Vecuronium/ Norcuron

Question 1

Vecuronium Class

Answer 1

Non-depolarizing neuromuscular blocking agent

Question 2

Vecuronium Action

Answer 2

• Skeletal muscle paralysis
• Has little agonist activity, with no depolarizing effect at the motor endplate.
• Muscle relaxation begins in the eyelids and jaw, progresses to the limbs, the abdomen, and finally the diaphragm and intercostals.
• Vecuronium has no effect on consciousness
• Causes little histamine or cardiovascular response

Question 3

Vecuronium Indications

Answer 3

• Facilitation of intubation

* Maintenance of paralysis following RSI

Question 4

Vecuronium Contraindications

Answer 4

Hypersensitivity

Question 5

Vecuronium Precautions

Answer 5

• Pregnancy (C)
• History of malignant hyperthermia
• Cardiac or hepatic disease
• Respiratory disease
• Narrow-angle glaucoma
• Elderly or debilitated patients
• Must be ready to intubate as soon as given, use cricoid pressure to secure airway from gastric regurgitation. Dehydration, electrolyte or acid/base imbalance (potentiates the actions)
• Neuromuscular disease (prolonged effects, i.e. myasthenia gravis)

Question 6

Vecuronium Dosage

Answer 6

Adults: (Medical Control Order)
• IV: 0.1 mg/kg, repeat PRN
Pediatrics: (Medical Control Order)
• IV: 0.1 mg/kg, repeat PRN
• NOTE: The dose required for induction or maintenance may be higher, but it also may last 1 ½ times as long

Question 7

Vecuronium Onset/ Duration

Answer 7

• Onset: IV—1 minute (good intubation conditions within 2.5-3.0 min)
• Duration: IV—30-60 minutes

Question 8

Vecuronium Side Effects

Answer 8

Side effects are rare, but with neuromuscular blockers, histamine release can cause:
• Bronchospasm
• Dysrhythmias
• Hyper- or Hypotension

Question 9

Vecuronium Interactions

Answer 9

Opiates or anti-arrhythmics can potentiate the effects of vecuronium.