PANCURONIUM BROMIDE

Aminosteroid non-depolarising neuromuscular blocker with long duration of effect

Dosage Forms

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Injection

2 mg/ml

Uses

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  • Neuromuscular blockade during surgery
  • Neuromuscular blockade during intensive care

Dose and Duration

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Neuromuscular blockade during surgery

Adult and child over 1 month: by IV injection, initially 0.1 mg/kg then 0.02 mg/kg as required

Neonate: initially 0.1 mg/kg, then 0.05 mg/kg repeated as necessary

Neuromuscular blockade during intensive care

Adult: by IV injection, initially 0.1 mg/kg (optional) then 0.06 mg/kg every 60–90 minutes

Contraindications

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  • Concurrent use of a depolarising neuromuscular agent
  • Hypersensitivity to pancuronium

Side Effects

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  • Prolonged post-operative apnoea (temporary cessation of breathing)
  • Tachycardia, hypertension, arrhythmias
  • Salivation
  • Anaphylactoid reaction

Interactions

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  • Gentamicin, clindamycin, polymixin B (effects of pancuronium enhanced)
  • Phenytoin (effect of pancuronium reduced by long-term use of phenytoin)

Pregnancy

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  • Can be used

Breast-feeding

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  • Can be used

Storage

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  • Store at 2–8°C. Do not freeze

⚠️ Caution

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  • Risk of allergic cross-sensitivity with other neuromuscular blocking drugs
  • Use lower doses in myasthenia gravis and hypothermia
  • Use with caution in patients with other neuromuscular disorders and fluid and electrolyte disturbances
  • Patients with burns may require higher doses
  • There may be higher dosage requirements in hepatic impairment and prolonged recovery time
  • Use with caution in renal impairment since there may be prolonged duration of block
  • Calculate dose on basis of ideal body weight in obesity to avoid excessive dosage
  • In patients receiving magnesium sulphate for toxaemia of pregnancy, the reversal of neuromuscular block induced by pancuronium may be unsatisfactory because magnesium salts enhance neuromuscular blockade