Classes
DEA Class; Rx
Common Brand Names; Zemuron
- Neuromuscular Blockers, Nondepolarizing
Description
Parenteral, intermediate-acting, nondepolarizing, neuromuscular blocking agent (NMBA)
Used for an adjunct to general anesthesia to facilitate both rapid-sequence and routine tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation
Minimal histamine release
Indications
Indicated for muscular relaxation during non-emergent endotracheal intubation.
For muscular relaxation during rapid-sequence intubation (RSI).
For neuromuscular blockade during mechanical ventilation in intensive care patients.
For neuromuscular blockade during surgery.
For the prevention of shaking chills† induced by therapeutic hypothermia after cardiac arrest.
Contraindications
Hypersensitivity
Lack of ventilatory support, neuromuscular disease
Other neuromuscular blocking agents
Adverse Effects
- Transient hypotension (1-2%)
- Hypertension (1-2%)
- Dose-related tachycardia
- Apnea
- Abnormal ECG
- Injection site edema
- Hiccups
- Pruritus
- Nausea
- Wheezing
- Residual muscle weakness
- Allergic or idiosyncratic hypersensitivity reactions
- Malignant hyperthermia
Warnings
Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
Administer only by trained individuals familiar with its actions, characteristics, and hazard
Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken; neuromuscular cross-sensitivity with other nuromuscular blocking agents possible
Neuromuscular transmission should be monitored continuously during administration and recovery with the help of a nerve stimulator; additional doses of rocuronium or any other neuromuscular blocking agent should not be given until there is a definite response (one twitch of the train-of-four) to nerve stimulation
Use caution in patients with significant hepatic disease; if used for rapid sequence induction in patients with ascites, an increased initial dosage may be necessary to assure complete block
Some patients may experience prolonged recovery (paralysis) of neuromuscular function
Pregnancy and Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk; effect on nursing infant not known
Maximum Dosage
How supplied
Rocuronium bromide
injectable solution
- 10mg/mL (5 & 10mL vials)
