Rocuronium Kabi

Rocuronium Br

Adjunct to general anesth to facilitate tracheal intubation & skeletal muscle relaxation during surgery in adults & childn (neonates) to adolescents (0 to <18 yr). Adjunct in ICU to facilitate tracheal intubation & mechanical ventilation & for use in rapid sequence induction.

Administered as IV bolus or continuous infusion. Individualised dosage. Surgical procedures: Tracheal intubation Standard dose: 0.6 mg/kg. Rapid sequence induction of anesth: 1 mg/kg. Maintenance dose: 0.15 mg/kg. Long-term inhalational anesth: 0.075-0.1 mg/kg. Continuous infusion Loading dose: 0.6 mg/kg. Adult under IV anesth Infusion rate: 0.3-0.6 mg/kg/hr; under inhalational anesth 0.3-0.4 mg/kg/hr. Patient undergoing caesarean section 0.6 mg/kg. Neonate (0-28 days), infant (28 days to ≤3 mth), toddler (>3 mth to ≤2 yr), childn (2-11 yr) & adolescent (12 to ≤17 yr) Recommended intubation dose during routine anesth & maintenance dose: Similar to adults. Continuous infusion rates in ped are the same as adults (higher infusion rates for childn may be necessary). Geriatric & patient w/ hepatic &/or biliary tract disease &/or renal failure Routine anesth: 0.6 mg/kg. Maintenance dose: 0.075-0.1 mg/kg. Infusion rate: 0.3-0.4 mg/kg/hr. Intensive care procedures Same dose w/ surgical procedures.

Hypersensitivity to rocuronium Br or Br ion.

Mandatory ventilatory support for patients until adequate spontaneous respiration is restored. Extubate only after patient has recovered sufficiently from neuromuscular block. Consider factors eg, drug interactions or patient's condition in the post-op phase that may cause residual curarization. Anaphylactic reactions. Allergic cross-reactivity to neuromuscular blockers. Prolonged paralysis &/or skeletal muscle weakness in long-term use. Monitor neuromuscular transmission throughout use. Malignant hyperthermia. Myopathy may occur after long-term concurrent use of corticosteroids. Do not administer until there is full recovery from neuromuscular blockade caused by suxamethonium. Prolonged circulation time in patients w/ CV diseases, old age & oedematous state. Neuromuscular disease or after poliomyelitis. Hepatic &/or biliary disease &/or renal failure. Hypothermia; obesity, burns. Hypokalemia, hypermagnesemia, hypocalcaemia, hypoproteinaemia, dehydration, acidosis, hypercapnia & cachexia. Correct severe electrolyte disturbances, altered blood pH or dehydration. May affect ability to drive or operate machinery. Pregnancy & lactation. Childn.

Inj site pain/reaction.

Increased effect w/ halogenated volatile anesth; high doses (thiopental, methohexital, ketamine, fentanyl, γ-hydroxybutyrate, etomidate & propofol); other non-depolarizing neuromuscular blocking agents, suxamethonium. Prolonged duration of neuromuscular block or myopathy w/ corticosteroids. Antibiotics (eg, aminoglycosides, lincosamides, polypeptide antibiotics, acylamino-penicillin, tetracyclines, high doses of metronidazole; diuretics, thiamine, MAOIs, quinidine & its isomer quinine, protamine, adrenergic blockers, Mg & lithium salts, Ca channel blockers, local anesth. Decreased effect w/ neostigmine, edrophonium, pyridostigmine, aminopyridine derivatives, corticosteroids, phenytoin, carbamazepine, noradrenaline, azathioprine, theophylline, CaCl, KCl, PIs. May produce attenuation or potentiate neuromuscular block w/ non-depolarizing neuromuscular blockers & suxamethonium. More instant effect of lidocaine.

Neuromuscular Blocking Agents

M03AC09 - rocuronium bromide ; Belongs to the class of other quaternary ammonium-containing agents used as peripherally-acting muscle relaxants.

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