로쿠로늄 브로마이드

비탈분극성 신경근 차단제

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**.

동물 종별 용량

Cats

As a neuromuscular blocker · 0.6 mg/kg IV · IV · Single dose · Rapid onset, short duration of action, and does not cause significant changes in heart rate.
Neuromuscular blockade / Endotracheal intubation · 0.3-0.6 mg/kg i.v. · IV · Single dose · Approx 20 min at 0.6 mg/kg · 0.6 mg/kg has a rapid onset and short duration of action (20 min). Requires prompt successful intubation and ventilation.

Horses

As a neuromuscular blocker · 0.6 mg/kg IV · IV · Single dose · Provided predictable blockade without hemodynamic changes, but large variation between individuals; monitoring of neuromuscular block is essential.

Dogs

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 · Authors concluded it was effective and easily applicable, but further work is required on infusion titration.
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 · Monitoring with a nerve stimulator is recommended.
Centralize the globe for ophthalmic surgery · 0.05-0.1 mg/kg i.v. · IV · Single dose or prn · As needed · Considerably lower doses are required for this indication.

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

투여 경로

금기

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

이상반응

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)

약물 상호작용

Other Non-depolarizing Muscle Relaxants · May have a synergistic effect if used concurrently with rocuronium.
Succinylcholine · May speed the onset of action and enhance the neuromuscular blocking actions of rocuronium; do not give rocuronium until succinylcholine effects have subsided.
Aminoglycosides (e.g., gentamicin, amikacin) · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Inhalant Anesthetics (halothane, isoflurane, sevoflurane) · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Clindamycin, Lincomycin · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Dantrolene · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Magnesium Salts · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Piperacillin, Mezlocillin · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Quinidine · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Tetracyclines · May enhance or prolong the neuromuscular blocking activity of rocuronium.
Verapamil · May enhance or prolong the neuromuscular blocking activity of rocuronium.

모니터링

Degree of neuromuscular blockade (using a peripheral nerve stimulator/Train-of-Four monitor)
Heart rate and rhythm
Blood pressure
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

과용량

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.

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