로쿠로늄 브로마이드
Rocuronium Bromide
Rocuronium bromide
다른 이름: Zemuron · Esmeron · ORG-9426 · rocuronii · rocuronio · rokuroniowy · rokuronyum · Rocuronium 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 neuromuscular blocker | 0.5 mg/kg bolus and then a CRI was started immediately at 0.2 mg/kg/hour | IV | Bolus followed by CRI | — | 🌎 NA |
| Neuromuscular blockade during anaesthesia | 0.4 mg/kg i.v. followed, when required, by a maintenance dose of 0.16 mg/kg i.v. prn or continuous rate infusion of 0.2 mg/kg/h | IV | prn or CRI | As needed during surgery | 🌍 EU |
| Centralize the globe for ophthalmic surgery | 0.05-0.1 mg/kg i.v. | IV | Single dose or prn | As needed | 🌍 EU |
- As a neuromuscular blocker: Authors concluded it was effective and easily applicable, but further work is required on infusion titration.
- Neuromuscular blockade during anaesthesia: Monitoring with a nerve stimulator is recommended.
- Centralize the globe for ophthalmic surgery: Considerably lower doses are required for this indication.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| As a neuromuscular blocker | 0.6 mg/kg IV | IV | Single dose | — | 🌎 NA |
| Neuromuscular blockade / Endotracheal intubation | 0.3-0.6 mg/kg i.v. | IV | Single dose | Approx 20 min at 0.6 mg/kg | 🌍 EU |
- As a neuromuscular blocker: Rapid onset, short duration of action, and does not cause significant changes in heart rate.
- Neuromuscular blockade / Endotracheal intubation: 0.6 mg/kg has a rapid onset and short duration of action (20 min). Requires prompt successful intubation and ventilation.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| As a neuromuscular blocker | 0.6 mg/kg IV | IV | Single dose | — | 🌎 NA |
- As a neuromuscular blocker: Provided predictable blockade without hemodynamic changes, but large variation between individuals; monitoring of neuromuscular block is essential.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
로쿠로늄 브로마이드는 아미노스테로이드계, 경쟁적, 비탈분극성 신경근 차단제(NMBA)입니다. 주로 전신 마취의 보조제로 사용되어 신속한 기관 내 삽관을 용이하게 하고, 섬세한 수술(예: 안과, 신경외과 또는 흉부외과 수술) 중 깊은 골격근 이완을 제공합니다.
주요 약리학적 특징은 다음과 같습니다:
- 빠른~중간 정도의 발현 시간: 베쿠로늄이나 아트라쿠륨에 비해 작용 발현이 빠르며(베쿠로늄보다 2-3배 빠름), 숙시닐콜린과 거의 비슷하게 빠르지만 부작용은 더 적습니다.
- 중간 정도의 작용 지속 시간: 베쿠로늄 및 아트라쿠륨과 유사한 작용 시간을 가집니다.
- 심혈관계 안정성: 기존의 신경근 차단제에 비해 심혈관계 및 히스타민 분비에 미치는 영향이 최소화되었습니다.
임상 핵심 포인트: 로쿠로늄과 같은 신경근 차단제는 진통, 진정 또는 기억 상실 효과가 전혀 없습니다. 의식이 있거나 마취가 불충분한 환자에게 투여하면 완전히 깨어 있고 통증을 느낄 수 있는 상태에서 전신이 마비되는 끔찍한 경험을 초래합니다. 따라서 반드시 깊게 마취되어 있고 기계적 환기가 즉시 가능한 환자에게만 사용해야 합니다.
작용 기전
Rocuronium acts by competitively antagonizing acetylcholine (ACh) at the neuromuscular junction.
- Mechanism: It binds to nicotinic cholinergic receptors at the motor end plate of skeletal muscle.
- Pathway: Rocuronium occupies the receptor site → prevents ACh from binding → inhibits depolarization of the muscle cell membrane → results in flaccid paralysis.
- Reversal: Because the blockade is competitive, it can be antagonized by increasing the concentration of ACh in the synaptic cleft. This is achieved using acetylcholinesterase inhibitors (e.g., neostigmine, edrophonium). Alternatively, rocuronium can be directly encapsulated and inactivated in the plasma by the selective relaxant binding agent sugammadex.
