rocuronium (Zemuron)
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Introduction
Tradename: Zemuron.
Indications
- inpatient & outpatient use as an adjunct to general anesthesia
- rapid-sequence & routine endotracheal intubation
- skeletal muscle relaxation during surgery or mechanical ventilation
Dosage
- induction 0.6 mg/kg IV bolus
- infusion: 0.01-0.012 mg/kg/min after early evidence of spontaneous neuromuscular function is evident
Injection: 10 mg/mL ( 5 mL, 10 mL).
Pharmacokinetics
- good intubating conditions in 1-3 minutes
- maximum neuromuscular blockade in 3-4 minutes
- duration of action: 7-70 minutes
- minimal hepatic metabolism
- excreted primarily by the biliary secretion
elimination via liver
Adverse effects
- not common (> 1%)
- transient hypotension & hypertension
- uncommon (< 1%)
- arrhythmias, abnormal EKG, tachycardia, nausea/vomiting, bronchospasm, wheezing, rhonchi, hiccups, rash, edema at site of injection, pruritus
- other
- respiratory acidosis, hypomagnesemia, hypokalemia, & hypocalcemia may enhance the actions of rocuronium
- dehydration may alter effects of rocuronium
Drug interactions
- aminoglycosides, clindamycin, quinidine, magnesium sulfate, verapamil, furosemide
- reduction in maintenance & infusion of enflurane or isoflurane may be necessary