Pharmacokinetics of ORG NG45 (Norcuron) in Patients with and without Renal Failure

Fahey, Mark R.; Morris, Robert B.; Miller, R. D.; Nguyen, Timothy; Upton, Robert A.

doi:10.1097/00132586-198210000-00003

Cited by 5 publications

(6 citation statements)

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“…Therefore, although changes in plasma vecuronium levels were noted between the two groups following deflation of the tourniquet, they were of insufficient magnitude to cause a significant difference between groups in the volume of distribution. Volume of distribution values for vecuronium vary widely between studies but the values generated in this investigation ( Table 3) are typically lower than previous reports, (8)(9)(10)(11) which range from 0.25 to 0.50 L / kg for Vss. This difference can be explained by the model-independent methodology we used to calculate the Vss value, which is a departure from the model-dependent methods used in other studies.…”

Section: Discussioncontrasting

confidence: 60%

Sequestration of vecuronium bromide during extremity surgery involving use of a pneumatic tourniquet

Barnette¹,

Eriksson²,

Cooney³

et al. 1997

Acta Anaesthesiol Scand

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Section: Discussioncontrasting

confidence: 60%

Sequestration of vecuronium bromide during extremity surgery involving use of a pneumatic tourniquet

Barnette¹,

Eriksson²,

Cooney³

et al. 1997

Acta Anaesthesiol Scand

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“…The subordinate role of renal function in vecuronium elimination is seen in the lack of significant differences in pharmacokinetics or time Course of neuromuscular effects after doses of 0.1 to 0.14 mg/kg in otherwise normal patients and patients with renal failure (Bencini et al 1986;Fahey et al 1981). This may explain the lack of accumulation or of cumulative pharmacodynamic effects after repeated administration of the drug to these patient groups (Buzello & N6ldge 1982;Hunter et al 1984;Khuenl-Brady et al 1991).…”

Section: Vecuroniummentioning

confidence: 99%

Clinical Pharmacokinetics of Neuromuscular Blocking Drugs

Ágoston

Vandenbrom

Wierda

1992

Clinical Pharmacokinetics

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Neuromuscular blocking agents provide muscle relaxation for a great variety of surgical procedures with light planes of general anaesthesia. Besides having a significant impact in the development of anaesthesia and surgery, these agents continue to play an important role as pharmacological tools in the elucidation of the physiological and pharmacological regulation of neuromuscular transmission and the morphofunctional organisation of the neuromuscular junction. In the daily practice of anaesthesia, muscle relaxants are considered to be safe drugs with predictable, straightforward pharmacological actions. However, the use of relaxants constitutes a deliberate encroachment on respiration, one of the most important physiological mechanisms. The pharmacokinetic behaviour of this class of agents is little influenced by age or anaesthetic agents; however, hepatic or renal disease may profoundly alter their excretion pattern, resulting in prolonged duration of neuromuscular blockade. Biotransformation plays an important role in the total elimination of recently introduced compounds. Consequently, knowledge of the disposition pharmacokinetics, excretion and biotransformation of this class of drugs is indispensable for their rational choice for various surgical procedures. In this review, the known pharmacokinetics of standard compounds (introduced before 1980) are briefly summarised and new information generated by the development of vecuronium, rocuronium, pipecuronium (steroidal agents) and atracurium, mivacurium, doxacurium (benzylisoquinolinium esters) is discussed in more detail.

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“…In pharmacokinetic studies of vecuronium, the first sample was drawn 1 min Lien et al 1991;Meiste1man et al 1986;), 2 min (Arden et al 1988;Lynam et al 1988), 4 min (Fahey et al 1981; Van der Veen & Bencini 1980) or even 5 min (Lebrault et al 1985(Lebrault et al , 1986 after bolus administration. This paucity of data points over the first 5 min and the lack of pharmacokinetic data during the first minute may lead to inaccurate extrapolations.…”

mentioning

confidence: 99%

“…Furthermore, most studies involved the measurement of peripheral venous concentrations (Arden et al 1988;Bencini et al 1986;Cronnely et al 1983;Fahey et al 1981;LebrauIt et al 1985LebrauIt et al , 1986Lynam et al 1988;Meistelman et al 1986;Rupp et al 1987;Sohn et al 1986; Van der Veen & Bencini 1980) which can be markedly lower than arterial concentrations (Chiou 1989;Donati et al 1991b). Since vecuronium block develops over 3 min, the first samples drawn 1 to 5 min after injection were obtained while block was well initiated, or even when it was complete.…”

mentioning

confidence: 99%

Importance of Early Blood Sampling on Vecuronium Pharmacokinetic and Pharmacodynamic Parameters

Ducharme

Bevan

Donati

1993

Clinical Pharmacokinetics

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The effect of early blood sampling on the description of the vecuronium pharmacokinetic-pharmacodynamic relationship was studied following a bolus injection. Sample collection every 10 sec during the first 2 min showed a high concentration peak at 30 to 40 sec, accounting for an important proportion of the total area under the plasma concentration-time curve (AUC). Neglecting it, using only blood samples drawn at 1 and 2 min (limited sampling), led to a significant overestimation of noncompartmentally derived values of mean residence time, clearance, volume of distribution at steady-state and rate of transfer of vecuronium into the effect compartment. Compartmental pharmacokinetics could not be applied to concentration-time curves constructed with early samples, but limited sampling data were fitted to a 2-compartment model. Derived compartmental pharmacokinetic and pharmacokinetic-pharmacodynamic parameters were similar to those obtained noncompartmentally with complete sampling every 10 sec, because back-extrapolation to time zero contributed to the increase in the AUC. However, compartmental analysis does not provide an accurate description of concentration changes following injection.

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Pharmacokinetics of ORG NG45 (Norcuron) in Patients with and without Renal Failure

Cited by 5 publications

References 0 publications

Sequestration of vecuronium bromide during extremity surgery involving use of a pneumatic tourniquet

Sequestration of vecuronium bromide during extremity surgery involving use of a pneumatic tourniquet

Clinical Pharmacokinetics of Neuromuscular Blocking Drugs

Importance of Early Blood Sampling on Vecuronium Pharmacokinetic and Pharmacodynamic Parameters

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