AHFS/Drugs.com Monograph ATC code M03AC03 (WHO) Bioavailability 100% (IV) Molar mass 637.73 g/mol | Routes of
administration Intravenous Legal status US: ℞-only CAS ID 50700-72-6 | |
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Pregnancy
category US: C (Risk not ruled out) | ||
Medical vocabulary what does vecuronium bromide mean
Vecuronium bromide, sold under the brand name Norcuron among others, is a medication used as part of general anesthesia to provide skeletal muscle relaxation during surgery or mechanical ventilation. It is also used to help with endotracheal intubation; however, suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.
Contents
- Medical vocabulary what does vecuronium bromide mean
- Clinical pharmacology
- History
- Society and culture
- Non medical use
- References
Side effects may include low blood pressure and prolonged paralysis. Allergic reactions are rare. It is unclear if use in pregnancy is safe for the baby. Vecuronium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles.
Vecuronium was approved for medical use in the United States in 1984. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. Vecuronium is available as a generic medication. In the United States it is less than 25 USD a dose. The effects may be reversed with neostigmine and atropine.
Clinical pharmacology
Vecuronium operates by competing for the cholinoceptors at the motor end plate thereby exerting its muscle-relaxing properties which are used adjunctively to general anesthesia. Under balanced anesthesia, the time to recovery to 25% of control (clinical duration) is approximately 25 to 40 minutes after injection and recovery is usually 95% complete approximately 45 to 65 minutes after injection of intubating dose. The neuromuscular blocking action of vecuronium is slightly enhanced in the presence of potent inhalation anesthetics. If vecuronium is first administered more than 5 minutes after the start of the inhalation of enflurane, isoflurane, or halothane, or when a steady state has been achieved, the intubating dose of vecuronium may be decreased by approximately 15%.
History
Vecuronium's structure is derived from the same aminosteroid structure as pancuronium, but it is missing the methyl group on the piperidine nitrogen that is attached to the 'A' ring, making it monoquaternary, like D-tubocurarine. It has the same configuration at all ten stereocentres as pancuronium, and is a single-isomer preparation.
Society and culture
It is commercially available as ampoules containing 4 or 10 mg of the drug in powder form which needs to be dissolved in distilled water prior to being given.
Non-medical use
Vecuronium bromide can be used as part of a drug cocktail that prisons in the United States use as a means to put a condemned prisoner to death. Vecuronium is used to paralyze the prisoner and stop his or her breathing, in conjunction with a sedative and potassium chloride to stop the prisoner's heart. Injections of vecuronium bromide without proper sedation allow the person to be fully awake but unable to move in response to pain.
In 2001, Japanese nurse Daisuke Mori was reported to have murdered 10 patients using vecuronium bromide. He was convicted of murder and was sentenced to life imprisonment.