Vekuroniya bromide

When ATH:
M03AC03

Characteristic.

Non-depolarizing muscle relaxant average duration.

The white crystalline powder, soluble in water and alcohol. Molecular weight 637,74.

Pharmacological action.
N-holinolitičeskoe, miorelaksiruyuschee, nedepoliarizuth.

Application.

The relaxation of skeletal muscles (during surgery under general anesthesia).

Contraindications.

Hypersensitivity (incl. histamine, ʙromidam), bronchial asthma.

Restrictions apply.

Cancer of the bronchi, diseases of the cardiovascular system, myasthenia gravis, obesity, diseases in violation of neuromuscular transmission, polio (history), expressed human liver and kidneys, violation of the acid-base balance and electrolyte balance, respiratory depression, advanced age.

Pregnancy and breast-feeding.

Maybe, if the effect of therapy outweighs the potential risk to the fetus. Data on the use of vecuronium bromide during pregnancy in animals and humans is not enough. It can be used for caesarean section.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

Data on the penetration of breast milk is not available.

Side effects.

Allergic reactions: bronchospasm, edema, эritema, itching, skin rash, arrhythmia, hives, laringospazm.

Cardio-vascular system and blood (hematopoiesis, hemostasis): decrease in blood pressure, tachycardia.

Other: lengthening the time of neuromuscular blockade, intracranial hypertension, malignant hyperthermia, mioglobinemiya and myoglobinuria, induced rhabdomyolysis (can cause acute renal failure, especially in children), drooling.

Cooperation.

If succinylcholine is used for intubation, introduction of vecuronium bromide should be postponed until the signs of recovery of neuromuscular.

Антагонисты — антихолинэстеразные препараты (Neostigmine and others.). Enhances the effect of: halothane, ether, enfluran, izofluran, metoksifluran, cyclopropane, thiopental sodium, metogeksital, ketamine, Fentanyl, etomidate, sodium hydroxybutyrate, non-depolarizing muscle relaxants, aminoglikozidy, polypeptide antibiotics, Diuretic, beta-blockers, MAO inhibitors, quinidine, protamine, Alpha-blockers, imidazolы, metronidazol. Reduces the effect of: propanidid, glucocorticoids, norepinephrine, azathioprine, theophylline, sodium chloride, potassium chloride, calcium chloride. The subsequent introduction of depolarizing muscle relaxants can strengthen or weaken the effect of.

Overdose.

Symptoms: the weakness of the skeletal muscles, gipopnoэ, apnea, excessive reduction of blood pressure, collapse, paralysis, shock.

Treatment: IVL, для устранения миорелаксирующего эффекта — ингибиторы холинэстеразы (neostigmine, pyridostigmine bromide), simptomaticheskaya therapy.

Dosing and Administration.

B /. The initial dose (for intubation) у взрослых 80–100 мкг/кг, поддерживающая доза — 20–30 мкг/кг. Больным с ожирением — доза расcчитывается на величину идеальной массы тела. In newborns and infants up 4 мес начальная доза составляет 10–20 мкг/кг.

Precautions.

The effect is reduced under hypothermia. Action is enhanced by hypokalemia (after severe vomiting, diarrhea, digitizations, diuretic therapy), gipermagniemii, hypocalcemia (after massive blood transfusion), gipoproteinemii, degidratacii, Acidosis, giperkapnii, kaxeksii. Before applying a correction of acid-base balance of blood, severe electrolyte imbalance, degidratacii.