pipecuronium (Arduan)

Introduction

Tradename: Arduan.

Indications

• skeletal muscle relaxation during surgery
• skeletal muscle relaxation during endotracheal intubation
• recommended only for procedures anticipated to last at least 90 minutes

Contraindications

Caution:

• for only with assisted ventilation

Dosage

• adults:
  • initial: 85-100 ug/kg IV
  • maintenance: 5-25 ug/kg
• children 1-14 years of age may be less sensitive to effects
• infants 3 months to 1 year: adult schedule

Powder for injection: 10 mg vial.

Pharmacokinetics

• onset of action: within 2-3 minutes
• metabolized in the liver primarily to 3 desacetyl- pipecuronium
• elimination: 40% excreted unchanged in the urine

elimination via liver

elimination via kidney

Adverse effects

• common (> 10%)
  • hypotension, bradycardia
• less common (> 5%)
  • atrial fibrillation, myocardial ischemia, thrombosis, hypertension, ventricular extrasystole, CNS depression, urticaria, hypoglycemia, hyperkalemia, muscle atrophy, anuria, respiratory depression, dyspnea

More general terms

• neuromuscular blocker (paralyzing agent)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=50192
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=65332
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=50190
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5284608