판쿠로늄 브롬화물

비탈분극성 신경근 차단제

판쿠로늄 브롬화물은 주로 전신 마취의 보조제로 사용되는 **비탈분극성 신경근 차단제**입니다. **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.

동물 종별 용량

Cats

General muscle relaxation · 0.044-0.11 mg/kg IV · IV · as needed · higher dose used initially; lower doses required if repeated doses are necessary
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 · Initially use a higher dose. Repeated doses may be cumulative and lead to difficulty in antagonism.

SmallMammals

Muscle relaxation · 0.1 mg/kg IV · IV · as needed · Dose for rabbits

Dogs

As a paralytic during mechanical ventilation · 0.05-0.1 mg/kg IV · IV · lasts about an hour · must give sedation as well
General muscle relaxation · 0.044-0.11 mg/kg IV · IV · as needed · higher dose used initially; lower doses required if repeated doses are necessary
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 · Used when IV/regional techniques are inadequate to prevent spontaneous movement
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 · Initially use a higher dose. Repeated doses may be cumulative and lead to difficulty in antagonism.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

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)

이상반응

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

약물 상호작용

Azathioprine · May reverse pancuronium's neuromuscular blocking effects
Aminoglycosides (e.g., gentamicin) · May enhance the neuromuscular blocking activity of pancuronium
Calcium (IV) · May reverse the effects of nondepolarizing neuromuscular blocking agents
Lincosamides (e.g., clindamycin) · May enhance the neuromuscular blocking activity of pancuronium
Magnesium sulfate or HCl · May enhance the neuromuscular blocking activity of pancuronium
Quinidine · May enhance the neuromuscular blocking activity of pancuronium
Succinylcholine · May speed the onset of action and enhance the neuromuscular blocking actions of pancuronium. Do not give pancuronium until succinylcholine effects have subsided.
Theophylline · May inhibit or reverse the neuromuscular blocking action of pancuronium and possibly induce arrhythmias
Tricyclic Antidepressants (e.g., clomipramine, amitriptyline) · Increased risk for cardiac arrhythmias when used with halothane anesthesia
Volatile anaesthetics · Prolonged neuromuscular blockade · moderate
Aminoglycosides · Prolonged neuromuscular blockade · major
Clindamycin · Prolonged neuromuscular blockade · moderate

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

과용량

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.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.