Therapeutic Classification: neuromuscular blocking agents-nondepolarizing
Absorption: Following IV administration, absorption is essentially complete.
Distribution: Distributes into extracellular space; crosses the placenta.
Metabolism/Excretion: Metabolized in plasma; <5% excreted unchanged in urine
Half-Life: Infants: 20 min; Children: 17 min; Adults: 16 min;
Contraindicated in:
- Hypersensitivity;
- Pedi: Products containing benzyl alcohol should be avoided in neonates.
Use Cautiously in:
- Dehydration or electrolyte abnormalities (should be corrected);
- Situations in which histamine release would be problematic;
- Fractures or muscle spasm;
- Hyperthermia (↑ duration/intensity of paralysis);
- Shock;
- Extensive burns (may be more resistant to effects);
- Low plasma pseudocholinesterase levels (may be seen in association with anemia, dehydration, cholinesterase inhibitors/insecticides, severe liver disease, pregnancy, or hereditary predisposition);
- Obese patients;
- OB: Safety not established (use only if benefit outweighs potential risk to fetus);
- Pedi: Children <1 mo (safety and effectiveness not established).
Exercise Extreme Caution in:
- Neuromuscular diseases such as myasthenia gravis (small test dose may be used to assess response).
