Vecuronium bromide

Description

Vecuronium, 1-[(2β,3α,5α,16β,17β,)-3,17-bis(acetyloxy)-2-(1-piperidinyl) androstan-16-yl]-1-methylpiperidinium bromide (15.1.9), differs from panuronium only in the extent of alkylation. Only the piperidine substituent on C16 of the steroid skeleton is transformed into a quaternary salt.

Description

Vecuronium is a non-depolarizing muscle relaxant derived from the aminosteroid pancuronium and used adjunctively to general anesthesia. It competitively blocks cholinergic receptors at the motor end plate of the neuromuscular junction, inducing temporary paralysis. In humans, it has been shown to reduce muscle twitch tension with an ED₅₀ value of 0.15 mg/kg for a duration of 27 minutes without inducing cardiovascular effects.

Chemical properties

White Solid

The Uses of Vecuronium bromide

An aminosteroid, competitive neuromuscular blocker agent.

The Uses of Vecuronium bromide

alcohol antagonist

What are the applications of Application

Vecuronium bromide is ompetes with acetylcholine and binds to cholinergic receptors

Definition

ChEBI: The organic bromide salt of a 5alpha-androstane compound having 3alpha-acetoxy-, 17beta-acetoxy-, 2beta-piperidinino- and 16beta-N-methylpiperidinium su stituents.

brand name

Norcuron (Organon).

Biological Functions

Vecuronium bromide (Norcuron) is chemically identical to pancuronium except for a tertiary amine in place of a quaternary nitrogen. However, some of the drug will exist as the bisquaternary compound, depending on body pH. Vecuronium has a moderate onset of action (2.4 minutes) and a duration of effect of about 50 minutes. Like pancuronium, it does not block ganglia or vagal neuroeffector junctions, does not release histamine, and is eliminated by urinary excretion.

General Description

Vecuronium bromide, 1-(3 ,17 -dihydroxy-2 -piperidino-5 -androstan-16 -yl)-1-methylpiperidinium bromide diacetate (Norcuron), is themonoquaternary analog of pancuronium bromide. It belongsto the class of nondepolarizing neuromuscular blockingagents and produces effects similar to those of drugs in thisclass. It is unstable in the presence of acids and undergoesgradual hydrolysis of its ester functions in aqueous solution.Aqueous solutions have a pH of about 4.0.

Mechanism of action

Vecuronium bromide is a bisquaternary nitrogen compound that acts by competitively binding to nicotinic cholinergic receptors. The binding of vecuronium decreases the opportunity for acetylcholine to bind to the nicotinic receptor at the postjunctional membrane of the myoneural junction. As a result, depolarization is prevented, calcium ions are not released and muscle contraction does not occur.

Pharmacology

Vecuronium bromide is steroidal agent that was developed in an attempt to reduce the cardiovascular effects of pancuronium. I t is similar in structure to the older drug, differing only in the loss of a methyl group from one quaternary ammonium radical. Thus it is a monoquaternary amine. An intubating dose of 0.1mgkg^-1 produces profound neuromuscular block within 3min. This dose produces clinical block for about 30min. Vecuronium rarely produces histamine release, nor does it have any direct cardiovascular effects, although it allows the cardiac effects of other anaesthetic agents, such as bradycardia produced by the opioids, to go unchallenged. Vecuronium is excreted through the kidneys (30%), although to a lesser extent than pancuronium, and undergoes hepatic deacetylation; the deacetylated metabolites have neuromuscular blocking properties. Repeated doses should be used with care in patients with renal or hepatic disease because they accumulate.

Clinical Use

Vecuronium Bromide is usedmainly to produce skeletal muscle relaxation during surgeryand to assist in controlled respiration after general anesthesiahas been induced.

Side Effects

Common side effects of Vecuronium bromide include: muscle weakness, redness or inflammation at the injection site. Serious side effects include: measles, difficulty breathing, swelling of the face, lips, tongue, or throat; weak or shallow breathing, persistent muscle weakness, loss of movement in any part of the body, dizziness, and fever.

Veterinary Drugs and Treatments

Vecuronium is indicated as an adjunct to general anesthesia to produce muscle relaxation during surgical procedures or mechanical ventilation and to facilitate endotracheal intubation. It causes very minimal cardiac effects and generally does not cause the release of histamine.

Drug interactions

Potentially hazardous interactions with other drugs
Anaesthetics: enhanced muscle relaxant effect.
Anti-arrhythmics: procainamide enhances muscle relaxant effect.
Antibacterials: effect enhanced by aminoglycosides, clindamycin, polymyxins and piperacillin.
Antiepileptics: muscle relaxant effects antagonised by carbamazepine; effects reduced by long-term use of fosphenytoin and phenytoin but might be increased by acute use.
Botulinum toxin: neuromuscular block enhanced (risk of toxicity).

Metabolism

Vecuronium partly metabolised by the liver; the metabolites have some neuromuscular blocking activity. It is excreted mainly in bile as unchanged drug and metabolites; some is also excreted in the urine.