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| Interactions: | Amphotericin B
Adverse Effect: enhanced muscle relaxation secondary to hypokalemia Clinical Management: Carefully monitor serum potassium concentrations in patients receiving Pancuronium and amphotericin B. Clinicians should be alert to potentially enhanced muscle paralysis in these patients.
Betamethasone
Adverse Effect: Decreased pancuronium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of pancuronium and adjust the dose as required, especially in patients receiving high-dose Betamethasone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Carbamazepine
Adverse Effect: Decreased pancuronium duration of action Clinical Management: Monitor patients for an appropriate clinical response to the neuromuscular blocker. Closer dosing intervals or higher doses of pancuronium may be needed in patients receiving carbamazepine.
Clindamycin
Adverse Effect: enhanced and prolonged neuromuscular blockade Clinical Management: If concurrent therapy with these agents is required, closely monitor patients for excessive neuromuscular blockade. A reduction in the dose of pancuronium may be advantageous. The need for respiratory support should be anticipated.
Colistin Sulphate
Adverse Effect: enhanced or prolonged neuromuscular blockade Clinical Management: Avoid concomitant use of Colistin Sulphate and Pancuronium. If the combination cannot be avoided, observe patients closely for enhanced or prolonged neuromuscular blockade which may require mechanical ventilation.
Dexamethasone
Adverse Effect: decreased pancuronium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of pancuronium and adjust the dose as required, especially in patients receiving high-dose Dexamethasone. With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Digoxin
Adverse Effect: An increased risk of cardiac arrhythmias Clinical Management: Cardiac rhythm should be closely monitored when administering pancuronium to a digitalized patient.
Frusemide
Adverse Effect: Increased or decreased neuromuscular blockade Clinical Management: Dosage modifications may be needed when furosemide and pancuronium are given concurrently.
Gentamicin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Gentamicin and Pancuronium if possible. Concurrent use of Gentamicin and Pancuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Glyceryl Trinitrate
Adverse Effect: an increase in pancuronium duration of action Clinical Management: Concurrent administration of nitroglycerin and pancuronium is not recommended. If concurrent use cannot be avoided, carefully titrate the dose of the neuromuscular blocking agent and monitor for increased or prolonged respiratory depression or paralysis (apnea).
Hydrocortisone
Adverse Effect: decreased effectiveness of non depolarising agents; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of Pancuronium and adjust the dose as required, especially in patients receiving high-dose Hydrocortisone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Lincomycin
Adverse Effect: pancuronium toxicity (respiratory depression) Clinical Management: If concurrent therapy is required, a reduction in the dose of pancuronium may be required. The need for respiratory support should be anticipated.
Lithium
Adverse Effect: Prolongation of the neuromuscular blockade
Neomycin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Neomycin and Pancuronium if possible. Concurrent use of Neomycin and Pancuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Netilmicin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Netilmicin and Pancuronium if possible. Concurrent use of Netilmicin and Pancuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Phenytoin
Adverse Effect: Decreased or increased pancuronium effectiveness Clinical Management: If clinically possible, avoid the concomitant administration of phenytoin with pancuronium. If phenytoin is combined with pancuronium, metocurine, vecuronium or tubocurarine, close monitoring of neuromuscular blockade is essential. The need for respiratory support should be anticipated.
Prednisolone
Adverse Effect: decreased effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of pancuronium and adjust the dose as required, especially in patients receiving high-dose Prednisolone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Procainamide
Adverse Effect: excessive neuromuscular blockade Clinical Management: A reduction in the pancuronium dose may be necessary when administered with procainamide.
Quinidine
Adverse Effect: pancuronium toxicity (respiratory depression, apnea) Clinical Management: Quinidine should be avoided if possible in the immediate postoperative period when the effects of neuromuscular blockers may be present. If quinidine is utilized, the need for respiratory support should be anticipated
Quinine
Adverse Effect: pancuronium toxicity (respiratory depression, apnea) Clinical Management: Quinine should be avoided if possible in the immediate postoperative period when the effects of neuromuscular blockers may be present. If quinine is used, the need for respiratory support should be anticipated.
Ranitidine
Adverse Effect: Antagonism of neuromuscular blockade
Sisomicin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Sisomicin and Pancuronium if possible. Concurrent use of Sisomicin and Pancuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Soframycin - Ocular
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Soframycin - Ocular and Pancuronium if possible. Concurrent use of Soframycin - Ocular and Pancuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Streptomycin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Streptomycin and Pancuronium if possible. Concurrent use of Pancuronium and Streptomycin requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Succinyl Choline
Adverse Effect: pancuronium toxicity (respiratory depression, apnea) Clinical Management: Monitor patients for slower recovery from neuromuscular blockade.
Theophylline
Adverse Effect: Decreased pancuronium effectiveness Clinical Management: Monitor the patients cardiac status and degree of neuromuscular blockade. Larger doses of pancuronium may be necessary.
Tobramycin
Adverse Effect: enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Avoid concomitant use of Tobramycin and Pancuronium if possible. Concurrent use of Tobramycin and Pancuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Triamcinolone
Adverse Effect: Decreased pancuronium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of pancuronium and adjust the dose as required, especially in patients receiving high-dose Triamcinolone . With prolonged coadministration of these agents, consider allowing the patient to have unparalyzed periods to reduce the total dose of the neuromuscular blocker.
Verapamil
Adverse Effect: enhanced neuromuscular blockade Clinical Management: Concurrent administration of verapamil and pancuronium is not recommended. If concurrent use cannot be avoided, carefully titrate the dose of the neuromuscular blocking agent and monitor for increased or prolonged respiratory depression or paralysis (apnea). |
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