Vecuronium

Vecuronium is a bis quaternary nitrogen compound that acts by competitively binding to nicotinic cholinergic receptors. It is a nondepolarizing neuromuscular blocking agent used to relax muscles or as an adjunct in general anesthesia during surgical procedures. The binding of vecuronium decreases the opportunity for acetylcholine to bind to the nicotinic receptor at the postjunctional membrane of the myoneural junction. As a result, depolarization is prevented, calcium ions are not released, and muscle contraction does not occur.

Common side effects of Vecuronium include: muscle weakness; redness or irritation at the injection site.
Serious side effects of Vecuronium include: hives; difficulty breathing; swelling in the face, lips, tongue, or throat; weak or shallow breathing; ongoing muscle weakness; loss of movement in any part of the body; dizziness, and fever.

Vecuronium is a short-acting non-depolarizing muscle relaxant structurally related to pancuronium, with a time to onset of action of 1.5 to 2.0 minutes after intravenous bolus infusion, with a duration of effect that lasts only 30 to 40 minutes. It has few cardiovascular side effects and is cleared rapidly by biliary excretion. Thus, it is safer than pancuronium in the presence of renal failure. Interference with excretion or potentiation of effect has been suggested when vecuronium is used in combination with metronidazole, aminoglycosides, and hydantoins. However, no problems have been observed in infants receiving these agents and vecuronium in its usual dosage. Acidosis can be expected to enhance the neuromuscular blockade provided by vecuronium and alkalosis to antagonize it.