Rocuronium bromide

Question 1

What is the trade name for rocuronium bromide?

Answer 1

Zemuron

Question 2

What is the drug classification of rocuronium bromide (Zemuron)?

Answer 2

Non-depolarizing neuromuscular blocking agent

Question 3

How is rocuronium bromide (Zemuron) supplied?

Answer 3

10mg/5mL vial

Question 4

Describe the MOA (pharmacodynamics) of rocuronium bromide (Zemuron).

Answer 4

Prevents neuromuscular transmission by acting as a competitive antagonist to block the effect of acetylcholine (ACh) at the myoneural junction. It overwhelms the receptors thus blocking depolarization

Question 5

List the indications for rocuronium bromide (Zemuron).

Answer 5

• MFI after administration of sedation/analgesia (When succinylcholine is contraindicated and sedation/analgesia is not enough to facilitate intubation and rescue airway available with no contraindications to use of the rescue airway)
• Post intubation to facilitate airway control & maintain muscle paralysis

Question 6

What is the MFI Loading dose for rocuronium bromide?

Answer 6

0.6 to 1.2 mg/kg IVP (in most patients intubation can proceed within 2 min; Use patient’s total body weight)

Question 7

What is the maintenance dose for rocuronium bromide?

Answer 7

0.1 to 0.6 mg/kg IVP; Use patient’s total body weight

Question 8

List the contraindications for rocuronium bromide.

Answer 8

• Hypersensitivity to drug or components
• A difficult intubation in a patient who is presently self ventilating adequately and ventilation may be difficult once paralyzed

Question 9

List some precautions for rocuronium bromide.

Answer 9

• Has no sedative/analgesic properties

- Hepatic disease

Question 10

Your patient is taking an acetylcholinesterase inhibitor, what affect could this have on rocuronium bromide?

Answer 10

Acetylcholinesterase inhibitors, such as neostigmine, antagonize the action of rocuronium.

Question 11

Does rocuronium bromide have many cardiovascular effects?

Answer 11

Minimal cardiovascular effects; may cause slight increase in heart rate (adults) / BP and may induce bronchospasm. Can cause tachycardia in pediatrics

Question 12

Does rocuronium bromide cause a histamine release?

Answer 12

NO

Question 13

Do NMBD (like rocuronium bromide) have an effect on pain sensation or mental status?

Answer 13

NO. So you must be sure to provide adequate sedation/analgesia dosing regimens in conjunction with NMBD administration.

Question 14

Why is it important to avoid over administration of rocuronium bromide?

Answer 14

It may delay assessment of the patient at the receiving facility.