High Alert
Contraindicated in:
Use Cautiously in:
Exercise Extreme Caution in:
CV: atracuriumhypotension, pancuroniumhypertension, atracurium, pancuroniumtachycardia
Derm: rash, atracuriumskin flushing
GI: pancuroniumexcessive salivation
Resp: bronchospasm
Drug-drug:
Atracurium
(Generic available)Cisatracurium
(Generic available)Pancuronium
(Generic available)Rocuronium
(Generic available)Vecuronium
(Generic available)Atracurium
Cisatracurium
Pancuronium
Rocuronium
Vecuronium
atracurium: Tracrium,
cisatracurium: Nimbex,
pancuronium: Pavulon,
rocuronium: Zemuron,
vecuronium: Norcuron
Absorption: Following IV administration, absorption is essentially complete.
Distribution: AtracuriumDistributes into extracellular space; crosses the placenta. CisatracuriumRapidly distributes into extracellular space.PancuroniumRapidly distributes into extracellular fluid; small amounts cross the placenta. RocuroniumRapidly distributes into extracellular space.VecuroniumRapidly distributes in extracellular fluid; minimal penetration of the CNS.
Half-Life: AtracuriumInfants: 20 min; Children: 17 min; Adults: 16 min; Cisatracurium2231 min; Pancuronium2 hr; RocuroniumInfants 312 mo: 0.81.8 hr; Children 13 yr: 0.41.8 hr; Children 38 yr: 0.51.1 hr; Adults: 1.42.4 hr (↑ to 4.3 hr in hepatic impairment and 2.4 hr in renal impairment); VecuroniumInfants: 65 min; Children: 41 min; Adults: 6575 min (↓ near term in pregnant patients, ↑ in hepatic impairment).
ROUTE | ONSET | PEAK | DURATION |
Atracurium IV | 14 min | 35 min | 2035 min |
Cisatracurium IV | 23 min | 35 min | 2850 min |
Pancuronium IV | 3045 sec | 23 min | 4060 min |
Rocuronium IV | 1 min | 0.51 min (peds) 13.7 min (adults) | 2640 min (peds) 31 min (adults)* |
Vecuronium IV | 13 min | 35 min | 3040 min |
*Following 0.6 mg/kg dose in adult patients.