Bromuro de pancuronio
Pancuronium Bromide
Pancuronium bromide
También conocido como: Pavulon · Org-NA-97 · pancuronii bromidum · Pancuronium bromide
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a paralytic during mechanical ventilation | 0.05-0.1 mg/kg IV | IV | lasts about an hour | — | 🌎 NA |
| General muscle relaxation | 0.044-0.11 mg/kg IV | IV | as needed | — | 🌎 NA |
| Anesthesia maintenance adjunct (when inhalational agents result in severe hypotension) | 0.02-0.04 mg/kg IV | IV | provides 30-45 minutes of muscle relaxation | — | 🌎 NA |
| Neuromuscular blockade during anaesthesia | 0.025-0.075 mg/kg initially; repeat doses at increments of 0.01 mg/kg | IV | as needed | Duration of action >45 min | 🌍 EU |
- As a paralytic during mechanical ventilation: must give sedation as well
- General muscle relaxation: higher dose used initially; lower doses required if repeated doses are necessary
- Anesthesia maintenance adjunct (when inhalational agents result in severe hypotension): Used when IV/regional techniques are inadequate to prevent spontaneous movement
- Neuromuscular blockade during anaesthesia: Initially use a higher dose. Repeated doses may be cumulative and lead to difficulty in antagonism.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| General muscle relaxation | 0.044-0.11 mg/kg IV | IV | as needed | — | 🌎 NA |
| Neuromuscular blockade during anaesthesia | 0.025-0.075 mg/kg initially; repeat doses at increments of 0.01 mg/kg | IV | as needed | Duration of action >45 min | 🌍 EU |
- General muscle relaxation: higher dose used initially; lower doses required if repeated doses are necessary
- Neuromuscular blockade during anaesthesia: Initially use a higher dose. Repeated doses may be cumulative and lead to difficulty in antagonism.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Muscle relaxation | 0.1 mg/kg IV | IV | as needed | — | 🌎 NA |
- Muscle relaxation: Dose for rabbits
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El bromuro de pancuronio es un agente bloqueante neuromuscular no despolarizante utilizado principalmente como coadyuvante en la anestesia general. Proporciona relajación del músculo esquelético para facilitar la intubación endotraqueal, la ventilación mecánica y diversos procedimientos quirúrgicos.
NOTA CLÍNICA CRÍTICA: El pancuronio NO posee propiedades analgésicas, sedantes ni amnésicas. Los pacientes deben estar adecuadamente sedados y anestesiados antes y durante su uso para evitar la experiencia aterradora de estar paralizado mientras se está consciente.
- Es un relajante muscular aminosteroideo de acción prolongada.
- En comparación con otros agentes, tiene una duración de acción relativamente larga (30-45 minutos dependiendo de la dosis) y depende en gran medida de la excreción renal.
- Se considera 5 veces más potente que la d-tubocurarina y aproximadamente ⅓ tan potente como el vecuronio (aunque algunas fuentes sugieren equipotencia en animales).
Mecanismo de acción
Pancuronium acts as a competitive antagonist at the nicotinic acetylcholine receptors (nAChRs) located at the neuromuscular junction (motor endplate).
- Pancuronium competitively binds to nAChRs → prevents acetylcholine (ACh) from binding → inhibits depolarization of the muscle fiber membrane → results in flaccid skeletal muscle paralysis.
- Cardiovascular Effects: Unlike some other neuromuscular blockers, pancuronium has slight vagolytic (anticholinergic) activity at postganglionic muscarinic receptors in the heart → leads to slight increases in heart rate and blood pressure.
- It rarely causes histamine release compared to older agents like d-tubocurarine.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to pancuronium or bromides
- Myasthenia gravis (extreme caution or contraindicated)
- Conscious or inadequately anaesthetized animals
- Lack of positive pressure ventilation facilities
- Lack of monitoring equipment (nerve stimulator)
Efectos adversos
- Slight elevations in cardiac rate and blood pressure
- Hypersalivation (if not pretreated with an anticholinergic agent)
- Prolonged or profound muscular weakness
- Respiratory depression
- Histamine release with resultant hypersensitivity reaction (Very Rare)
- Tachycardia (due to vagolytic effect)
- Prolonged neuromuscular blockade
- Mild hypertension
Precauciones
WARNING: Pancuronium has NO analgesic or sedative/anesthetic actions. It must only be used in adequately anesthetized/sedated patients with full ventilatory support available.
