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MUSCULO-SKELETAL SYSTEM › MUSCLE RELAXANTS › MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS › Other quaternary ammonium compounds
pipecuronium bromide
M03AC06
Forms & Strengths
- 10 mg/mL solution for injection
- 4 mg/mL solution for injection
- 2 mg/mL solution for injection
Adult Dosing
- Initial dose: 0.07-0.09 mg/kg IV
- Maintenance dose: 0.01-0.02 mg/kg IV, repeat as needed
Pediatric Dosing
- Neonates (<1 month): 0.05-0.07 mg/kg IV
- Infants (1-12 months): 0.06-0.08 mg/kg IV
- Children (1-12 years): 0.07-0.09 mg/kg IV
Indications
- Skeletal muscle relaxation during surgery or mechanical ventilation
- Facilitating endotracheal intubation
Mechanism of Action
- Non-depolarizing neuromuscular blocker
- Competitively inhibits acetylcholine at the nicotinic receptor
Contraindications
- Known hypersensitivity to pipecuronium or other neuromuscular blockers
- Acute respiratory or cardiac distress
Adverse Reactions
- Residual neuromuscular blockade
- Anaphylaxis
- Histamine release
- Hypotension
- Bronchospasm
Drug Interactions
- Anesthetics: may enhance neuromuscular blockade
- Aminoglycosides: may potentiate neuromuscular blockade
- Anticholinesterases: may reverse neuromuscular blockade
Curated Content: Needs Vetting Before Put to Clinical Use