Difference between revisions of "Vecuronium"
From WikiAnesthesia
Chris Rishel (talk | contribs) m (Added embedded dosage calculation) |
Cornel Chiu (talk | contribs) (Brief summary, Uses, contraindication, precautions, pharmacodynamics, adverse effects, chemistry and formulation) |
||
| Line 20: | Line 20: | ||
}} | }} | ||
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== | ||
Revision as of 08:12, 3 January 2023
Vecuronium
 | |
| Clinical data | |
| Drug class |
Neuromuscular blocker |
|---|---|
| Routes of administration |
Intravenous |
| Dosage | |
| Pharmacodynamics | |
| Mechanism of action |
Nicotinic acetylcholine antagonism |
| Pharmacokinetics | |
| Physical and chemical data | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Vecuronium is an steroidal intermediate acting non-depolarizing neuromuscular blocking agent
Uses
- 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
Absolute contraindications
Known hypersensitivity
Precautions
Prolonged duration of action in patients with cholestasis or cirrhosis
Dose requirement can be unpredictable in patients with renal failure
Pharmacology
Pharmacodynamics
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
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
- Anaphylactic reaction
Pharmacokinetics
Duration of action of 40 minutes
Chemistry and formulation
2-desmethyl derivative of pancuronium
History
First non-depolarizing neuromuscular blocking agent with an intermediate duration of action to be introduced into clinical practice
References
Top contributors: Cornel Chiu and Chris Rishel