	\| dosage_calculation = vecuronium		\| dosage_calculation = vecuronium
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	* Prolonged duration of action in patients with cholestasis or cirrhosis		* Prolonged duration of action in patients with cholestasis or cirrhosis
	* ~~Dose requirement can be unpredictable~~ in patients with renal failure		* Use in patients with renal failure

	* Patients with myasthenia gravis/myathenic syndrome
	* Amyotrophic lateral sclerosis
	* Autoimmune disorders including polymyositis, dermatomyositis and systemic lupus erythematous
	* Familial periodic paralysis hyperkalemia
	* Guillain-Barré syndrome
	* Muscular dystrophy (Duchenne type)
	* Myotonia including dystrophic, congenital,, and paramyotonia
	* Patient may have resistance include:
	** Burn injury
	** Cerebral palsy
	** Hemiplegia (on the affected side)
	** Muscular denervation
	** Severe chronic infection such as tetanus and botulism

	==Pharmacology==		==Pharmacology==
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	* Anaphylactic reaction		* Anaphylactic reaction
			*Muscle weakness or myopathy due to persistent failure of neuromuscular transmission and immobilization-induced atrophy of diaphragm
			*Posttraummatic stress syndrome from awareness during paralysis if sedation is not used adequately.
			*Impairment of ventilation-perfusion distribution and decreased right ventricular end-diastolic volume due to abolishment of spontaneous breathing.
			*Incomplete reversal of neuromuscular blocking agent leading to respiratory depression

	===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===		===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===

	* Duration of action of 40 minutes		* Duration of action after 1 x ED<sub>95</sub> is 40 minutes<ref name=":0">{{Citation\|last=Lien\|first=Cynthia A.\|title=Neuromuscular Blockers and Reversal Drugs\|date=2013\|url=http://dx.doi.org/10.1016/b978-1-4377-1679-5.00019-3\|work=Pharmacology and Physiology for Anesthesia\|pages=325–348\|publisher=Elsevier\|access-date=2023-01-05\|last2=Eikermann\|first2=Matthias}}</ref>

	==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==		==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==

	* 2-desmethyl derivative of pancuronium		* 2-desmethyl derivative of pancuronium<ref name=":0" />
			*Supplied as crystalline particles that may be reconstituted with IV fluid<ref name=":1">{{Cite web\|title=Login Selection - Lane Medical Library, Stanford University Medical Center\|url=https://lane.stanford.edu/discoveryLoginPage.html?entityID=https%3A%2F%2Flane.stanford.edu%2Fshibboleth&return=https%3A%2F%2Flane.stanford.edu%2FShibboleth.sso%2FLogin%3FSAMLDS%3D1%26target%3Dss%253Amem%253Aafeae087fc51b2fb759e03714dfd19fe64f11fde03eebe29f6663b080e5d8858\|access-date=2023-01-05\|website=lane.stanford.edu}}</ref>

	==History<!-- Describe the historical development of the drug. -->==		==History<!-- Describe the historical development of the drug. -->==
	First non-depolarizing neuromuscular blocking agent with an intermediate duration of action to be introduced into clinical practice
			* First non-depolarizing neuromuscular blocking agent with an intermediate duration of action to be introduced into clinical practice<ref name=":0" />

	==References==		==References==
			Lien, Cynthia A.; Eikermann, Matthias (2013), "Neuromuscular Blockers and Reversal Drugs", ''Pharmacology and Physiology for Anesthesia'', Elsevier, pp. 325–348, retrieved 2023-01-05<ref name=":0" />

			Anita Gupta, Nina Singh-Radcliff. ''Pharmacology in Anesthesia Practice''. Oxford University Press; 2013. Accessed January 5, 2023. <nowiki>https://search-ebscohost-com.laneproxy.stanford.edu/login.aspx?direct=true&db=nlebk&AN=603930&site=ehost-live</nowiki><ref name=":1" />

	[[Category:Drug reference]]		[[Category:Drug reference]]
	[[Category:Neuromuscular blockers]]		[[Category:Neuromuscular blockers]]
	[[Category:Nondepolarizing neuromuscular blockers]]		[[Category:Nondepolarizing neuromuscular blockers]]

Cornel.Chiu: Precautions, brief summary

2023-01-04T15:41:11Z

Precautions, brief summary

← Older revision		Revision as of 08:41, 4 January 2023
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	}}		}}

	Vecuronium is an steroidal intermediate acting non-depolarizing neuromuscular blocking agent		Vecuronium is a steroidal intermediate acting non-depolarizing neuromuscular blocking agent used for tracheal intubation and surgical relaxation in patients. It is also used to provide paralysis in patients with acute respiratory distress syndrome in the intensive care unit.