안전성·주의사항
금기사항
- Hypersensitivity to rocuronium or other neuromuscular blocking agents
- Patients who are not adequately anesthetized or sedated
- Settings lacking immediate access to intubation, mechanical ventilation, and oxygen therapy
- Conscious or inadequately anaesthetized animals
- Lack of positive pressure ventilation facilities
부작용
- Changes in heart rate (mild, transient tachycardia)
- Changes in blood pressure (hypotension or hypertension)
- Severe anaphylaxis (reported in humans)
- Histaminoid reactions (rare)
- Severe burning pain at the injection site (if administered before deep anesthesia is achieved)
- Increased heart rate
- Mild hypertension (at high doses)
주의
Rocuronium must only be used by trained personnel in settings where the patient can be fully monitored and where endotracheal intubation, mechanical ventilation, oxygen therapy, and reversal agents are immediately available.
It should only be administered to patients that are adequately anesthetized or sedated. Because the drug can cause severe burning pain upon injection, it is recommended to administer it only after a deep stage of anesthesia has been achieved. Use with caution in patients with hepatic or renal impairment, as elimination may be delayed (some sources prefer atracurium in these patients).
약물 상호작용
May have a synergistic effect if used concurrently with rocuronium.
May speed the onset of action and enhance the neuromuscular blocking actions of rocuronium; do not give rocuronium until succinylcholine effects have subsided.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
모니터링
- Degree of neuromuscular blockade (using a peripheral nerve stimulator/Train-of-Four monitor)
- Heart rate and rhythm
- Oxygenation (SpO2) and ventilation (End-tidal CO2)
- Depth of anesthesia
- Neuromuscular blockade depth (using a peripheral nerve stimulator)
- Heart rate and blood pressure
- Spontaneous respiratory effort during recovery
약동학
흡수
Rapid to intermediate onset depending on dose when administered IV.
분포
Specific parameters for veterinary species are not well documented.
대사
Eliminated primarily by the liver in dogs and cats. The principle metabolite, 17-desacetyl-rocuronium, has approximately 1/20th the neuromuscular-blocking potency of the parent drug in cats.
배설
Primarily hepatic elimination.
과다투여
Overdosage with neuromuscular blocking agents results in prolonged neuromuscular blockade (extended paralysis).
- Primary Treatment: Maintenance of a patent airway, continuous mechanical ventilation, oxygenation, and adequate sedation/anesthesia until full recovery of muscle function is assured.
- Reversal: Only after spontaneous evidence of recovery is observed should administration of an anticholinesterase drug (e.g., neostigmine) combined with an anticholinergic agent (e.g., atropine or glycopyrrolate to prevent severe bradycardia) be considered.
- Specific Antidote: Rocuronium's effects can be rapidly and specifically reversed by sugammadex, a cyclodextrin binding agent that encapsulates the drug in the plasma.
제품
제형
- Injection
- Injectable: 10 mg/ml solution
인용의약품
- Rocuronium Bromide for Injection 10 mg/mL in 5 mL & 10 mL multi-dose vials
- Esmeron 10 mg/ml solution for injection
규제 현황
Human authorized product used under the cascade.
Human authorized product used under the cascade.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store at 2°-8°C (36°-46°F). Do not freeze. When removed from refrigeration to room temperature storage conditions (25°C; 77°F), use within 60 days. Use opened vials of rocuronium within 30 days. Infusion solutions should be used within 24 hours of mixing. Unused portions of infusion solutions should be discarded.
보호자 정보
로쿠로늄은 병원에서 전신 마취 중에만 엄격하게 사용되는 특수 약물입니다.
- 목적: 골격근을 일시적으로 마비시키는 근육 이완제입니다. 안과, 뇌 또는 흉부 수술과 같이 미세한 반사적 움직임조차도 위험할 수 있는 섬세한 수술에 매우 중요합니다.
- 안전성: 이 약물이 투여되기 전에 반려동물은 완전히 잠들고 의식이 없는 상태(완전 마취 상태)가 됩니다. 호흡 근육도 이완시키기 때문에, 수의료진은 호흡 튜브를 삽입하고 약효가 지속되는 동안 인공호흡기를 사용하여 반려동물의 호흡을 돕습니다.
- 회복: 약물의 효과는 자연스럽게 사라지며, 수술이 안전하게 끝난 후 수의사가 특정 역전제(해독제)를 투여하여 근육 기능을 빠르게 회복시킬 수도 있습니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.