indication

Used as a muscle relaxant during anesthesia and surgical procedures.

pharmacology

Pancuronium is a typical non-depolarising curare-mimetic muscle relaxant. It acts as a competitive acetylcholine antagonist on neuromuscular junctions, displacing acetylcholine (hence competitive) from its post-synaptic nicotinic acetylcholine receptors. It is, unlike suxamethonium, a non-depolarising agent, which means, that it causes no spontaneous depolarisations upon association with the nicotinic receptor in neuromuscular junction, thus producing no muscle fasciculations upon administration. Pancuronium has no hormonal activity. It exerts slight vagolytic activity (i.e. diminishing activity of the vagus nerve) and no ganglioplegic (i.e., blocking ganglions) activity.

mechanism of action

Nondepolarizing neuromuscular blocking agents inhibit neuromuscular transmission by competing with acetylcholine for the cholinergic receptors of the motor end plate, thereby reducing the response of the end plate to acetylcholine. This type of neuromuscular block is usually antagonized by anticholinesterase agents.

biotransformation

Hepatic.

half life

1.5 to 2.7 hours.

drug interactions

Amikacin: The agent increases the effect of muscle relaxant

Aminophylline: Theophylline decreases the effect of muscle relaxant

Azathioprine: The agent decreases the effect of the muscle relaxant

Carbamazepine: Decreases the effect of muscle relaxant

Clindamycin: The agent increases the effect of muscle relaxant

Colistimethate: Colistimethate may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. If possible, avoid concomitant use of these products. Monitor for deeper, prolonged neuromuscular-blocking effects (respiratory paralysis) in patients receiving concomitant neuromuscular-blocking agents and polymyxin antibiotics (e.g., colistimethate, polymyxin B).

Fosphenytoin: Phenytoin decreases the effect of muscle relaxant

Gentamicin: The agent increases the effect of muscle relaxant

Lincomycin: The agent increases the effect of muscle relaxant

Mercaptopurine: The agent dereases the effect of the muscle relaxant

Netilmicin: The agent increases the effect of muscle relaxant

Oxtriphylline: Theophylline decreases the effect of muscle relaxant

Phenytoin: Phenytoin decreases the effect of the muscle relaxant

Piperacillin: The agent increases the effect of the muscle relaxant

Quinidine: The quinine derivative increases the effect of the muscle relaxant

Quinine: The quinine derivative increases the effect of the muscle relaxant

Theophylline: Theophylline decreases the effect of the muscle relaxant

Tobramycin: The agent increases the effect of the muscle relaxant