	==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==		==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==
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	===Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. -->===		===Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. -->===
	Known hypersensitivity
			* Known hypersensitivity

	===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===		===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===
	~~Prolonged duration of action in patients with cholestasis or cirrhosis~~

	Dose requirement can be unpredictable in patients with renal failure		* Prolonged duration of action in patients with cholestasis or cirrhosis
			* Dose requirement can be unpredictable in patients with renal failure

			* Patients with myasthenia gravis/myathenic syndrome
			* Amyotrophic lateral sclerosis
			* Autoimmune disorders including polymyositis, dermatomyositis and systemic lupus erythematous
			* Familial periodic paralysis hyperkalemia
			* Guillain-Barré syndrome
			* Muscular dystrophy (Duchenne type)
			* Myotonia including dystrophic, congenital,, and paramyotonia
			* Patient may have resistance include:
			** Burn injury
			** Cerebral palsy
			** Hemiplegia (on the affected side)
			** Muscular denervation
			** Severe chronic infection such as tetanus and botulism

	==Pharmacology==		==Pharmacology==

	===Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system -->===		===Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system -->===
	~~Primarily eliminated via hepatic metabolism: 30-40%~~

	Elimination via bile: 40%		* Primarily eliminated via hepatic metabolism: 30-40%
			* Elimination via bile: 40%
			* Elimination via renal: 20-30%
			* 3-desacetylvecuronium, 17-desacetylvecuronium and 3,17-desacetylvecuronium metabolites have neuromuscular blocking activity

	~~Elimination via renal: 20~~-~~30%~~		====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====

	~~3-desacetylvecuronium, 17-desacetylvecuronium and 3,17-desacetylvecuronium metabolites have neuromuscular blocking activity~~		* Competitive antagonism of acetylcholine at the post junctional receptors preventing depolarization of the muscle preventing any movement. Only one molecule of the neuromuscular blocker is needed to prevent activation of the receptor as it competes with acetylcholine at the two binding sites.

	~~====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====~~
	Competitive antagonism of acetylcholine at the post junctional receptors preventing depolarization of the muscle preventing any movement. Only one molecule of the neuromuscular blocker is needed to prevent activation of the receptor as it competes with acetylcholine at the two binding sites.

	====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====		====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====
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	===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===		===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===
	Duration of action of 40 minutes
			* Duration of action of 40 minutes

	==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==		==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==
	2-desmethyl derivative of pancuronium
			* 2-desmethyl derivative of pancuronium

	==History<!-- Describe the historical development of the drug. -->==		==History<!-- Describe the historical development of the drug. -->==

Cornel.Chiu: Brief summary, Uses, contraindication, precautions, pharmacodynamics, adverse effects, chemistry and formulation

2023-01-03T15:12:27Z

Brief summary, Uses, contraindication, precautions, pharmacodynamics, adverse effects, chemistry and formulation

← Older revision		Revision as of 08:12, 3 January 2023
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	}}		}}

	~~Provide a brief summary of this drug here.~~		Vecuronium is an steroidal intermediate acting non-depolarizing neuromuscular blocking agent

	==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==		==Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. -->==

			* Optimizing tracheal intubation condition
			** Abduction of vocal cords
			** Opening of mouth
			** Reduction in coughing and gagging
			* Provide surgical relaxation
			* Optimizing mechanical ventilation conditions
			** Reduction in bucking/coughing
			** Reduction in breath stacking

			* Provide paralysis in patients with acute respiratory distress syndrome in the intensive care unit via continuous infusion early in the course of ARDS for patients with a PaO2/FiO2 less than 150. The proposed mechanism of the beneficial effect is possibly by lowering trans-pulmonary pressure reducing barotrauma.

