| Name: |
VECURONIUM (NorcuronR) |
| Classification: |
non-depolarizing neuromuscular blocker; skeletal muscle relaxant
- used to facilitate mechanical ventilation
- reduces airway resistance/pressures; decreases intrathoracic pressures
- reduces metabolic rate and O2 consumption
- used in the management of tetanus
- safe for use in patients with malignant hyperthermia
may be used to stop muscle activity during a seizure but has no anticonvulsant properties |
| Dose: |
- Bolus:
- 0.05-0.1 mg/kg IV direct
- onset of action 4 minutes, duration of action 20-30 min
- Continuous infusion:
- dose reductions may be indicated in hepatic insufficiency and elderly patients
|
| Administration: |
IV Infusion:
50mg/50 mL SWFI for syringe pump infusion
- mechanical ventilation must be increased to provide full support prior to administration
|
| Adverse Effects: |
- tachycardia or bradycardia
- arrhythmias
- hypertension or hypotension
- bronchospasm
- anaphylaxis
- hypothermia
- corneal ulceration
- excessive salivation
|
| Caution: |
- in history of myasthenia gravis, Eaton-Lambert syndrome, amyotrophic lateral sclerosis or other neutomuscular disease; respiratory acidosis, electrolyte imbalance
|
| Antidote: |
- anticholinesterase agents, e.g. neostigmine
|
| Drug Interactions: |
- vecuronium + aminoglycosides = increased neuromuscular blocking effect
- vecuronium + clindamycin = increased neuromuscular blocking effect
- vecuronium + steroids = increased risk of myopathy
- vecuronium + inhalational anaesthetics = increased neuromuscular blocking effect
- vecuronium+ amphotericin B = increased neuromuscular blocking effect
- vecuronium + aminoglycoside = increased neuromuscular blocking effect
- vecuronium + quinidine = increased neuromuscular blocking effect
- vecuronium + hypokalemia = increased neuromuscular blocking effect
- vecuronium + magnesium salts = increased neuromuscular blocking effect
|
| Monitoring Therapy: |
- train of four (peripheral nerve stimulator); goal 2-3/4
- HR, ECG
- BP
- ventilator parameters and alarms, chest sounds
- blood gases, Sp02
- electrolytes
- liver enzymes
- temperature
- eyes - keep moist, patched
- skin/limb support
NOTE:
- Has no CNS effects, therefore, consider patients able to hear and comprehend.
- Has no analgesic or sedative properties; patients require continuous analgesic and sedative administration.
- Pupils and GI tract are not affected.
|
| CCTC Protocol: |
- May be administered by IV infusion or IV direct by an approved nurse in CCTC providing that the patient is receiving full mechanical ventilation and the initial dose is given by a physician.
- Continuous infusion must be administered via an infusion pump.
- Patient requires placement of an arterial line to monitor BP.
- A bedside sign alerting staff of neuromuscular blocker use must be displayed.
|
Print
Handheld
Contrast
