Pancuronium bromide

Pancuronium

Clinical data
AHFS/Drugs.com	Monograph
Pregnancy category	AU: B2 US: C (Risk not ruled out)
Routes of administration	Intravenous
ATC code	M03AC01 (WHO)
Legal status
Legal status	AU: S4 (Prescription only) UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability	NA
Protein binding	77 to 91%
Metabolism	Hepatic
Biological half-life	1.5 to 2.7 hours
Excretion	Renal and biliary
Identifiers
IUPAC name [(2S,3S,5S,8R,9S,10S,13S,14S,16S,17R)-17-Acetyloxy-10,13-dimethyl-2,16-bis(1-methyl-3,4,5,6-tetrahydro-2H-pyridin-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-3-yl] acetate
CAS Number	16974-53-1 Y
PubChem CID	441289
IUPHAR/BPS	4001
DrugBank	DB01337 Y
ChemSpider	25453 N
UNII	U9LY9Y75X2
KEGG	D00492 Y
ChEBI	CHEBI:7908 N
ChEMBL	CHEMBL185073 N
ECHA InfoCard	100.035.923
Chemical and physical data
Formula	C35H60N2O4
Molar mass	572.861 g/mol
InChI InChI=1S/C35H60N2O4.2BrH/c1-24(38)40-32-21-26-13-14-27-28(35(26,4)23-31(32)37(6)19-11-8-12-20-37)15-16-34(3)29(27)22-30(33(34)41-25(2)39)36(5)17-9-7-10-18-36;;/h26-33H,7-23H2,1-6H3;2*1H/q+2;;/p-2/t26-,27+,28-,29-,30-,31-,32-,33-,34-,35-;;/m0../s1 N Key:NPIJXCQZLFKBMV-YTGGZNJNSA-L N
NY (what is this?)

Pancuronium (trademarked as Pavulon) is a muscle relaxant with various medical uses. It is used in euthanasia and is the second of three drugs administered during most lethal injections in the United States.

Pancuronium is a typical non-depolarizing curare-mimetic muscle relaxant. It competitively inhibits the nicotinic acetylcholine receptor at the neuromuscular junction by blocking the binding of acetylcholine. It has slight vagolytic activity, causing an increase in heart rate, but no ganglioplegic (i.e., blocking ganglions) activity. It is a very potent muscle relaxant drug, with an ED95 (i.e., the dose that causes 95% depression of muscle twitch response) of only 60 µg/kg body weight. Onset of action is relatively slow compared to other similar drugs, in part due to its low dose - an intubating dose takes 3–6 minutes for full effect. Clinical effects (muscle activity lower than 25% of physiological) last for about 100 minutes. The time needed for full (over 90% muscle activity) recovery after single administration is about 120–180 minutes in healthy adults. The effects of pancuronium can be at least partially reversed by anticholinesterasics, such as neostigmine, pyridostigmine, and edrophonium.

Pancuronium is designed to mimic the action of two molecules of acetylcholine with the quaternary nitrogen atoms spaced rigidly apart by the steroid rings at a distance of ten atoms (interonium distance). Decamethonium and suxamethonium also have this same interonium distance.