Vecuronium
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Vecuronium
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| Systematic (IUPAC) name | |
| [(2S,3S,5S,8R,9S,10S,13S,14S,16S,17S)- 17-acetyloxy-10,13-dimethyl-16-(1-methyl-3,4, 5,6-tetrahydro-2H-pyridin-1-yl)-2-(1-piperidyl)- 2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro- 1H-cyclopenta[a]phenanthren-3-yl] acetate |
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| Identifiers | |
| CAS number | |
| ATC code | M03 |
| PubChem | |
| Chemical data | |
| Formula | C34H57N2O4+ |
| Mol. mass | 557.827 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 100% (IV) |
| Metabolism | liver 30% |
| Half life | 51–80 minutes (longer with renal failure) |
| Excretion | Fecal (40-75%) and renal (30% as unchanged drug and metabolites) |
| Therapeutic considerations | |
| Pregnancy cat. |
C(US) |
| Legal status | |
| Routes | Intravenous |
Vecuronium bromide (trade name Norcuron) is a muscle relaxant in the category of non depolarising neuromuscular blocking agents. Vecuronium bromide is indicated as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Although vecuronium bromide is often thought of as a muscle relaxant, it may be more accurate to classify it as a paralyzing agent.
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[edit] Clinical pharmacology
Vecuronium operates by competing for the cholinergic receptors at the motor end plate thereby exerting its muscle relaxing properties which are used adjunctively to general anesthesia. Under balanced anesthesia, the time to recovery to 25% of control (clinical duration) is approximately 25 to 40 minutes after injection and recovery is usually 95% complete approximately 45 to 65 minutes after injection of intubating dose. The neuromuscular blocking action of vecuronium is slightly enhanced in the presence of potent inhalation anesthetics. If vecuronium is first administered more than 5 minutes after the start of the inhalation of enflurane, isoflurane, or halothane, or when steady state has been achieved, the intubating dose of vecuronium may be decreased by approximately 15%.
Vecuronium is normally given at 0.08–0.1 mg/kg intravenously and its maintenance dose is usually between 0.02–0.03 mg/kg, but as with all other neuromuscular blocking agents, the doses need to be tailored for each individual patient.
It is an aminosteroid.
[edit] In the news
In 2001, Japanese nurse Daisuke Mori was reported to murder 10 patients using vecuronium bromide.[1] He was convicted of a murder and was sentenced to life imprisonment.[2]
[edit] See also
[edit] References
- ^ "Japanese nurse kills 10 patients, says wanted to trouble hospital", The Indian Express, 2001-01-10. Retrieved on 2008-03-22.
- ^ "Top court dismisses appeal by ex-nurse over Sendai clinic murder", Breitbart.com, 2008-02-27. Retrieved on 2008-03-22.
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