Pipekuroniya bromide

When ATH:
M03AC06

Characteristic.

Non-depolarizing muscle relaxant. Bischetvertichnoe synthetic steroid compound, having no hormonal activity.

Almost white crystalline powder colors, soluble in water and alcohol, slightly soluble in fats. The solution is transparent, colorless, pH 5,0–6,5.

Pharmacological action.
N-holinolitičeskoe, miorelaksiruyuschee, nedepoliarizuth.

Application.

The relaxation of skeletal muscles and to facilitate tracheal intubation during surgical and diagnostic procedures in a ventilator.

Contraindications.

Hypersensitivity (incl. to bromides), myasthenia.

Restrictions apply.

Violation of the liver and / or kidney, severe heart failure, bronhogennaâ cancer, swelling, degidratatsiya, violation of electrolyte and acid-base balance, gipotermiя, respiratory insufficiency.

Pregnancy and breast-feeding.

Contraindicated in early pregnancy. To a small extent crosses the placenta. It does not have teratogenic and mutagenic effects.

Use in cesarean section does not change Apgar scores, muscle tone and cardiovascular adaptation fetus.

Unknown, Do penetrates pipekuroniya bromide in breast milk.

Side effects.

From the nervous system and sensory organs: gipesteziya, CNS depression.

Cardio-vascular system and blood (hematopoiesis, hemostasis): bradycardia, decrease in blood pressure, cerebrovascular disorders, myocardial ischemia, thrombosis, Atrial fibrillation, ventricular premature beats.

From the respiratory system: breathlessness, respiratory depression, atelectasis, apnea (during the aftereffect).

Metabolism: increase in serum creatinine, gipoglikemiâ, hyperkalemia.

Allergic reactions: rash, hives, anaphylactic reactions.

Other: muscular atrophy, anurija.

Cooperation.

You can not be mixed with other injection or infusion solutions (possible precipitation of the active substance), with the exception of isotonic sodium chloride solution, and dextrose, Ringer. Strengthen and prolong the effect of: halothane, metoksifluran, diethyl ether, chloroform, trichlorethylene, izofluran, enfluran, barbiturates, ketamine, propanidid, prokayn, quinidine, Fentanyl, metronidazol, klindamiцin, lincomycin, aminoglikozidy, tetracikliny, bacitracin, polymyxin B, Diuretic, beta-blockers, MAO inhibitors, protamine, phenytoin, Alpha-blockers, Calcium channel blockers, magnesium salts, lidocaine at / in use, massive blood transfusion citrate. Opioid analgesics may potentiate respiratory depression. Reduce the effect of administered before surgery corticosteroids, neostigmine (Other cholinesterase inhibitors), norepinephrine, theophylline, potassium chloride, sodium chloride, calcium chloride. When coadministered with quinidine may develop transient paralysis. Depolarizing muscle relaxants can both strengthen, and weaken the effect of dose-dependently, time of application and the individual sensitivity.

Overdose.

Symptoms: muscle weakness, apnea, prolonged paralysis, gipotenziya.

Treatment: IVL, введение неостигмина метилсульфата в дозе 1–3 мг или галантамина в дозе 10–30 мг на фоне в/в введения 1,25 mg atropine.

Dosing and Administration.

B /. The solution for injection is prepared time using the supplied solvent. Endotracheal intubation, adults and children over 14 years: начальная доза — 70–85 мкг/кг (на фоне суксаметония — 40–50 мкг/кг), поддерживающая доза — 10–15 мкг/кг.

Babies: dose for children under 3 Months are not defined, from 3 to 12 Months - 40 mg / kg (It provides muscle relaxation lasting from 10 to 44 m), from 1 Year to 14 years - 57 mg / kg (мышечная релаксация — от 18 to 52 m).

Precautions.

It is used only under the supervision of an experienced anesthesiologist, if the conditions for intubation, IVL, Oxygen therapy. Must be available antagonists (cholinesterase inhibitors), atropyn. Mandatory careful monitoring during surgery and in the early postoperative period in order to maintain vital functions to the full restoration of adequate muscle tone.

Titration is carried out with regard to age, body weight, liver and kidney function (the content of creatinine in plasma and its clearance) and other factors. Patients with disorders of neuromuscular transmission, obesity, renal failure, diseases of the liver and biliary tract, poliomyelitis (history) to reduce the dose. It will be appreciated, that in conditions of acute and chronic electrolyte imbalance or disorder may KHS as strengthening, and the effect of the weakening miorelaksiruyuschego. Kaliopenia, digitization, gipermagniemiya, hypocalcemia, hypoproteinemia, degidratatsiya, giperkapniя, kaxeksija, hypothermia may enhance or prolong the effect. Before the start of anesthesia requires normalization of electrolyte balance, acid-base balance, elimination of dehydration. States, accompanied by an increase in volume of distribution, eg slow circulation time in cardiovascular diseases, can lead to a lengthening of the latent period.

Cooperation