Adjunct to general anesth to facilitate rapid sequence & routine tracheal intubation & provide skeletal muscle relaxation during surgery or mechanical ventilation.
Dosage/Direction for Use
AdultTracheal intubation during routine anesth 0.6 mg/kg. Rapid sequence induction of anesth 1 mg/kg or 0.6 mg/kg (for those undergoing caesarean section). If 0.6 mg/kg is used, intubate after 90 sec. Maintenance: 0.15 mg/kg. Long-term inhalation anesth Reduce dose to 0.075-0.1 mg/kg. Continuous infusion Initially 0.6 mg/kg. Infusion rate: 0.3-0.6 mg/kg hrly for patients under IV anesth, 0.3-0.4 mg/kg hrly for patients under inhalation anesth. Mechanical ventilation Initially 0.6 mg/kg. Initial infusion rate for maintenance: 0.3-0.6 mg/kg hrly during the 1st hr, decreased during the following 6-12 hr.
Contraindications
Hypersensitivity.
Special Precautions
Conditions associated w/ prolonged circulation time, neuromuscular disease, hypothermic conditions, obesity, patients w/ burns. Hypokalemia, hypermagnesemia, hypocalcemia, hypoproteinemia, dehydration, acidosis, hypercapnia, cachexia increases effects. Severe electrolyte disturbances, altered blood pH or dehydration should be corrected. Not recommended to drive or operate machinery w/in 24 hr after full recovery. Hepatic &/or biliary tract & renal failure. Pregnancy & lactation.
Adverse Reactions
Inj site pain/reaction, changes in vital signs & prolonged neuromuscular block; anaphylactic & anaphylactoid reactions.
Increased effect w/ halogenated volatile anesth. May also inhibit blockade reversal w/ acetylcholinesterase. After intubation w/ suxamethonium. Long-term use w/ corticosteroids in ICU. Antibiotics, diuretics, Ca channel blockers, lithium salts, local anesth (lidocaine IV, epidural bupivacaine), acute administration of phenytoin or β-blockers. Aminoglycosides, lincosamide, polypeptide & acylamino-penicillin, quinidine, quinine & Mg salts may cause recurarization after post-op. Decreased effect w/ chronic administration of phenytoin or carbamazepine; PIs (gabexate, ulinastatin). Attenuated/potentiated neuromuscular-blocking effect w/ other nondepolarizing neuromuscular blockers & suxamethonium. Quicker onset of lidocaine action.
Sign Out
