pancuronium (Pavulon®)
Neuromuscular blocker (Nondepolarizing)
Pancuronium produces complete muscular relaxation by binding to the nicotinic M receptors for acetylcholine at the neuromuscular junctions, without initiating depolarization of the muscle membrane.
As the concentration of acetylcholine rises in the neuromuscular junction, pancuronium is displaced and muscle tone is regained.
Pancuronium is used to optimize conditions for endotracheal intubation and assisted ventilations.
Paralysis in 3-5 minutes
45-60 minutes
Induction or maintenance of paralysis after intubation to assist ventilations
Known hypersensitivity to the drug
Inability to control airway and/or support ventilations with oxygen and positive pressure
Neuromuscular diseases (e.g. myasthenia gravis)
Transient hypotension
Tachycardia
Dysrhythmias
Increased blood pressure
Excessive salivation
Pain, burning at IV injection site
Positive chronotropic drugs may potentiate tachycardias
4mg/2ml ampule
0.1 mg/kg slow IV; repeat every 30-60 minutes as needed
0.04 – 0.1 mg/kg slow IV push (newborn: 0.02 mg/kg )
If the patient is conscious, explain the effects of the medication prior to administration and always sedate the patient prior to using a neuromouscular blocker.
Pregnancy Safety: not established
Neuromuscular blocking agents will produce respiratory depression. Therefore, intubation and ventilatory support must be readily available.
Carefully monitor the patient and be prepared to resuscitate.
The effects of pancuronium may be reversed with neostigmine (Prostigmin) 0.05 mg/kg and should be accompanied by atropine (0.6-1.2 mg IV).
Pancuronium has no effect on consciousness or pain.
Will not stop neuronal seizure activity nor decrease CNS damage secondary to seizures.
Pancuronium is excreted in the urine; doses should be decreased for patients with renal disease.