U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C35H60N2O4
Molecular Weight 572.8619
Optical Activity UNSPECIFIED
Defined Stereocenters 10 / 10
E/Z Centers 0
Charge 2

SHOW SMILES / InChI
Structure of PANCURONIUM

SMILES

[H][C@@]12C[C@@H]([C@H](OC(C)=O)[C@@]1(C)CC[C@@]3([H])[C@@]2([H])CC[C@@]4([H])C[C@H](OC(C)=O)[C@H](C[C@]34C)[N+]5(C)CCCCC5)[N+]6(C)CCCCC6

InChI

InChIKey=GVEAYVLWDAFXET-XGHATYIMSA-N
InChI=1S/C35H60N2O4/c1-24(38)40-32-21-26-13-14-27-28(35(26,4)23-31(32)37(6)19-11-8-12-20-37)15-16-34(3)29(27)22-30(33(34)41-25(2)39)36(5)17-9-7-10-18-36/h26-33H,7-23H2,1-6H3/q+2/t26-,27+,28-,29-,30-,31-,32-,33-,34-,35-/m0/s1

HIDE SMILES / InChI
Pancuronium (trademarked as Pavulon) is an aminosteroid muscle relaxant with various medical uses. Pancuronium is a typical non-depolarizing curare-mimetic muscle relaxant. It competitively inhibits the nicotinic acetylcholine receptor at the neuromuscular junction by blocking the binding of acetylcholine. It has slight vagolytic activity, causing an increase in heart rate, but no ganglioplegic (i.e., blocking ganglions) activity. It is a very potent muscle relaxant drug, with an ED95 of only 60 µg/kg body weight. The onset of action is relatively slow compared to other similar drugs, in part due to its low dose - an intubating dose takes 3–6 minutes for full effect. Clinical effects (muscle activity lower than 25% of physiological) last for about 100 minutes. The time needed for full (over 90% muscle activity) recovery after single administration is about 120–180 minutes in healthy adults. Pancuronium is used with general anesthesia in surgery for muscle relaxation and as an aid to intubation or ventilation. It does not have sedative or analgesic effects. Side-effects include moderately raised heart rate and thereby arterial pressure and cardiac output, excessive salivation, apnea and respiratory depression, rashes, flushing, and sweating. The muscular relaxation can be dangerous for the seriously ill and it can accumulate leading to extended weakness. Pancuronium is not preferable to long-term use in ICU-ventilated patients. Pancuronium is also used as one component of a lethal injection in the administration of the death penalty in some parts of the United States.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
15.0 nM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
PAVULON

Approved Use

Pancuronium bromide injection is indicated as an adjunct to general anesthesia, to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Launch Date

1972
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
460 ng/mL
4 mg single, intravenous
dose: 4 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
PANCURONIUM plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
600 ng/mL
4 mg single, intravenous
dose: 4 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
PANCURONIUM plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
0.761 μg/mL
6 mg single, intravenous
dose: 6 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
PANCURONIUM plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
12.46 min
6 mg single, intravenous
dose: 6 mg
route of administration: Intravenous
experiment type: SINGLE
co-administered:
PANCURONIUM plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
0.15 mg/kg 1 times / day single, intravenous
Highest studied dose
Dose: 0.15 mg/kg, 1 times / day
Route: intravenous
Route: single
Dose: 0.15 mg/kg, 1 times / day
Sources:
unhealthy, 17 years
n = 1
Health Status: unhealthy
Age Group: 17 years
Sex: F
Population Size: 1
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG

OverviewOther

Other InhibitorOther SubstrateOther Inducer

Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
yes
PubMed

PubMed

TitleDatePubMed
Ultra-fast-track anesthetic technique facilitates operating room extubation in patients undergoing off-pump coronary revascularization surgery.
2001 Apr
Suramin prevents cerebellar granule cell-death induced by dequalinium.
2001 Feb
[Anesthetic experience of emergency coronary artery bypass graft operation in a patient with cardioamyloidosis].
2001 Jan
Facilitation of fiberoptic nasotracheal intubation by simultaneous direct laryngoscopy in anesthetized patients.
2001 Jun
Anaesthetic management of baboons undergoing heterotopic porcine cardiac xenotransplantation.
2001 May
Efficacy of propofol to prevent bronchoconstriction: effects of preservative.
2001 May
Influence of blood cell transfusion on the presence of propofol in blood components.
2001 Nov-Dec
The kinetics of inhibition of nicotinic acetylcholine receptors by (+)-tubocurarine and pancuronium.
2001 Oct
Different patterns of mast cell activation by muscle relaxants in human skin.
2001 Sep
[Hemostatic profile of women using low-dose oral contraceptive Mercilon. (Preliminary report)].
2002
Increased airway resistance during xenon anaesthesia in pigs is attributed to physical properties of the gas.
2002 Apr
A study of the in vitro clinical interaction between lidocaine and premedications using rat liver microsomes.
2002 Aug
Synthesis and structure-activity relationships of neuromuscular blocking agents.
2002 Aug
Intramucosal-arterial PCO2 gap fails to reflect intestinal dysoxia in hypoxic hypoxia.
2002 Dec
A combination of intrathecal morphine and remifentanil anesthesia for fast-track cardiac anesthesia and surgery.
2002 Dec
The use of neuromuscular blocking drugs in adult cardiac surgery: results of a national postal survey.
2002 Dec
Responses of diencephalic nociceptive neurones to orofacial stimuli and effects of internal capsule stimulation in the rat.
2002 Dec
The detection and identification of quaternary nitrogen muscle relaxants in biological fluids and tissues by ion-trap LC-ESI-MS.
2002 Jan-Feb
Vasoactive modulators during and after craniotomy: relation to postoperative hypertension.
2002 Jul
Tachyphylaxis associated with continuous cisatracurium versus pancuronium therapy.
2002 Jul
Presynaptic inhibitory effects of rocuronium and SZ1677 on [3H]acetylcholine release from the mouse hemidiaphragm preparation.
2002 Jun
Intradermal cholinergic agonists induce itch-associated response via M3 muscarinic acetylcholine receptors in mice.
2002 Mar
Impact of shorter-acting neuromuscular blocking agents on fast-track recovery of the cardiac surgical patient.
2002 Mar
Anionic cyclophanes as potential reversal agents of muscle relaxants by chemical chelation.
2002 Mar 11
Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data.
2002 Oct
Cost comparisons of pharmacological strategies in open-heart surgery.
2003
Diverse range of fixed positional deformities and bone growth restraint provoked by flaccid paralysis in embryonic chicks.
2003 Aug
Mouse muscle denervation increases expression of an alpha7 nicotinic receptor with unusual pharmacology.
2003 Feb 15
Resuscitation from hemorrhagic shock: experimental model comparing normal saline, dextran, and hypertonic saline solutions.
2003 Jul
Tolerance to acute isovolemic hemodilution. Effect of anesthetic depth.
2003 Jul
Screening procedure for eight quaternary nitrogen muscle relaxants in blood by high-performance liquid chromatography-electrospray ionization mass spectrometry.
2003 Jun 5
[The use of muscle relaxants for routine induction of anesthesia in Germany].
2003 May
Angiotensin AT1 receptor antagonist losartan and the defence reaction in the anaesthetised rat. Effect on the carotid chemoreflex.
2003 May
The hemodynamic and metabolic effects of shivering during acute normovolemic hemodilution.
2003 Oct
Thermogenesis elicited by skin cooling in anaesthetized rats: lack of contribution of the cerebral cortex.
2004 Mar 1
Patents

