ROCURONIUM (ZEMURON)

Class

Skeletal muscle relaxant, neuromuscular blocking agent

Pharmacology and Actions

1. Non-depolarizing neuromuscular blocking agent with intermediate to rapid onset
2. Acts by competitive inhibition of cholinergic receptors at the motor end-plate
3. Higher doses produce a longer duration of action

Indications for Use:

1. Facilitate endotracheal intubation
2. Provide skeletal muscle relaxation for mechanical ventilation

Contraindications

1. Known hypersensitivity to rocuronium
2. Myasthenia gravis

Precautions

1. Severe liver disease.
2. Vancomycin and tetracycline antibiotics prolong the effects.
3. Tegretol and Dilantin decrease the effects and duration.

Side Effects:

1. Cardiovascular: arrhythmias, tachycardia
2. Respiratory:  bronchospasm, hiccups
3. Dermatologic:  rash, itching, injection site edema
4. Gastrointestinal:  nausea, vomiting

Administration:

1. Rapid Sequence Intubation Dose: 1 mg/kg IV/IO, may repeat one time after 2 minutes if   inadequate response is obtained.

Side Effects and Special Notes:

1. Duration of effect is slightly increased in patients > 65 year
2. Compatible with all IV solutions