Generic Name:

Rocuronium

Trade Name:

Zemuron

Actions:

Non-Depolarizing Neuromuscular Blocking Agent

Indications:

- Adjunct to general anesthesia- provide neuromuscular blockade during surgery and during mechanical ventilation in the ICU

- Rapid sequence intubation

- Facilitate tracheal intubation

Administration Guidelines:

Intubation:

For continuous infusion:

Usual Dose and Route:

0.6 to 1 mg/kg IVP

Initial: Bolus of 0.6 to 1 mg/kg

Maintenance: 4 to 12 mcg/kg/min. Dose may vary according to response.

**Obese: use actual body weight**

Standard Concentration:

500mg/100ml (5mg/mL), 100mg/100ml (1mg/mL)

Microinfusion: central line preferred

500mg/50ml syringe

Special Considerations:

- Paralytic therapy should be started only after adequate sedation therapy has been initiated.

-Ongoing sedation should be maintained and evaluated periodically.

-Neuromuscular function should be monitored with a peripheral nerve-stimulator during administration and dose adjusted accordingly.

-Adequate level of paralysis is generally considered to be 1-2 out of 4 on the train of four with a peripheral nerve stimulator

-Rocuronium has no effect on pain threshold.

-Use with caution in the elderly; effects and duration are more variable.

-Use with caution in patients with hepatic or renal impairment; effects and duration are more variable.

-Reduce dose in patients with neuromuscular disease (e.g. myasthenia gravis).

-Acid-base and/or serum electrolyte abnormalities may potentiate or antagonize the action (increase pH, decrease T1/2; decreased pH, increase T1/2).

-Burn patients and patients with hemiparisis/paraparesis may develop resistance

-Store vials in refrigerator

-Diluted infusions should be used within 24 hrs of mixing at room temperature; unused portions should be discarded

Precautions/Side Effects:

Adverse reactions; cardiac dysarrythmia, hypertension and hypotension, tachyarrhythmia, anaphylaxis, bronchospasm

Drug Delivery Rate (mcg/kg/min)

4

5

6

7

8

9

10

11

12

Weight (KG)

Infusion Rate (mL/hr)

40

1.0

1.2

1.4

1.7

1.9

2.2

2.4

2.6

2.9

45

1.1

1.4

1.6

1.9

2.2

2.4

2.7

3.0

3.2

50

1.2

1.5

1.8

2.1

2.4

2.7

3.0

3.3

3.6

55

1.3

1.7

2.0

2.3

2.6

3.0

3.3

3.6

4.0

60

1.4

1.8

2.2

2.5

2.9

3.2

3.6

4.0

4.3

65

1.6

2.0

2.3

2.7

3.1

3.5

3.9

4.3

4.7

70

1.7

2.1

2.5

2.9

3.4

3.8

4.2

4.6

5.0

75

1.8

2.3

2.7

3.2

3.6

4.1

4.5

5.0

5.4

80

1.9

2.4

2.9

3.4

3.8

4.3

4.8

5.3

5.8

85

2.0

2.6

3.1

3.6

4.1

4.6

5.1

5.6

6.1

90

2.2

2.7

3.2

3.8

4.3

4.9

5.4

5.9

6.5

95

2.3

2.9

3.4

4.0

4.6

5.1

5.7

6.3

6.8

100

2.4

3.0

3.6

4.2

4.8

5.4

6.0

6.6

7.2

105

2.5

3.2

3.8

4.4

5.0

5.7

6.3

6.9

7.6

110

2.6

3.3

4.0

4.6

5.3

5.9

6.6

7.3

7.9

115

2.8

3.5

4.1

4.8

5.5

6.2

6.9

7.6

8.3

120

2.9

3.6

4.3

5.0

5.8

6.5

7.2

7.9

8.6

125

3.0

3.8

4.5

5.3

6.0

6.8

7.5

8.3

9.0

130

3.1

3.9

4.7

5.5

6.2

7.0

7.8

8.6

9.4

135

3.2

4.1

4.9

5.7

6.5

7.3

8.1

8.9

9.7

140

3.4

4.2

5.0

5.9

6.7

7.6

8.4

9.2

10.1

145

3.5

4.4

5.2

6.1

7.0

7.8

8.7

9.6

10.4

150

3.6

4.5

5.4

6.3

7.2

8.1

9.0

9.9

10.8