|
| Interactions: | Amphotericin B
Adverse Effect: enhanced muscle relaxation secondary to hypokalemia Clinical Management: Carefully monitor serum potassium concentrations in patients receiving Vecuronium and amphotericin B. Clinicians should be alert to potentially enhanced muscle paralysis in these patients.
Betamethasone
Adverse Effect: Decreased vecuronium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of vecuronium 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 vecuronium duration of action Clinical Management: Monitor patients for an appropriate clinical response to the neuromuscular blocker. Closer dosing intervals or higher doses of vecuronium 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 vecuronium 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 Vecuronium . If the combination cannot be avoided, observe patients closely for enhanced or prolonged neuromuscular blockade which may require mechanical ventilation.
Dexamethasone
Adverse Effect: Decreased vecuronium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of vecuronium 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.
Frusemide
Adverse Effect: Increased or decreased neuromuscular blockade Clinical Management: Dosage modifications may be needed when furosemide and vecuronium 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 Vecuronium if possible. Concurrent use of Gentamicin and Vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
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 vecuronium 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: Vecuronium toxicity (respiratory depression) Clinical Management: If concurrent therapy is required, a reduction in the dose of vecuronium may be required. The need for respiratory support should be anticipated.
Mg. salts
Adverse Effect: Enhanced neuromuscular blockade Clinical Management: The dose of vecuronium may need to be adjusted downward in patients receiving large doses of magnesium salts administered for toxemia of pregnancy.
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 Vecuronium if possible. Concurrent use of Neomycin and Vecuronium 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 Vecuronium if possible. Concurrent use of Netilmicin and Vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Phenytoin
Adverse Effect: Decreased or increased vecuronium effectiveness Clinical Management: Patients on chronic phenytoin therapy may require larger doses of vecuronium to achieve an appropriate clinical response. Conversely, in patients who have received phenytoin for a relatively short period of time, smaller doses of vecuronium may be needed.
Piperacillin
Adverse Effect: Enhanced and/or prolonged neuromuscular blockade which may lead to respiratory depression and paralysis Clinical Management: Concurrent use of piperacillin and vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status. Edrophonium, neostigmine, or atropine may provide partial reversal of hypoventilation. As the block is reversible with time, artificial ventilation may be required and should be maintained until adequate respiration returns.
Prednisolone
Adverse Effect: decreased effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of vecuronium 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 vecuronium dose may be necessary when administered with procainamide.
Quinidine
Adverse Effect: Vecuronium 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.
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 Vecuronium if possible. Concurrent use of Sisomicin and Vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status. Calcium ions should be given in some form, particularly if large amounts of blood have been transfused. Edrophonium, neostigmine, or atropine may provide partial reversal of hypoventilation. As the block is reversible with time, artificial ventilation may be required and should be maintained until adequate respiration returns.
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 Vecuronium if possible. Concurrent use of Soframycin - Ocular and Vecuronium 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 Vecuronium if possible. Concurrent use of Streptomycin and Vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
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 Vecuronium if possible. Concurrent use of Tobramycin and Vecuronium requires close monitoring of the patients clinical condition, especially respiratory and oxygenation status.
Triamcinolone
Adverse Effect: Decreased vecuronium effectiveness; prolonged muscle weakness and myopathy Clinical Management: If concurrent therapy is required, monitor the effectiveness of vecuronium 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 vecuronium 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) |
|
|