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Brand Name :
Arduan
(United States) [Available]Synonyms :
pipecurium, pipecuronium
Class :
Muscle relaxants
Brand Name :
Arduan
(United States) [Available]Synonyms :
pipecurium, pipecuronium
Class :
Muscle relaxants
Dosage forms and strengths Â
powder for injectionÂ
10 mg (single dose vial)Â
Indicated for Endotracheal intubation under balanced anesthesia
For individuals who are not obese and have appropriate renal function, the starting dosage is 70 to 85 mcg/kg intravenously, which provides 1-2 hours of clinical relaxation
Indicated for Recovery after endotracheal intubation with succinylcholine
The recommended dose is 50mcg/kg injection produces relaxation that lasts for around 45 minutes; Succinylcholine should not be administered before it
Maintenance dose:
for balanced anaesthesia, The recommended maintenance dose is 10 to 15mcg/kg intravenously offers relaxation for 50 minutes
Dosage forms and strengthsÂ
powder for injectionÂ
10 mg (single dose vial)Â
Inhalational And Balanced AnesthesiaÂ
For infants aged 3 months-1 year:
The recommended dose is 40mcg/kg intravenously offers relaxation in duration between 10-44 minutes
For children aged 1-14 years:
The recommended dose is 57mcg/kg intravenously offers relaxation in duration between 18-52 minutes
Refer adult dosingÂ
it may diminish the therapeutic efficacy when combined with castor oil
The potential for increased CNS depression risk or seriousness occurs when articaine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when asenapine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when benperidol is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when benzphetamine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when brivaracetam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when bromocriptine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when brompheniramine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when bupivacaine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when bupropion is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when butabarbital is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when carbamazepine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when cariprazine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when cetirizine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when chlorpheniramine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when chlorpromazine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when cisapride is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when cyclizine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when daridorexant is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when desflurane is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when desipramine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when dexbrompheniramine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when dextromethorphan is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when diazepam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when dihydroergotamine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when doxepin is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when ergometrine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when ergotamine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when estazolam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when fenfluramine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when flibanserin is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when flunitrazepam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when flurazepam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when gabapentin is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when glutethimide is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when halazepam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when halothane is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when imipramine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when ketamine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when ketazolam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when lamotrigine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when levobupivacaine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when levocetirizine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when lisuride is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when loxapine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when meclizine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when melatonin is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when mepivacaine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when methysergide is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when minaprine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when nitrazepam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when nitrous oxide is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when olanzapine is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when ondansetron is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when oxazepam is used together with pipecuronium
The potential for increased CNS depression risk or seriousness occurs when pentobarbital is used together with pipecuronium
Actions and Spectrum:Â
Action: pipecuronium competes with the nicotinic acetylcholine receptors on skeletal muscle’s motor end plate. When acetylcholine is usually released from nerve terminals, it binds to these receptors and triggers muscle contraction. pipecuronium competes with acetylcholine for binding to these receptors, preventing the standard transmission of nerve impulses. This results in muscle relaxation and paralysis.Â
Spectrum: pipecuronium, like other non-depolarizing neuromuscular blockers, has a relatively long duration of action and is often used for maintaining muscle relaxation during surgery or for prolonged mechanical ventilation in intensive care unitsÂ
Frequency not defined Â
Reduced cardiac outputÂ
BradycardiaÂ
Transient hypotensionÂ
Black Box Warning:Â Â
None
Contraindication/Caution:Â Â
Hypersensitivity: People with a history of allergy or hypersensitivity to the pipecuronium or any of its ingredients shouldn’t use it.Â
Certain Medical Conditions: pipecuronium should be used cautiously or avoided in patients with certain medical conditions, such as severe cardiovascular disease, severe respiratory disease, and conditions affecting neuromuscular transmission.Â
Renal or Hepatic Impairment: Patients with severe renal (kidney) or hepatic (liver) impairment may experience altered metabolism and elimination of pipecuronium, potentially leading to prolonged effects and increased risk of adverse reactions.Â
Neuromuscular Disorders: Individuals with certain neuromuscular disorders, other than myasthenia gravis, might be at increased risk of adverse reactions when using pipecuronium due to the underlying muscle pathology.Â
Pediatric Patients: The safety and efficacy of pipecuronium in pediatric patients, especially infants, might differ from those in adults. Special caution should be exercised when administering the medication to this population.Â
Pregnancy and Breastfeeding: The use of pipecuronium during pregnancy and breastfeeding should be carefully evaluated by a healthcare professional.Â
Pregnancy warnings:    Â
Pregnancy category: N/AÂ
Lactation: Excreted into human milk is unknownÂ
Pregnancy Categories:        Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology:Â Â
pipecuronium belongs to the non-depolarizing neuromuscular blocking agents, also known as neuromuscular blockers or muscle relaxants.Â
Pharmacodynamics:Â Â
pipecuronium, like other non-depolarizing neuromuscular blocking agents, competitively antagonizes the actions of acetylcholine at the neuromuscular junction. It binds to the nicotinic receptors on the motor end plate of skeletal muscle, preventing acetylcholine from binding and triggering muscle contraction.Â
Pharmacokinetics:Â
AbsorptionÂ
pipecuronium is typically administered intravenously, leading to rapid onset of action.Â
DistributionÂ
It has a moderate volume of distribution, with limited distribution to tissues due to its charged nature.Â
MetabolismÂ
In liver pipecuronium is primarily metabolized, with the ester bond being hydrolyzed by enzymes to produce inactive metabolites.Â
Excretion and EliminationÂ
The metabolites are primarily excreted through urine, and The drug elimination half-life is relatively long, which can lead to prolonged effects.Â
Administration: Â
pipecuronium is administered intravenously (IV)Â
Patient information leafletÂ
Generic Name: pipecuroniumÂ
Why do we use pipecuronium? Â
Anesthesia: pipecuronium is used as an adjunct to anesthesia during surgical procedures. It helps to achieve muscle relaxation, making intubation (insertion of a breathing tube) and surgery easier by preventing spontaneous muscle contractions.Â
Anesthesia Induction: pipecuronium is used as an adjunct to anesthesia induction during surgical procedures. It helps facilitate endotracheal intubation by providing muscle relaxation, allowing the anesthesiologist to control the airway and assist with ventilation.Â
Muscle Relaxation: pipecuronium is administered to achieve muscle relaxation during surgical procedures, particularly those requiring optimal muscle relaxation to perform surgeries in specific body areas, such as abdominal or orthopedic procedures.Â
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