Vecuronium bromide

Vecuronium bromide, sold under the brand name Norcuron among others, is a medication used as part of general anesthesia to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Vecuronium bromide

Norcuron; ORG NC 45; Vecuronii bromidum

Neovec, Norcuron, Survec, Troyvec, Varium, Vecurnis, Vecuron, Vercurex, Veroni, Verunium, Vibro

1-[(1S,2S,4S,5S,7S,10R,11S,13S,14R,15S)-5,14-bis(acetyloxy)-2,15-dimethyl-4-(piperidin-1-yl)tetracyclo[8.7.0.0²,?.0¹¹,¹?]heptadecan-13-yl]-1-methylpiperidin-1-ium

100% hepatic metabolism.

It is a nitrogen bisquaternary compound act by binding to nicotinic cholinergic receptors competitively; this operates by competing for the cholino receptors at the motor end plate thereby exerting its muscle-relaxing properties which are used adjunctively to general anesthesia. 

Intravenous

Vecuronium is a muscle relaxing agent and is used as an ajunct in general anesthesia.

Anaphylaxis, respiratory failure, apnoea, muscle weakness, paralysis, muscle atrophy (after long term use), hypersensitivity reactions e.g urticaria and erythema.

• Increases neuromuscular blockade with enflurane, halothane, methoxyflurane, ether, isoflurane, propofol and cyclopropane (volatile anaesthetic agents), fentanyl, other non-depolarising muscle relaxants, prior admin of succinylcholine, tetracyclines, polymyxins, diuretics, thiamine, MAOIs, colistin, bacitracin, sodium colistimethate, aminoglycoside antibiotics, acylaminopenicillins, high dose metronidazole, protamine, β-adrenergic blocking agents, calcium antagonists e.g. verapamil, and Mg.
• Decreased neuromuscular blockade with phenytoin, anticholinesterases, prior chronic admin of corticosteroids, noradrenaline, carbamazepine, azathioprine, theophylline, calcium chloride.

Hypersensitivity to vecuronium or bromide

NA

Molecular weight

557.8274

Molecular formula

C34H57N2O4

CAS number

86029-43-8

Precautions

• Renal and hepatic impairment.
• Pregnancy, lactation, elderly.
• Do not administer vecuronium if facilities are not there i.e artificial respiration, for intubation, agents for neuromuscular reversal and oxygen therapies are immediately available.
• Correct severe electrolyte disturbances, altered blood pH, dehydration where possible before vecuronium admin.
• Increase in onset time in conditions associated with prolonged circulation time (e.g. CV disease, oedema).
• Hypothermia, burns patients. Decrease dose in obese patients, taking into account lean body-mass.
• Neuromuscular disease e.g. myasthenia gravis, Eaton-Lambert syndrome or after poliomyelitis.
• Do not drive and  do not operate potentially dangerous machinery within 24 hours after full recovery from the neuromuscular blocking action of vecuronium.