User:Mr. Ibrahem/Rocuronium

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Mr. Ibrahem/Rocuronium
Clinical data
Trade namesZemuron, Esmeron, others
Other namesRocuronium bromide, [3-hydroxy-10,13-dimethyl-2-morpholin-4-yl-16-(1-prop-2-enyl-2,3,4,5-tetrahydropyrrol-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl] acetate
AHFS/Drugs.comMonograph
Pregnancy
category
  • C
Routes of
administration		Intravenous
Drug classNeuromuscular blocker
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: ℞-only
Pharmacokinetic data
BioavailabilityNA
Protein binding~30%
MetabolismSome de-acetylation
Onset of action60 secs[1]
Elimination half-life66–80 minutes
Duration of action25 to 90 mins[1][2]
ExcretionUnchanged, in bile and urine
Identifiers
  • 1-((2S,3S,5S,8R,9S,10S,13S,14S,16S,17R)-17-acetoxy-3-hydroxy-10,13-dimethyl-2-morpholinohexadecahydro-1H-cyclopenta[a]phenanthren-16-yl)-1-allylpyrrolidinium bromide
Chemical and physical data
FormulaC32H53BrN2O4
Molar mass609.690 g·mol−1
3D model (JSmol)
  • CC(=O)O[C@H]1[C@H](C[C@@H]2[C@@]1(CC[C@H]3[C@H]2CC[C@@H]4[C@@]3(C[C@@H]([C@H](C4)O)N5CCOCC5)C)C)[N+]6(CCCC6)CC=C.[Br-]
  • InChI=1S/C32H53N2O4.BrH/c1-5-14-34(15-6-7-16-34)28-20-26-24-9-8-23-19-29(36)27(33-12-17-37-18-13-33)21-32(23,4)25(24)10-11-31(26,3)30(28)38-22(2)35;/h5,23-30,36H,1,6-21H2,2-4H3;1H/q+1;/p-1/t23-,24+,25-,26-,27-,28-,29-,30-,31-,32-;/m0./s1 ☒N
  • Key:OYTJKRAYGYRUJK-FMCCZJBLSA-M ☒N
 ☒NcheckY (what is this?)  (verify)

Rocuronium, sold under a number of brands, is a medication used to paralyze muscles for endotracheal intubation, including rapid sequence induction (RSI).[3][4] It may also be used to relax muscles during surgery and when people are on a ventilator.[3] It is given by injection into a vein.[3] A single dose begins working after about 45 to 120 seconds and lasts for 25 to 90 minutes.[1][2]

Common side effects include low blood pressure and high blood pressure.[3] Other serious side effects may include anaphylaxis and prolonged muscle weakness.[3][5] While not well studied in pregnancy, no harms have been found.[6] Breastfeeding shortly following use is likely okay.[7] Rocuronium is a neuromuscular blocker of the non-depolarizing type.[8]

Rocuronium was approved for medical use in the United States in 1994.[3] It is avaliable as a generic medication.[9][10] In the United States it costs about 40 USD for 500 mg as of 2020.[11] In the United Kingdom this amount costs the NHS about 25 pounds.[10] Rocuronium is stable at room temperature for about 12 weeks.[2]

References[edit]

  1. ^ a b c d "Rapid sequence intubation - WikEM". wikem.org. Archived from the original on 3 August 2020. Retrieved 19 August 2020.
  2. ^ a b c "Succinylcholine vs. Rocuronium: Battle of the RSI Paralytics". JEMS. 14 May 2019. Archived from the original on 24 September 2020. Retrieved 28 September 2020.
  3. ^ a b c d e f "Rocuronium Bromide Monograph for Professionals". Drugs.com. Archived from the original on 26 June 2019. Retrieved 19 August 2020.
  4. ^ Tran, DT; Newton, EK; Mount, VA; Lee, JS; Wells, GA; Perry, JJ (29 October 2015). "Rocuronium versus succinylcholine for rapid sequence induction intubation". The Cochrane Database of Systematic Reviews. 10 (10): CD002788. doi:10.1002/14651858.CD002788.pub3. PMC 7104695. PMID 26512948.
  5. ^ Jain, Ankit; Wermuth, Harrison R.; Maani, Christopher V. (2020). "Rocuronium". StatPearls. StatPearls Publishing. Archived from the original on 29 August 2021. Retrieved 19 August 2020.
  6. ^ "Rocuronium (Zemuron) Use During Pregnancy". Drugs.com. Archived from the original on 3 December 2020. Retrieved 19 August 2020.
  7. ^ "Rocuronium". Drugs and Lactation Database (LactMed). National Library of Medicine (US). 2006. Archived from the original on 30 November 2020. Retrieved 19 August 2020.
  8. ^ "Rocuronium - WikEM". wikem.org. Archived from the original on 4 October 2017. Retrieved 19 August 2020.
  9. ^ "Rocuronium (Zemuron) | Davis's Drug Guide". nursing.unboundmedicine.com. Archived from the original on 13 August 2020. Retrieved 19 August 2020.
  10. ^ a b BNF 79. London: Pharmaceutical Press. March 2020. p. 1379. ISBN 978-0857113658.
  11. ^ "Rocuronium Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 10 November 2019. Retrieved 19 August 2020.
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