Pipecuronium bromide

Muscle relaxant in general anaesthesia, Facilitate endotracheal intubation

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.

Hypersensitivity.

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.

C

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.

Transient hypotension, bradycardia, reduced cardiac output. Potentially Fatal: Anaphylactic reactions and malignant hyperthermia.

Pipecuronium bromide is an aminosteroidal competitive neuromuscular blocker. It does not have significant CV adverse effects or histamine-related effects.