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Rocuronium

    DEA Class;  Rx

    Common Brand Names; Zemuron

    • Neuromuscular Blockers, Nondepolarizing
     

    Parenteral, intermediate-acting, nondepolarizing, neuromuscular blocking agent (NMBA)
    Used for an adjunct to general anesthesia to facilitate both rapid-sequence and routine tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation
    Minimal histamine release

    Indicated for muscular relaxation during non-emergent endotracheal intubation.

    For muscular relaxation during rapid-sequence intubation (RSI).

    For neuromuscular blockade during mechanical ventilation in intensive care patients.

    For neuromuscular blockade during surgery.

    For the prevention of shaking chills† induced by therapeutic hypothermia after cardiac arrest.

    Hypersensitivity

    Lack of ventilatory support, neuromuscular disease

    Other neuromuscular blocking agents

    • Transient hypotension (1-2%)
    • Hypertension (1-2%)
    • Dose-related tachycardia
    • Apnea
    • Abnormal ECG
    • Injection site edema
    • Hiccups
    • Pruritus
    • Nausea
    • Wheezing
    • Residual muscle weakness
    • Allergic or idiosyncratic hypersensitivity reactions
    • Malignant hyperthermia

    Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent

    Administer only by trained individuals familiar with its actions, characteristics, and hazard

    Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken; neuromuscular cross-sensitivity with other nuromuscular blocking agents possible

    Neuromuscular transmission should be monitored continuously during administration and recovery with the help of a nerve stimulator; additional doses of rocuronium or any other neuromuscular blocking agent should not be given until there is a definite response (one twitch of the train-of-four) to nerve stimulation

    Use caution in patients with significant hepatic disease; if used for rapid sequence induction in patients with ascites, an increased initial dosage may be necessary to assure complete block

    Some patients may experience prolonged recovery (paralysis) of neuromuscular function

    Pregnancy Category: C

    Lactation: not known if excreted in breast milk; effect on nursing infant not known

    Specific maximum dosage information is not available. Dosage must be individualized based on clinical response.

    Rocuronium bromide

    injectable solution

    • 10mg/mL (5 & 10mL vials)