Pipecuronium bromide

Chemical name

2бета,16бета-бис-(4,4-Дим��тил-1-пиперазиний)-3ал��фа,17бета-диацепокси-5��льфа-андростана dibromide

Gross

C35-H62-Br2-N4-O4

Characteristics

Steroidne compound, a non-hormonal activity. Crystalline powder almost white, soluble in water and alcohol, poorly soluble in fats. Solutions are transparent, bestsvetny, pH 5,0-6,5.

Of drugs

The drugs-miorelaksirutee (nedepoliarizutee). Competitive blocks n-holinoretseptora poperechnopolostah muscles, excluding caused azetilholinom depoliarizatia tip plate and the initiation of muscle fibres. Acetylcholinesterase inhibitors, contributing to the accumulation of acetylcholine overcome effect pipekuronia Bromida.cl - 0.12 l / h / kg, the volume of 0.25 l / kg, the T_1/2 6.2 mines T_1/2 off - 1.7 hrs (44-137 min). The tissues are transformations, is the active metabolite 3-deazetilny (40-50% pipekuronia activity), and a number of inactive derivatives. Excreted mainly kidneys in the urine detected about 75% of dose, unedited, and 20% of производных.Нейромыш��чная blockade is on average within 5 minutes (dose 70-85 µ g / kg). Intubation can be only a 2.5-3 min after injection.

Indications

• medication at the time of the operation, the endotrahealna mouth.

Restrictions on the use of

Гиперчувствительност ь (incl. to bromidam), male, of the liver, kidneys, expressed heart failure, pregnancy (early).

Pregnancy and lactation

Contraindicated in the early stages of pregnancy.

Side-Effects

The paralysis of skeletal muscles to the development of respiratory failure and patients, gipotenzia, aetiology, the increase in activated partial tromboplastinovogo and protrombinovogo time, hypertension, myocardial ischaemia, cerebrovascular violations thrombosis, fibrillace predserdy, ventricular arrythmia, increase in the level of creatinine, hypoglycaemia, giperkaliemia, muscle atrophy, gipestesia, oppression CNS, cough, anuria, skin skin.

Patient interaction

The increase miorelaxation izofluran, anfluran, tiobarbiturata, suxamethonium and fentanyl, aminoglikozida, tetratziklin, bacitracin, polimiksin B dioretiki, beta-adrenoblokatora, alfa-adrenoblokatora, calcium antagonists, salt magnesium, lidocaine, reduce-glukokortikoida, neostigmine (and other cholinesterase inhibitors), and noradrenalin theofillin. When coupled with a possible hinidine development Andersen paralysis.

Overdosing

Symptoms : patients, long paralysis Gipotenzia.lechenie : IVL, the introduction neostigmina dose of 1-3 mg / background / in the 0.25 mg atropine.

Precautions

Can appointed only under the supervision of an experienced anaesthetist, in the presence of the conditions for the lease, IVL, oxygen therapy. There is a need to have to have a dress (cholinesterase inhibitors), atropine. Required closely monitored during the operation and in the early period of aftercare for the maintenance of life to the full restoration of adequate muscle strength. Selection of doses takes into account age, sex, body mass index, the degree of obesity, the liver disease, the level of kidney function (as creatinine plasma and Cl). It should be borne in mind that in the face of acute and chronic imbalance elektrolitnogo or breached KHS might as strengthening or weakening miorelaksirutego effect. History accompanied by increased distribution for the reduced circulation in heart disease may lead to longer latency period.

Dosing and Administration

B / 386/1989 Mortar for injections are ex tempore of the enclosed solvent. Endotrahealnaya intubation, 70-85 µ g / kg (in the background suktinilholina 40-50 µ g / kg), which supports the dose 10-15 µ g / Kg.detam : for narcosis (in combination with diazepam, ketaminom, fentanyl and nitrous oxide) initial dose at least 80 to 90 µ g / kg; Up 30% of the initial dose; Newborns-60 µ g / kg

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