パンクロニウム臭化物
Pancuronium Bromide
Pancuronium bromide
別名: Pavulon · Org-NA-97 · pancuronii bromidum · Pancuronium bromide
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
小型哺乳類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.1 mg/kg IV | IV | as needed | — | 🌎 NA |
- Muscle relaxation: Dose for rabbits
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
パンクロニウム臭化物は、主に全身麻酔の補助として使用される非脱分極性神経筋遮断薬です。気管挿管、人工呼吸、および各種外科手術を容易にするための骨格筋弛緩を提供します。
重要な臨床的注意：パンクロニウムには鎮痛、鎮静、または健忘作用は一切ありません。意識がある状態で麻痺する恐怖を防ぐため、使用前および使用中は患者に適切な鎮静と麻酔を行う必要があります。
- 長時間作用型のアミノステロイド系筋弛緩薬です。
- 他の薬剤と比較して作用時間が比較的長く（用量により30〜45分）、腎排泄に大きく依存します。
- d-ツボクラリンの5倍の効力があり、ベクロニウムの約3分の1の効力があると考えられています（ただし、動物では同等の効力があるとする文献もあります）。
作用機序
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.
安全性・警告
禁忌
- 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)
有害事象
- 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
注意事項
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).
医薬品相互作用
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
監視
- 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
薬物動態
半減期
吸収
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.
分布
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.
代謝
Partially metabolized by the liver.
消失
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.
過剰投与
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.
製品
製剤
- Injection: 1 mg/mL
- Injection: 2 mg/mL
- 2 mg/ml injectable solution
ヒト用医薬品
- 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
規制ステータス
POM (Prescription Only Medicine). Use restricted to anaesthetized animals with ventilation support.
POM-V. Use restricted to anaesthetized animals with ventilation support.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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).
飼主向け情報
パンクロニウムは、手術中やペットが人工呼吸器による呼吸サポートを必要とする場合に、病院内でのみ厳密に使用される強力な筋弛緩薬です。
- 鎮痛作用なし：この薬自体には鎮痛作用や鎮静作用はありません。獣医療チームは、この薬を投与する前に、他の麻酔薬を使用してペットが完全に眠り、意識がなく、痛みを感じない状態を確実にします。
- 呼吸サポート：呼吸に使われる筋肉を含め、すべての骨格筋の動きを一時的に止めるため、薬が効いている間は機械によって呼吸がサポートされ、専門家によって継続的に監視されます。
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