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Rocuronium

Rocuronium. New drug authorized to administer by DHS. BUT is limited to use in a successfully intubated patient. Rocuronium. Description: Neuromuscular blocking (paralyzing) agent Mechanism of action:

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Rocuronium

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  1. Rocuronium New drug authorized to administer by DHS. BUT is limited to use in a successfully intubated patient.

  2. Rocuronium Description: Neuromuscular blocking (paralyzing) agent Mechanism of action: Produces neuromuscular blockade by competing with acetylcholine for cholinergic receptors at the motor end plate. Half-life: Rocuronium has a biphasic distribution. The rapid distribution half-life is 1 to 2 minutes, and the slower distribution half-life is 14 to 18 minutes. Rocuronium has no effect on consciousness or pain threshold. Therefore, when rocuronium is used, adequate analgesia and sedation should be administered.

  3. Rocuronium Description: Neuromuscular blocking (paralyzing) agent Mechanism of action: Produces neuromuscular blockade by competing with acetylcholine for cholinergic receptors at the motor end plate. Half-life: Rocuronium has a biphasic distribution. The rapid distribution half-life is 1 to 2 minutes, and the slower distribution half-life is 14 to 18 minutes. Rocuronium has no effect on consciousness or pain threshold. Therefore, when rocuronium is used, adequate analgesia and sedation should be administered.

  4. Rocuronium • No effects on HR or BP • Reliable and controllable duration of action • Fast onset • Stable hemodynamics/no histamine release • Supplied: Solution as 10mg/cc vials of 50mg. Stable for 60 days at room temperature.

  5. Reversal Agent • It’s effects may be reversed by administering an anticholinesterase such as Prostigimine. Which increases the amount of acetylcholine at the receptors to compete with rocuronium. • But not in EMS scope of practice in AZ • Reversal of blockade virtually is never indicated following emergency airway management. • Atropine 0.01mg per kg IV is given to block excessive muscarinic stimulation (SLUDGE syndrome) • .

  6. Maintenance/Pain Management • Midalzolam 5mg/PRN • Morphine Same MS protocol for pain 2 mg initial dose 2-6 mg subsequent doses max. 20mg Remember: None of the previously reviewed medications: Etomidate, Succinylcholine, Versed, and Rocuronium are analgesics. Treat your patients pain!

  7. Midazolam (Versed) • Short-acting sedative hypnotic • Benzodiazepine • Water-soluble • CNS depressant and causes significant amnesia following administration • Has some muscle relaxant thus serves to calm and sedate patients, relax skeletal muscles, and, in high doses, causes sleep. • Midazolam DOES NOT have analgesic properties.

  8. Questions?

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