 Pancuronium (brand name Pavulon) is a medication used as a neuromuscular blocker, primarily in surgical settings to facilitate endotracheal intubation and muscle relaxation during surgery. It works by blocking the action of acetylcholine at the neuromuscular junction, thereby preventing muscle contraction.
Dosing:
The dose of pancuronium varies depending on the patient’s weight, age, and medical condition. The usual dose for an adult is 0.04-0.1 mg/kg given as an intravenous injection. The onset of action occurs within 2-3 minutes after injection, and the duration of action is typically 1-2 hours.
Side Effects:
Like other neuromuscular blocking agents, pancuronium can cause a range of side effects, some of which can be serious. These include:
- Respiratory depression or arrest (difficulty breathing or stopping breathing altogether)
- Hypotension (low blood pressure)
- Tachycardia (rapid heartbeat)
- Bradycardia (slow heartbeat)
- Increased intraocular pressure (pressure inside the eye)
- Myoglobinuria (presence of myoglobin in the urine)
- Allergic reactions such as anaphylaxis
Mechanism of Action:
Pancuronium is a non-depolarizing neuromuscular blocking agent that works by binding to and blocking the action of acetylcholine at the neuromuscular junction, which prevents muscle contraction. It binds competitively to the nicotinic acetylcholine receptor, which is located on the motor endplate of the neuromuscular junction. This causes relaxation of skeletal muscles and allows for easier intubation during surgical procedures.