Pipecuronium bromide
Indications
Pipecuronium bromide is used for:
Muscle relaxant in general anaesthesia, Facilitate endotracheal intubation
Adult Dose
Intravenous
Muscle relaxant in general anaesthesia; Facilitate endotracheal intubation
Adult: Initial dose: 80-100 mcg/kg. Subsequent doses: 10-20 mcg/kg.
Initial dose following suxamethonium admin or in patients at high risk: 50-60 mcg/kg.
Initial dose for caesarean section: 35 mcg/kg.
Child Dose
Renal Dose
Administration
Contra Indications
Hypersensitivity.
Precautions
Pulmonary disease, respiratory insufficiency, asthma, neuromuscular disease, dehydration, severely ill patients, hepatic or renal impairment. Doses in obese patients should be based on patient's ideal body weight. Pregnancy, lactation.
Pregnancy-Lactation
Interactions
Actions antagonised by cholinesterases and long term carbamazepine, phenytoin or corticosteroids usage. Enhanced block when used with drugs that have neuromuscular blocking activity such as lidocaine, quinidine, verapamil and aminoglycosides.
Potentially Fatal: Effects enhanced by volatile inhalational anaesthetics, ketamine (IV), antiarrhythmics, antibacterials, K depleting diuretics, parenteral Mg salts.
Adverse Effects
Side effects of Pipecuronium bromide :
Transient hypotension, bradycardia, reduced cardiac output.
Potentially Fatal: Anaphylactic reactions and malignant hyperthermia.
Mechanism of Action
Pipecuronium bromide is an aminosteroidal competitive neuromuscular blocker. It does not have significant CV adverse effects or histamine-related effects.