Patents

Sample Use Guides

Load: 0.04-0.1 mg/kg IV Maintenance: 0.015-0.1 mg/kg IV q30-60min OR Continuous infusion: 0.1 mg/kg/hr IV Dose should be calculated based on ideal body weight Monitoring of muscle twitch response to a peripheral nerve stimulator is advised
Route of Administration: Intravenous
HEK293 cells were prepared for patch clamp recording by replacing the culture medium with an extracellular solution consisting of 150 mM NaCl, 5.6 mM KCl, 1.8 mM CaCl2, 1.0 mM MgCl2, and 10 mM HEPES, pH 7.3. Subsequently, 3−5 μl of polystyrene beads coated with a monoclonal antibody specific for the CD8 antigen (Dyna-beads; Dynal, Lake Success, NY) were added to the culture dish. Good expression of nAChR channels in excised patches was found for most cells having two or three beads attached. Patch pipettes, filled with a solution consisting of 140 mM KCl, 5 mM EGTA, 5 mM MgCl2, and 10 mM HEPES, pH 7.3, had resistances of 3−6 MΩ. An outside-out patch24 with a seal resistance of 5 GΩ or greater was excised from a cell and moved into position at the outflow of a HSSE-2 rapid perfusion device (ALA Scientific Instruments, Westbury, NY). The perfusion system consisted of solution reservoirs, manual switching valves, a solenoid-driven pinch valve, and two tubes inserted into the culture dish and had a time resolution of less than 100 μs. One tube contained extracellular solution without agonist (normal solution); the other contained extracellular solution with 300 μM acetylcholine (test solution). In the control protocol, the patch, initially perfused with normal solution, was exposed to a series of ten 0.25- s exposures to the test solution at 5-s intervals. Manual valves were used to connect to reservoirs containing a defined concentration of competitive antagonist (Pancuronium ) with or without acetylcholine. An equilibrium (+/+) protocol was performed by exposing the patch to acetylcholine plus antagonist for 0.25 s, with a 5-s interval of antagonist alone. After switching back to antagonist free solutions, the control protocol was repeated
Name Type Language
PANCURONIUM
VANDF   WHO-DD  
Common Name English
1,1'-(3.ALPHA.,17.BETA.-DIHYDROXY-5.ALPHA.-ANDROSTAN-2.BETA.,16.BETA.-YLENE)BIS(1-METHYLPIPERIDINIUM) DIACETATE
Common Name English
VECURONIUM BROMIDE IMPURITY B [EP IMPURITY]
Common Name English
Pancuronium [WHO-DD]
Common Name English
PIPERIDINIUM, 1,1'-((2.BETA.,3.ALPHA.,5.ALPHA.,16.BETA.,17.BETA.)-3,17-BIS(ACETYLOXY)ANDROSTANE-2,16-DIYL)BIS(1-METHYL-
Common Name English
PANCURONIUM [VANDF]
Common Name English
Classification Tree Code System Code
WHO-VATC QM03AC01
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
WHO-ATC M03AC01
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
NDF-RT N0000175720
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
NCI_THESAURUS C29696
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
NDF-RT N0000175732
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
Code System Code Type Description
EVMPD
SUB03618MIG
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
CHEBI
7907
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
EPA CompTox
DTXSID7048405
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
SMS_ID
100000085535
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
NCI_THESAURUS
C61876
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
IUPHAR
4001
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
LACTMED
Pancuronium
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
CAS
16974-53-1
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
DRUG BANK
DB01337
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
FDA UNII
J76UF062FS
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
DRUG CENTRAL
2052
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
DAILYMED
J76UF062FS
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
PUBCHEM
441289
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
WIKIPEDIA
Pancuronium
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
MESH
D010197
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY
RXCUI
7883
Created by admin on Fri Dec 15 15:28:14 GMT 2023 , Edited by admin on Fri Dec 15 15:28:14 GMT 2023
PRIMARY RxNorm