- Extreme Caution: Patients with myasthenia gravis (neuromuscular blocking agents should be used with extreme caution, if at all).
- Caution: Renal dysfunction. Plasma half-lives are doubled in renal failure; atracurium may be a better choice for these patients.
- Caution: Hepatic or biliary disease (lower doses may be necessary).
- Caution: Patients where tachycardias may be deleterious (due to the drug's slight vagolytic effects).
Interacciones farmacológicas
May reverse pancuronium's neuromuscular blocking effects
May enhance the neuromuscular blocking activity of pancuronium
May reverse the effects of nondepolarizing neuromuscular blocking agents
May enhance the neuromuscular blocking activity of pancuronium
May enhance the neuromuscular blocking activity of pancuronium
May enhance the neuromuscular blocking activity of pancuronium
May speed the onset of action and enhance the neuromuscular blocking actions of pancuronium. Do not give pancuronium until succinylcholine effects have subsided.
May inhibit or reverse the neuromuscular blocking action of pancuronium and possibly induce arrhythmias
Increased risk for cardiac arrhythmias when used with halothane anesthesia
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Monitorización
- Level of neuromuscular blockade (via peripheral nerve stimulation)
- Cardiac rate and rhythm
- Blood pressure
- Adequacy of ventilation and oxygenation
- Peripheral nerve stimulation (e.g., Train-of-Four)
- Heart rate and rhythm
- Respiratory rate, effort, and ventilator parameters (EtCO2, SpO2)
- Body temperature
- Acid-base status
- Serum potassium levels
Farmacocinética
Vida media
Absorción
After IV administration, muscle relaxation sufficient for endotracheal intubation generally occurs within 2-3 minutes (dose-dependent). Duration of action may persist 30-45 minutes.
Distribución
In humans, approximately 87% bound to plasma proteins, but may be used in hypoalbuminemic patients. Activity is not substantially affected by plasma pH or carbon dioxide levels.
Metabolismo
Partially metabolized by the liver.
Eliminación
Approximately 40% is excreted unchanged by the kidneys. The remainder is excreted in the bile (11%) or metabolized by the liver. In patients with renal failure, plasma half-lives are doubled.
Sobredosis
Overdosage increases the risk of hypotension, histamine release, and prolonged duration of muscle blockade.
Treatment:
- Conservative Support: Maintain mechanical ventilation, oxygen therapy, and IV fluids until spontaneous breathing returns.
- Pharmacologic Reversal: Blockade may be reversed by administering an anticholinesterase agent (e.g., edrophonium, physostigmine, or neostigmine).
- CRITICAL: An anticholinergic (atropine or glycopyrrolate) MUST be administered prior to or alongside the reversal agent to prevent severe bradycardia and muscarinic side effects.
- Suggested Reversal Protocol: Neostigmine 0.06 mg/kg IV after Atropine 0.02 mg/kg IV.
Productos disponibles
Formulaciones
- Injection: 1 mg/mL
- Injection: 2 mg/mL
- 2 mg/ml injectable solution
Etiquetado para humanos
- Pancuronium Bromide for Injection: 1 mg/mL in 10 mL vials
- Pancuronium Bromide for Injection: 2 mg/mL in 2 mL & 5 mL vials & ampules
- Pancuronium bromide 2 mg/ml injection
Estado regulador
POM (Prescription Only Medicine). Use restricted to anaesthetized animals with ventilation support.
POM-V. Use restricted to anaesthetized animals with ventilation support.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store under refrigeration (2-8°C). According to the manufacturer, it is stable for 6 months at room temperature. Do not store pancuronium in plastic syringes or containers as it may be adsorbed to plastic surfaces (it may be administered in plastic syringes, however).
Información para el cliente
El pancuronio es un relajante muscular potente que se utiliza estrictamente en entornos hospitalarios durante cirugías o cuando una mascota necesita ayuda para respirar mediante un ventilador mecánico.
- Sin alivio del dolor: Este medicamento no proporciona alivio del dolor ni sedación. Su equipo veterinario siempre se asegurará de que su mascota esté completamente dormida, inconsciente y cómoda con otros medicamentos anestésicos antes de administrar este fármaco.
- Soporte respiratorio: Debido a que detiene temporalmente el movimiento de todos los músculos esqueléticos, incluidos los músculos utilizados para respirar, la respiración de su mascota será asistida cuidadosamente por una máquina y monitoreada continuamente por profesionales mientras el medicamento esté haciendo efecto.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.