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

Details

Stereochemistry ABSOLUTE
Molecular Formula C35H60N2O4.2Br
Molecular Weight 732.67
Optical Activity UNSPECIFIED
Defined Stereocenters 10 / 10
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of PANCURONIUM BROMIDE

SMILES

[Br-].[Br-].[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=NPIJXCQZLFKBMV-YTGGZNJNSA-L
InChI=1S/C35H60N2O4.2BrH/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;2*1H/q+2;;/p-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
Arterial to end-tidal carbon dioxide difference during craniotomy in severely head-injured patients.
2001
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
Fast track anesthesia for liver transplantation reduces postoperative ventilation time but not intensive care unit stay.
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
Sustained firing of alpha and gamma hind limb motoneurons induced by stimulation of the pudendal nerve.
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
Comparison of a sidestream capnograph and a mainstream capnograph in mechanically ventilated dogs.
2002 Dec 1
Vasoactive modulators during and after craniotomy: relation to postoperative hypertension.
2002 Jul
Respiratory arrest in a child after flushing of pancuronium from the deadspace of intravenous cannula.
2002 Oct
Preemptive analgesia in rhegmatogenous retinal detachment surgery: is it effective?
2002 Oct
[Perioperative management for carotid endoarterectomy with induced mild hypothermia: a case report].
2002 Oct
Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data.
2002 Oct
Cost comparisons of pharmacological strategies in open-heart surgery.
2003
Selecting neuromuscular-blocking drugs for elderly patients.
2003
[Prolonged hyperthermia after isocarboxazid poisoning].
2003 Apr 28
Diverse range of fixed positional deformities and bone growth restraint provoked by flaccid paralysis in embryonic chicks.
2003 Aug
Anesthetic management for a hypertensive patent ductus arteriosus (PDA) closure in a patient with surgically uncorrectable long-segment right pulmonary artery hypoplasia and a ventricular septal defect.
2003 Dec
Characterization of human alpha 4 beta 2-nicotinic acetylcholine receptors stably and heterologously expressed in native nicotinic receptor-null SH-EP1 human epithelial cells.
2003 Dec
Effect of the respiratory-related bronchial rhythmic constriction on alveolar ventilation in the dog.
2003 Dec 16
Preoperative pulmonary assessment of the older adult.
2003 Feb
Efficacy and safety of remifentanil in coronary artery bypass graft surgery: a randomized, double-blind dose comparison study.
2003 Feb
No influence of the endothelin receptor antagonist bosentan on basal and indomethacin-induced reduction of cerebral blood flow in pigs.
2003 Feb
Mouse muscle denervation increases expression of an alpha7 nicotinic receptor with unusual pharmacology.
2003 Feb 15
Does pancuronium cause prolonged postoperative intubation in cardiac patients?
2003 Jan
Effect of neuromuscular blockade on energy expenditure in patients with severe head injury.
2003 Jan-Feb
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
[Application of muscle relaxants for rapid-sequence induction of anaesthesia].
2003 Jun
Effects of isoeugenol on in vitro neuromuscular blockade of rat phrenic nerve-diaphragm preparations.
2003 Jun
Screening procedure for eight quaternary nitrogen muscle relaxants in blood by high-performance liquid chromatography-electrospray ionization mass spectrometry.
2003 Jun 5
Gender differences in drug effects: implications for anesthesiologists.
2003 Mar
Prospective randomised double-blind comparative study of rocuronium and pancuronium in adult patients scheduled for elective 'fast-track' cardiac surgery involving hypothermic cardiopulmonary bypass.
2003 Mar
A combined stage 1 and 2 repair for hypoplastic left heart syndrome: anaesthetic considerations.
2003 May
A randomized trial of caudal block with bupivacaine 4 mg x kg-1 (1.8 ml x kg-1) plus morphine (150 microg x kg-1) vs general anaesthesia with fentanyl for cardiac surgery.
2003 May
[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
