베쿠로늄 브로마이드

동물 종별 용량

투여 경로

금기

• Known hypersensitivity to vecuronium or bromides
• Conscious or inadequately anesthetized animals
• Lack of facilities for positive pressure ventilation/mechanical ventilation
• Severe hepatic dysfunction (relative contraindication; atracurium preferred)

이상반응

• Profound, prolonged musculoskeletal paralysis (pharmacologic effect)
• Skeletal muscle weakness
• Respiratory arrest (if mechanical ventilation is not provided)
• Prolonged apnea (expected pharmacological effect)
• No cardiovascular effects or histamine release reported at clinical doses

약물 상호작용

• Other Non-Depolarizing Muscle Relaxants · May have a synergistic effect if used concurrently with vecuronium.
• Succinylcholine · May speed the onset of action and enhance the neuromuscular blocking actions of vecuronium; do not give vecuronium until succinylcholine effects have subsided.
• Aminoglycosides · May enhance or prolong the neuromuscular blocking activity. · major
• Inhalant Anesthetics (Halothane, Isoflurane, Sevoflurane) · May enhance or prolong the neuromuscular blocking activity.
• Clindamycin, Lincomycin · May enhance or prolong the neuromuscular blocking activity.
• Dantrolene · May enhance or prolong the neuromuscular blocking activity.
• Magnesium Salts · May enhance or prolong the neuromuscular blocking activity.
• Piperacillin, Mezlocillin · May enhance or prolong the neuromuscular blocking activity.
• Quinidine · May enhance or prolong the neuromuscular blocking activity.
• Tetracyclines · May enhance or prolong the neuromuscular blocking activity.
• Verapamil · May enhance or prolong the neuromuscular blocking activity.
• Volatile anaesthetics · Prolonged neuromuscular blockade · major

모니터링

• Level of neuromuscular relaxation (using a peripheral nerve stimulator/train-of-four monitor)
• Heart rate, blood pressure, and ECG
• SpO2 and End-tidal CO2 (capnography)
• Core body temperature
• Neuromuscular function (Peripheral nerve stimulator / Train-of-Four)
• Continuous respiratory monitoring (Capnography/ETCO2, SpO2)
• Heart rate and blood pressure
• Acid-base and electrolyte status (especially potassium)

과용량

No cases of vecuronium overdosage have been reported in human or veterinary medicine. **Treatment of Overdose**: * Treat conservatively with **mechanical ventilation**, oxygen therapy, and IV fluids until the block wears off naturally. * **Pharmacologic Reversal**: Blockade can be reversed using an **anticholinesterase agent** (e.g., edrophonium, physostigmine, or neostigmine) combined with an **anticholinergic** (atropine or glycopyrrolate) to prevent severe bradycardia and excessive salivation. * *Suggested Reversal Protocol*: Neostigmine **0.06 mg/kg IV** administered after Atropine **0.02 mg/kg IV**.