indication

Used as a muscle relaxant during anesthesia and surgical procedures.

pharmacology

Pipecuronium is a nondepolarizing neuromuscular blocking agent. Neuromuscular blocking agents produce skeletal muscle paralysis by blocking neural transmission at the myoneural junction. The paralysis is selective initially and usually appears in the following muscles consecutively: levator muscles of eyelids, muscles of mastication, limb muscles, abdominal muscles, muscles of the glottis, and finally, the intercostal muscles and the diaphragm. Neuromuscular blocking agents have no clinically significant effect on consciousness or the pain threshold.

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.

half life

Distribution Normal renal function: 6.22 (range, 1.34 to 10.66) minutes. Renal function impairment: 4.33 (range, 1.69 to 6.17) minutes. Elimination Normal renal function: 1.7 (range, 0.9 to 2.7) hours. The elimination half-life is not altered by hypothermia and bypass. Renal function impairment: 4 (range, 2 to 8.2) hours. [PharmGKB]

drug interactions

Amikacin: The agent increases the effect of muscle relaxant

Clindamycin: The agent increases the effect of muscle relaxant

Gentamicin: The agent increases the effect of muscle relaxant

Lincomycin: The agent increases the effect of muscle relaxant

Netilmicin: The agent increases the effect of muscle relaxant

Piperacillin: The agent increases the effect of the muscle relaxant

Tobramycin: The agent increases the effect of the muscle relaxant