pancuronium and Kidney-Diseases

Topics: Adult; Aged; Alcuronium; Child; Drug Interactions; Drug Utilization; Female; Gallamine Triethiodide; Humans; Infant, Newborn; Kidney Diseases; Liver Diseases; Maternal-Fetal Exchange; Neuromuscular Blocking Agents; Neuromuscular Depolarizing Agents; Neuromuscular Diseases; Neuromuscular Junction; Pancuronium; Pregnancy; Pyridinium Compounds; Succinylcholine; Synaptic Transmission; Tubocurarine

Topics: Acidosis; Aminopyridines; Electric Stimulation; Humans; Hypothermia; Kidney Diseases; Liver Diseases; Neostigmine; Neuromuscular Blocking Agents; Neuromuscular Junction; Pancuronium; Peripheral Nerves; Respiration; Sensory Receptor Cells; Synaptic Transmission; Water-Electrolyte Balance

The effect and plasma concentrations of vecuronium bromide were measured in normal patients after an intravenous dose of 50, 100, or 150 micrograms/kg and in patients with renal failure after 50 or 100 micrograms/kg. Urinary excretion of vecuronium was studied in normal patients after the 150 micrograms/kg dose. Pharmacokinetic parameters of patients with or without renal failure were similar. No metabolites of vecuronium were found in the plasma. Twenty percent of vecuronium was excreted unchanged in the urine; 5% as the 3-hydroxy derivative. No other metabolites of vecuronium were found in the urine. Increasing doses of vecuronium shortened the onset, but prolonged the duration of action and the recovery rate, to a similar extent in patients with or without renal failure. It was concluded that the disposition of vecuronium was best described by a three compartment model. Both the disposition and the effect of vecuronium are only marginally disturbed by renal failure.

Topics: Adult; Anesthesia, General; Female; Humans; Kidney; Kidney Diseases; Kinetics; Male; Middle Aged; Neuromuscular Blocking Agents; Pancuronium; Vecuronium Bromide

Topics: Animals; Atracurium; Child; Child, Preschool; Dogs; Humans; Isoquinolines; Kidney Diseases; Kinetics; Liver Diseases; Neuromuscular Blocking Agents; Pancuronium; Vecuronium Bromide

Topics: Animals; Atracurium; Isoquinolines; Kidney Diseases; Liver Diseases; Male; Neuromuscular Blocking Agents; Pancuronium; Portacaval Shunt, Surgical; Rats; Rats, Inbred Strains; Renal Circulation; Tubocurarine; Vecuronium Bromide

The new short acting steroid muscle relaxant vecuronium was tested clinically in 42 surgical patients and compared in three different groups of patients: normal patients, renal graft patients who received tobramycin preoperatively and other anephric patients undergoing surgery. Twenty-five percent recovery of initial twitch height as measured by NTM was significantly longer in the renal graft group than in the two other groups where recovery time is normal. Cardiovascular parameters were recorded before and after the injection of vecuronium. Reversal of the neuromuscular block was spontaneous or pharmacologically evoked by neostigmine. Clinical recovery was complete in all patients and there was no residual block.

Topics: Adult; Aged; Drug Synergism; Female; Hemodynamics; Humans; Kidney Diseases; Kidney Transplantation; Male; Middle Aged; Nephrectomy; Neuromuscular Blocking Agents; Pancuronium; Premedication; Tobramycin; Vecuronium Bromide

Topics: Adult; Anesthesia, Intravenous; Blood Coagulation Disorders; Blood Transfusion; Fentanyl; Fluid Therapy; Hemorrhage; Humans; Intraoperative Period; Ketamine; Kidney Diseases; Male; Pancuronium; Postoperative Complications; Respiratory Distress Syndrome; Shock

The extent of pancuronium binding in plasma in controversial due to a lack of definitive studies in human plasma. The degree of pancuronium binding in human plasma and the concomitant effects of age, sex, and renal disease on drug binding were determined by equilibrium dialysis using [3H]pancuronium. The free fraction of pancuronium was 93.2 +/- 1.6% in male subjects and 88.9 +/- 2.5% in adult nonpregnant female subjects, indicating that pancuronium is not highly protein bound. The free fraction in newborns and their mothers was 91.0 +/- 1.8% and 89 +/- 1.3%, respectively. There were no significant differences between the plasma binding of pancuronium in men, nonpregnant women (whether on oral contraceptives or not), pregnant women, or neonates. The free fraction of pancuronium was unaltered (90.7 +/- 2.1%) in patients with severe renal disease. We therefore conclude that the binding of pancuronium in human plasma is very low and that age, sex, oral contraceptives, pregnancy, and renal disease do not influence the plasma binding of this drug.

Topics: Adult; Aging; Blood Proteins; Contraceptives, Oral; Female; Humans; Infant, Newborn; Kidney Diseases; Male; Middle Aged; Pancuronium; Pregnancy; Protein Binding; Sex Factors

Topics: Alcuronium; Humans; Kidney Diseases; Kidney Transplantation; Neuromuscular Nondepolarizing Agents; Pancuronium; Transplantation, Homologous; Tubocurarine

Prolonged curarisation in the presence of renal failure occurred in six cases where pancuronium was used, and one case where alcuronium was used. The cases are presented with a brief review of the literature. Pancuronium must be used with great caution if postoperative reversal problems are to be avoided. Greater use of adjuvants will reduce requirements and may eliminate the problems encountered in renal failure.

Topics: Adult; Aged; Alcuronium; Female; Humans; Kidney Diseases; Kinetics; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Pancuronium; Postoperative Complications; Time Factors

Topics: Cardiac Output; Cardiovascular System; Heart Rate; Humans; Kidney Diseases; Muscles; Pancuronium; Pyridinium Compounds; Succinylcholine; Time Factors; Tubocurarine

Topics: Adolescent; Adult; Androstanes; Anesthesia, General; Body Weight; Child; Child, Preschool; Female; Histamine Release; Humans; Infant; Infant, Newborn; Kidney Diseases; Male; Middle Aged; Neuromuscular Depolarizing Agents; Neuromuscular Nondepolarizing Agents; Pancuronium; Pulse; Time Factors; Urologic Diseases; Vital Capacity