1
Rocuronium (Zemuron)
Special Considerations
- Patients must be sedated completely and have an artificial airway during paralysis.
- Carefully monitor the patient and be prepared to resuscitate.
- [Rx] has no effect on consciousness or pain. [Rx] will not stop neuronal seizure activity or decrease central nervous system damage caused by seizures.
- Heart rate and cardiac output will be increased.
- [Rx] is excreted in the urine; doses should be decreased for patients with renal disease.
- Neuromuscular blocking agents result in respiratory paralysis. Therefore, intubation and ventilatory support must be readily available.
- Pregnancy Safety: Category C
2
Succinylcholine (Anectine)
Special Considerations
- Appropriate sedation and analgesia should be used in any patient before undergoing neuromuscular blockade.
- Time management is crucial.
- Postintubation sedation and analgesia should be readily available.
- Pregnancy Safety: Category C
3
Vecuronium (Norcuron)
Special considerations:
- Reconstituted [Rx], do not mix with alkaline solutions (e.g., barbiturate solutions such as thiopental) in the same syringe or administer simultaneously during intravenous infusion through the same needle or through the same intra- venous line.
- Pregnancy Safety: Category C
4
Ketamine (Ketalar)
Special Considerations
- Contraindicated for use during pregnancy.
- Use in caution in older patients due to a higher risk of renal and fatal GI adverse reactions.
- Pregnancy Safety: Category C