Indications & Uses
Panalon is used alongside general anesthesia during surgery. It helps relax the skeletal muscles and makes it easier to insert a breathing tube into the windpipe, and its effect is suited to operations of medium to long duration.
Pharmacology
Pancuronium is a typical nondepolarizing, curare-mimetic muscle relaxant. It works as a competitive acetylcholine antagonist at the neuromuscular junction, displacing acetylcholine from the nicotinic acetylcholine receptors on the post-synaptic membrane. Unlike suxamethonium, it is a nondepolarizing agent, meaning it does not trigger spontaneous depolarisation when it binds to the nicotinic receptor at the neuromuscular junction, and so produces no muscle fasciculations on administration. Pancuronium has no hormonal activity. It has slight vagolytic activity (that is, it dampens vagus nerve activity) and no ganglioplegic activity (it does not block ganglia).
Nondepolarizing neuromuscular blocking agents work by competing with acetylcholine for the cholinergic receptors of the motor end plate, reducing the end plate's response to acetylcholine. This type of neuromuscular block can usually be reversed with anticholinesterase agents.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
To help with endotracheal intubation, and as a muscle relaxant in general anaesthesia, the adult dose of pancuronium bromide is 50 to 100 mcg/kg by injection, given initially. If it follows suxamethonium, the dose may be reduced to 20 to 60 mcg/kg. For maintenance, the dose is 10 to 20 mcg/kg.
For a child aged 0 to 30 days, the initial dose is 30 to 40 mcg/kg, with maintenance at 10 to 20 mcg/kg. A child older than 1 month gets the same dose as an adult.
To help with mechanical ventilation in intensive care, the adult dose is 60 mcg/kg every 1 to 1.5 hr, or less frequently.
Side Effects
Pancuronium Bromide can cause tachycardia, HTN, bradycardia, bronchospasm, hypotension, CV collapse and excessive salivation. There may also be pain or local skin reactions at the injection site. Hypersensitivity reactions are rare.
Cautions & Contraindications
Warnings & Precautions
Use with caution in patients with burn injury, biliary tract disease, pulmonary disease, muscular dystrophies, myasthenia gravis, myasthenic syndrome, electrolyte disturbance, altered blood pH, dehydration, CV (cardiovascular) disease, oedema, raised catecholamine concentration, and those at risk of HTN (hypertension). Also use cautiously in renal and hepatic impairment, in children, and during pregnancy and lactation.
Contraindications
Pancuronium should not be given to patients who are hypersensitive to it or to the bromide ion.
Pregnancy & Breastfeeding
Pancuronium bromide falls into Category C in pregnancy. Studies in animals have shown harmful effects on the foetus, which may include birth defects, damage to the developing embryo, or other problems. There are no controlled studies in pregnant women, and in some cases studies in women and animals are not available at all. Because of this, the medicine should be given only when the possible benefit to the mother clearly outweighs the possible risk to the foetus.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Obese patients: the dose of Pancuronium Bromide should be adjusted based on ideal body weight.
Renal impairment: In patients on haemodialysis or peritoneal dialysis, avoid use. In continuous renal replacement therapy, give 50% of the normal dose. If CrCl is below 10 mL/min, avoid use. If CrCl is 10 to 50 mL/min, give 50% of the normal dose.
Overdose
Symptoms
An overdose of Pancuronium Bromide can cause prolonged apnoea, respiratory depression and/or muscle weakness. Death may follow acute respiratory failure.
Management
Neostigmine 2.5 mg and atropine 1.2 mg may be given to reverse the neuromuscular block, while ventilation is continued. If the anticholinesterase agent doesn't reverse the neuromuscular blockade, keep ventilating the patient until spontaneous breathing returns.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Drug Interactions
Common questions about G Pancuronium 4 mg
What is G Pancuronium 4 mg Injection?
G Pancuronium 4 mg Injection is a medicine that contains Pancuronium Bromide. It is made by Gonoshasthaya Pharmaceuticals Ltd. It belongs to the Non depolarizing muscle relaxants group of medicines.
What is G Pancuronium used for?
Panalon is used alongside general anesthesia during surgery. It helps relax the skeletal muscles and makes it easier to insert a breathing tube into the windpipe, and its effect is suited to operations of medium to long duration.
What are the side effects of G Pancuronium?
Pancuronium Bromide can cause tachycardia, HTN, bradycardia, bronchospasm, hypotension, CV collapse and excessive salivation. There may also be pain or local skin reactions at the injection site.
Can I take G Pancuronium during pregnancy or while breastfeeding?
Pancuronium bromide falls into Category C in pregnancy. Studies in animals have shown harmful effects on the foetus, which may include birth defects, damage to the developing embryo, or other problems. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much G Pancuronium?
Symptoms An overdose of Pancuronium Bromide can cause prolonged apnoea, respiratory depression and/or muscle weakness. Death may follow acute respiratory failure. In an emergency call 999 or go to the nearest hospital emergency department.
Can I take other medicines with G Pancuronium?
Some medicines can interact with Pancuronium Bromide, for example: Theophylline, Nitroglycerin, Diazepam, Pyridostigmine, Azathioprine, Phenytoin. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for G Pancuronium?
G Pancuronium is a prescription (Rx) medicine. Take it as your doctor advises.