판쿠로늄 브롬화물
Pancuronium Bromide
Pancuronium bromide
다른 이름: Pavulon · Org-NA-97 · pancuronii bromidum · Pancuronium bromide
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
소형 포유류
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.1 mg/kg IV | IV | as needed | — | 🌎 NA |
- Muscle relaxation: Dose for rabbits
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
판쿠로늄 브롬화물은 주로 전신 마취의 보조제로 사용되는 비탈분극성 신경근 차단제입니다. 기관 내 삽관, 기계적 환기 및 다양한 외과 수술을 용이하게 하기 위해 골격근 이완을 제공합니다.
중요 임상 주의사항: 판쿠로늄은 진통, 진정 또는 기억 상실 효과가 전혀 없습니다. 의식이 있는 상태에서 마비되는 끔찍한 경험을 방지하기 위해, 이 약물을 사용하기 전과 사용하는 동안 환자는 충분한 진정 및 마취 상태를 유지해야 합니다.
- 장기 작용형 아미노스테로이드 근육 이완제입니다.
- 다른 약물에 비해 작용 시간이 비교적 길며(용량에 따라 30-45분), 신장 배설에 크게 의존합니다.
- d-투보쿠라린보다 5배 강력하고 베쿠로늄의 약 3분의 1 정도의 효능을 가진 것으로 간주됩니다(일부 문헌에서는 동물에서 동등한 효능을 가진다고 제안함).
작용 기전
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.
안전성·주의사항
금기사항
- 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)
부작용
- 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
주의
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).
약물 상호작용
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
모니터링
- 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
약동학
반감기
흡수
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.
분포
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.
대사
Partially metabolized by the liver.
배설
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.
과다투여
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.
제품
제형
- Injection: 1 mg/mL
- Injection: 2 mg/mL
- 2 mg/ml injectable solution
인용의약품
- 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
규제 현황
POM (Prescription Only Medicine). Use restricted to anaesthetized animals with ventilation support.
POM-V. Use restricted to anaesthetized animals with ventilation support.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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).
보호자 정보
판쿠로늄은 수술 중이거나 반려동물이 인공호흡기의 도움이 필요할 때 병원에서만 엄격하게 사용되는 강력한 근육 이완제입니다.
- 진통 효과 없음: 이 약 자체에는 진통이나 진정 효과가 없습니다. 수의사 팀은 이 약을 투여하기 전에 다른 마취제를 사용하여 반려동물이 완전히 잠들고 의식이 없으며 편안한 상태인지 항상 확인합니다.
- 호흡 지원: 호흡에 사용되는 근육을 포함하여 모든 골격근의 움직임을 일시적으로 멈추게 하므로, 약효가 지속되는 동안 반려동물의 호흡은 기계에 의해 안전하게 지원되고 전문가에 의해 지속적으로 모니터링됩니다.
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