Classifications: skeletal muscle relaxant, nondepolarizing; Therapeutic: skeletal muscle relaxant, nondepolarizing
Pregnancy Category: C
1 mg/mL, 2 mg/mL injection
Synthetic curariform nondepolarizing neuromuscular blocking agent that produces little or no histamine release or ganglionic
blockade and thus does not cause bronchospasm or hypotension. Produces skeletal muscle relaxation or paralysis by competing
with acetylcholine at cholinergic receptor sites on skeletal muscle endplate and thus blocks nerve impulse transmission.
Induces skeletal muscle relaxation or paralysis.
Adjunct to anesthesia to induce skeletal muscle relaxation. Also to facilitate management of patients undergoing mechanical
Hypersensitivity to the drug or bromides; tachycardia; pregnancy (category C).
Debilitated patients; dehydration; myasthenia gravis; neuromuscular disease; pulmonary, liver, or kidney disease; fluid
or electrolyte imbalance; lactation.
Route & Dosage
|Skeletal Muscle Relaxation
Adult/Child: IV 0.040.1 mg/kg initial dose, may give additional doses of 0.01 mg/kg at 3060 min intervals
Neonate: IV 0.02 mg/kg test dose, then 0.03 mg/kg
Clcr 1050 mL/min: use 50% of dose; <10 mL/min: do not use
- Plastic syringe may be used for administration, but drug may adsorb to plastic with prolonged storage.
- Use a test dose of 0.02 mg/kg in infants ≥1 mo.
PREPARE: Direct: Give undiluted.
ADMINISTER: Direct: Give over 3090 sec.
INCOMPATIBILITIES Solution/additive: Furosemide.
- Refrigerate at 2°8° C (36°46° F). Do not freeze.
Adverse Effects (≥1%)CV: Increased pulse rate and BP,
ventricular extrasystoles. Skin:
Transient acneiform rash, burning sensation along course of vein. Body as a Whole:
Salivation, skeletal muscle weakness, respiratory depression.
Diagnostic Test Interference
Pancuronium may decrease serum cholinesterase concentrations.
InteractionsDrug: general anesthetics
increase neuromuscular blocking and duration of action; aminoglycosides
, bacitracin, polymyxin B, clindamycin, lidocaine,
parenteral magnesium, quinidine, quinine, trimethaphan, verapamil
increase neuromuscular blockade; diuretics
may increase or decrease neuromuscular blockade; lithium
prolongs duration of neuromuscular blockade; narcotic analgesics
possibly add to respiratory depression; succinylcholine
increases onset and depth of neuromuscular blockade; phenytoin
may cause resistance to or reversal of neuromuscular blockade.
3045 sec. Peak:
23 min. Duration:
60 min. Distribution:
Well distributed to tissues and extracellular fluids; crosses placenta in small amounts. Metabolism:
Small amount in liver. Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Assess cardiovascular and respiratory status continuously.
- Observe patient closely for residual muscle weakness and signs of respiratory distress during recovery period. Monitor BP
and vital signs. Peripheral nerve stimulator may be used to assess the effects of pancuronium and to monitor restoration
of neuromuscular function.
- Note: Consciousness is not affected by pancuronium. Patient will be awake and alert but unable to speak.