Rocuronium

Rocuronium

[1 vial $18.43]

ADMINISTRATION ROUTES:

  • IV

ALTERNATIVE NAMES:

  • Esmeron

ICU INDICATIONS:

  1. Muscle Relaxant

PRESENTATION AND ADMINISTRATION:

  • IV:
    50mg in 5ml solution
    Supplied as a clear, aqueous solution for intravenous injection. Administer neat for IV injection or infusion
    Compatible with the following IV fluids: 5% dextrose, normal saline, Hartmanns, glucose and sodium chloride
    Store in the refrigerator at 2-8°C. The product can be stored outside the refrigerator at a temperature of up to 30°C for a maximum of 12 weeks. The product may not be placed back, once kept outside the refrigerator.

DOSAGE:

  • IV: 0.6-1.2mg/kg stat, then 0.1-0.2mg/kg boluses or 5-15mcg/kg/min

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose as in normal renal function (duration of action may be prolonged)

DOSAGE IN PAEDIATRICS:

  • IV: 0.6-1.2mg/kg stat, then 0.1-0.2mg/kg boluses or 5-15mcg/kg/min

CLINICAL PHARMACOLOGY:

  • Rocuronium is a fast onset, intermediate acting non-depolarizing neuromuscular blocking agent.

CONTRAINDICATIONS:

  1. hypersensitivity to rocuronium

WARNINGS

  • Anaphylactic reactions can occur following the administration of neuromuscular blocking agents including rocuronium.

PRECAUTIONS

  • General:
    In general, following long term use of neuromuscular blocking agents in the ICU, prolonged paralysis and/or skeletal muscle weakness has been noted. Myopathy after long term administration of other non-depolarizing neuromuscular blocking agents in the ICU in combination with corticosteroid therapy has been reported regularly. Therefore, for patients receiving both neuromuscular blocking agents and corticosteroids, the period of use of the neuromuscular blocking agent should be limited as much as possible.
    Like other neuromuscular blocking agents, rocuronium should be used with extreme caution in patients with a neuromuscular disease
  • Laboratory Tests: No tests additional to routine ICU tests are required
  • Drug/Laboratory Test Interactions: None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Drugs which may enhance the neuromuscular blocking action of rocuronium include: certain antibiotics, especially the aminoglycosides and polymyxins; lithium; magnesium salts; procainamide; and quinidine.
  • The prior administration of succinylcholine does not enhance the duration, but quickens the onset and may increase the depth, of neuromuscular block induced by rocuronium

ADVERSE REACTIONS

  • General: Allergic reactions (anaphylactic or anaphylactoid responses) which, in rare instances, were severe (e.g., cardiac arrest). Musculoskeletal: Inadequate block, prolonged block.
  • Cardiovascular: Hypotension, vasodilatation (flushing), tachycardia, bradycardia.
  • Respiratory: Dyspnea, bronchospasm, laryngospasm.
  • Integumentary: Rash, urticaria, reaction at injection site.

Critical Care Drug Manual

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