潘庫溴銨
Pancuronium Bromide
Pancuronium bromide
別名: Pavulon · Org-NA-97 · pancuronii bromidum · Pancuronium bromide
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
小型哺乳類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.1 mg/kg IV | IV | as needed | — | 🌎 NA |
- Muscle relaxation: Dose for rabbits
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
潘庫溴銨是一種非去極化型神經肌肉阻斷劑，主要作為全身麻醉的輔助藥物。它能提供骨骼肌鬆弛，以利於氣管插管、機械器械通氣及各類外科手術的進行。
重要臨床提示：潘庫溴銨不具備任何鎮痛、鎮靜或失憶作用。在使用前及使用期間，病患必須已接受充分的鎮靜與麻醉，以避免在意識清醒下被癱瘓的恐懼體驗。
- 它是一種長效的氨基類固醇肌肉鬆弛劑。
- 與其他藥物相比，其作用時間較長（依劑量而定約30-45分鐘），且高度依賴腎臟排泄。
- 其效力被認為是 d-tubocurarine 的5倍，約為 vecuronium 的三分之一（儘管有文獻指出在動物體內兩者效力相當）。
作用機轉
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.
安全性與警告
禁忌症
- 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)
不良反應
- 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
注意事項
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).
藥物交互作用
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
監測
- 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
藥物動力學
半衰期
吸收
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.
分佈
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.
代謝
Partially metabolized by the liver.
排除
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.
過量
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.
可用產品
劑型
- Injection: 1 mg/mL
- Injection: 2 mg/mL
- 2 mg/ml injectable solution
人用標示
- 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
各地核准狀態
POM (Prescription Only Medicine). Use restricted to anaesthetized animals with ventilation support.
POM-V. Use restricted to anaesthetized animals with ventilation support.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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).
飼主須知
潘庫溴銨是一種強效肌肉鬆弛劑，僅在醫院環境中用於手術或寵物需要呼吸機輔助呼吸時使用。
- 無止痛效果：此藥物本身不提供止痛或鎮靜效果。您的獸醫團隊在給予此藥物前，一定會使用其他麻醉藥物確保您的寵物完全熟睡、失去意識且舒適。
- 呼吸輔助：因為它會暫時停止所有骨骼肌的活動（包括用於呼吸的肌肉），在藥效期間，您的寵物將由機器輔助呼吸，並由專業人員進行嚴密監控。
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