Potentiation of mivacurium blockade by low dose of pancuronium: a pharmacokinetic study.
2003 May
Recovery of neuromuscular function after cardiac surgery: pancuronium versus rocuronium.
2003 May
[Anesthetic management of a patient with suspected pseudothrombocytopenia].
2003 Oct
Endotracheal intubation with a lightwand or a laryngoscope results in similar hemodynamic variations in patients with coronary artery disease.
2003 Oct
The hemodynamic and metabolic effects of shivering during acute normovolemic hemodilution.
2003 Oct
Pancuronium bromide, a non-depolarizing muscle relaxant which promotes apoptosis of blood lymphocytes in vitro.
2003 Oct
Who--and how--to kill are focus of US death penalty cases. Questions about prisoners' mental competence and use of pancuronium bromide ignite recent controversy.
2003 Oct 18
Critics say execution drug may hide suffering.
2003 Oct 7
Postanesthesia care unit recovery times and neuromuscular blocking drugs: a prospective study of orthopedic surgical patients randomized to receive pancuronium or rocuronium.
2004 Jan
Electrophysiological evaluation of phrenic nerve injury during cardiac surgery--a prospective, controlled, clinical study.
2004 Jan 14
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 BROMIDE
EP   HSDB   INN   MART.   MI   ORANGE BOOK   USAN   USP   USP-RS   VANDF   WHO-DD  
USAN   INN  
Official Name English
PANCURONIUM BROMIDE [ORANGE BOOK]
Common Name English
VECURONIUM BROMIDE IMPURITY, PANCURONIUM BROMIDE- [USP IMPURITY]
Common Name English
ORG-NA 97
Code English
PANCURONIUM BROMIDE [VANDF]
Common Name English
PAVULON
Brand Name English
PANCURONIUM BROMIDE [USAN]
Common Name English
PANCURONIUM BROMIDE [USP-RS]
Common Name English
MIOBLOCK
Brand Name English
PANCURONIUM BROMIDE [HSDB]
Common Name English
BROMUREX
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)-, DIBROMIDE
Common Name English
1,1'-(3.ALPHA.,17.BETA.-DIHYDROXY-5.ALPHA.-ANDROSTAN-2.BETA.,16.BETA.-YLENE)BIS(1-METHYLPIPERIDINIUM)DIBROMIDE DIACETATE
Common Name English
ORG-NA-97
Code English
pancuronium bromide [INN]
Common Name English
2.BETA.,16.BETA.-DIPIPERIDINO-5.ALPHA.-ANDROSTANE-3.ALPHA.,17.BETA.-DIOL DIACETATE DIMETHOBROMIDE
Common Name English
Pancuronium bromide [WHO-DD]
Common Name English
NSC-293162
Code English
PANCURONIUM BROMIDE [JAN]
Common Name English
PANCURONIUM BROMIDE [EP MONOGRAPH]
Common Name English
ORG NA 97
Code English
PANCURONIUM BROMIDE [MI]
Common Name English
PANCURONIUM BROMIDE [USP MONOGRAPH]
Common Name English
PANCURONIUM BROMIDE [MART.]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C29696
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
Code System Code Type Description
EVMPD
SUB09603MIG
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
CHEBI
7908
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
ECHA (EC/EINECS)
239-532-5
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
CAS
15500-66-0
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
NSC
293162
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
FDA UNII
U9LY9Y75X2
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
DRUG BANK
DBSALT000368
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
HSDB
3244
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
EPA CompTox
DTXSID9023415
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
INN
2489
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
NCI_THESAURUS
C47651
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
PUBCHEM
27350
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
MERCK INDEX
m8379
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY Merck Index
RS_ITEM_NUM
1494217
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
DAILYMED
U9LY9Y75X2
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
SMS_ID
100000082786
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
ChEMBL
CHEMBL185073
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY
RXCUI
7884
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY RxNorm
WIKIPEDIA
PANCURONIUM BROMIDE
Created by admin on Fri Dec 15 15:18:49 GMT 2023 , Edited by admin on Fri Dec 15 15:18:49 GMT 2023
PRIMARY