Pancuronium

Pancuronium bromide is a long-acting, bis-quaternary aminosteroid, non-depolarizing, neuromuscular blocking drug (NMBD), which was first synthesized in 1964 and found to possess fewer adverse effects with regards to hemodynamic stability and histamine release as compared to the prototypical NMBD, d-tubocurarine. After the arrival of intermediate-acting NMBDs such as vecuronium, rocuronium, cisatracurium, and atracurium, the use of pancuronium has fallen out of favor with many clinicians due to its long elimination and context-sensitive half time and predominantly renal clearance. This activity outlines the indications, mechanism of action, methods of administration, significant adverse effects, contraindications, monitoring, and toxicity of pancuronium, so providers can direct patient therapy to optimal outcomes in anesthesia and other conditions where pancuronium has therapeutic benefit.