PANCURONIUM

“PAVULON”

1) Action

• Nondepolarising muscle relaxant

2) Mechanism

• Competes with Ach for access to receptor sites on the muscle end plates [competitive blocking agent]

• Acts predominantly at the nicotinic receptor site to compete with Ach

3) Indications

• Adjunct to general anaesthesia; prior to introduction of neuromuscular blockers, adequate skeletal relaxation could only be achieved by deep anaesthesia with associated cardiorespiratory depression

4) Effects on organs—side effects

• Vagolytic action resulting in moderate increase in heart rate and cardiac output with subsequent increase in blood pressure

5) Toxic effects/ precautions with administration

• Patient remains aware: need for sedatives, analgesics

• Incomplete reversal may necessitate prolonged ventilation

6) Contraindications

• NONE

7) Reversal, antagonism or antidote

• Reversed by neostigmine; an inhibitor of cholinesterase— allows accumulation of Ach at endplates hence displaces relaxant from receptor site

8) Loading dose, maintenance dose, frequency & method of administration

• 2mg/ml [2ml] ampoule

9) Drug’s metabolism—Drug’s excretion—Half life (pharmacokinetics)

• Excreted by liver & kidney

• Duration of action is 25—35 minutes