Rocuronium

Mechanism :

Blocks acetylcholine from binding to receptors on motor endplate inhibiting depolarization.

Indication :

Neuromuscular blockade for endotracheal intubation, surgery, or mechanical ventilation.

Contraindications :

Hypersensitivity to rocuronium, other neuromuscular-blocking agents, or any component of the formulation.

Dosing :

Tracheal intubation:

0.45 mg/kg or 0.6 mg/kg IV.

Maintenance for continued surgical relaxation:

0.075 to 0.15 mg/kg IV; redose at 7 to 12 mcg/kg/minute (0.42 to 0.72 mg/kg/hour) as a continuous infusion.

Rapid sequence intubation (off-label use):

0.9 mg/kg or 1.2 mg/kg IV.

Adverse Effect :

Increased peripheral vascular resistance, tachycardia, hypertension, transient hypotension, anaphylaxis.

Interaction :

Acetylcholinesterase Inhibitors: May diminish the neuromuscular-blocking effect of non-depolarizing Neuromuscular-Blocking Agents.
Aminoglycosides: May enhance the respiratory depressant effect of Neuromuscular-Blocking Agents.
Calcium Channel Blockers: May enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents.
Cardiac Glycosides: Neuromuscular-Blocking Agents may enhance the arrhythmogenic effect of Cardiac Glycosides.
Inhalational Anaesthetics: May enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents.

Hepatic Dose :

Dose adjustment guidelines are not available, however dose reduction may be necessary in the setting of hepatic impairment, as prolonged clinical effect may be seen.