	==Contraindications<!-- List contraindications and precautions for use of the drug. -->==		==Contraindications<!-- List contraindications and precautions for use of the drug. -->==

	===Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. -->===		===Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. -->===
			Known hypersensitivity

	===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===		===Precautions<!-- List precautions for use of the drug. If none, this section may be removed. -->===
			Prolonged duration of action in patients with cholestasis or cirrhosis

			Dose requirement can be unpredictable in patients with renal failure

	==Pharmacology==		==Pharmacology==

	===Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system -->===		===Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system -->===
			Primarily eliminated via hepatic metabolism: 30-40%

			Elimination via bile: 40%

			Elimination via renal: 20-30%

			3-desacetylvecuronium, 17-desacetylvecuronium and 3,17-desacetylvecuronium metabolites have neuromuscular blocking activity

	====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====		====Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. -->====
			Competitive antagonism of acetylcholine at the post junctional receptors preventing depolarization of the muscle preventing any movement. Only one molecule of the neuromuscular blocker is needed to prevent activation of the receptor as it competes with acetylcholine at the two binding sites.

	====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====		====Adverse effects<!-- Describe any potential adverse effects of the drug. -->====

			* Anaphylactic reaction

	===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===		===Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. -->===
			Duration of action of 40 minutes

	==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==		==Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. -->==
			2-desmethyl derivative of pancuronium

	==History<!-- Describe the historical development of the drug. -->==		==History<!-- Describe the historical development of the drug. -->==
			First non-depolarizing neuromuscular blocking agent with an intermediate duration of action to be introduced into clinical practice

	==References==		==References==

Chris.Rishel: Added embedded dosage calculation

2022-03-30T07:33:56Z

Added embedded dosage calculation

← Older revision		Revision as of 00:33, 30 March 2022
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	{{Infobox drug reference		{{Infobox drug reference
	\| trade_names =		\| trade_names =
	\| drug_class =Neuromuscular blocker		\| drug_class = Neuromuscular blocker
	\| drug_class_color =neuromuscular_blocker		\| drug_class_color = neuromuscular_blocker
	\| uses =		\| uses =
	\| contraindications =		\| contraindications =
	\| routes =Intravenous		\| routes = Intravenous
	\| dosage =		\| dosage =
	\|halflife_redistribution=\|protein_binding=\|clearance=\|halflife_elimination=\|adverse_effects=\|metabolism=\|duration=\|time_onset=\|mechanism=Nicotinic acetylcholine antagonism\|image_file=Vecuronium.svg}}		\| halflife_redistribution =
			\| protein_binding =
			\| clearance =
			\| halflife_elimination =
			\| adverse_effects =
			\| metabolism =
			\| duration =
			\| time_onset =
			\| dosage_calculation = vecuronium
			\| mechanism = Nicotinic acetylcholine antagonism
			\| image_file = Vecuronium.svg
			}}

	Provide a brief summary of this drug here.		Provide a brief summary of this drug here.

Chris.Rishel at 11:26, 12 November 2021

2021-11-12T11:26:51Z

← Older revision		Revision as of 04:26, 12 November 2021
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	[[Category:Drug reference]]		[[Category:Drug reference]]
			[[Category:Neuromuscular blockers]]
			[[Category:Nondepolarizing neuromuscular blockers]]

Chris.Rishel: Created page with "{{Infobox drug reference | trade_names = | drug_class =Neuromuscular blocker | drug_class_color =neuromuscular_blocker | uses = | contraindications = | routes =Intravenou..."

2021-11-12T11:02:46Z

Created page with "{{Infobox drug reference | trade_names = | drug_class =Neuromuscular blocker | drug_class_color =neuromuscular_blocker | uses = | contraindications = | routes =Intravenou..."

New page

{{Infobox drug reference
| trade_names =
| drug_class =Neuromuscular blocker
| drug_class_color =neuromuscular_blocker
| uses =
| contraindications =
| routes =Intravenous
| dosage =
|halflife_redistribution=|protein_binding=|clearance=|halflife_elimination=|adverse_effects=|metabolism=|duration=|time_onset=|mechanism=Nicotinic acetylcholine antagonism|image_file=Vecuronium.svg}}

Provide a brief summary of this drug here.

==Uses==

==Contraindications==

===Absolute contraindications===

===Precautions===

==Pharmacology==

===Pharmacodynamics===

====Mechanism of action====

====Adverse effects====

===Pharmacokinetics===

==Chemistry and formulation==

==History==

==References==

[[Category:Drug reference]]