Rocuronium for Tracheal Intubation

Laura S. Willets, Pharm.D.

Disclosures

Pediatr Pharm. 2000;6(10) 

In This Article

Drug Interactions

Concurrent administration of inhalational anesthetics causes a nondepolarizing block and can potentiate the effects of rocuronium. This effect is often used therapeutically to allow a lower dose of the neuromuscular blocker. Aminoglycosides are also known to prolong skeletal muscle relaxation. Other antibiotics such as clindamycin, tetracycline and the polymyxins potentiate the blockade, but to a lesser extent. Potassium-wasting drugs such as thiazide and loop diuretics, amphotericin B, and corticosteroids may also prolong neuromuscular blockade. Other agents that may contribute to a longer duration of action for rocuronium include: calcium channel blockers, magnesium, beta-blockers, lithium, and procainamide.

Phenytoin and carbamazepine can antagonize the neuromuscular blockade produced by rocuronium. Sympathomimetic drugs, such as epinephrine, may also reverse neuromuscular blockade. Neostigmine and other acetylcholinesterase inhibitors are used to reverse the effects of nondepolarizing neuromuscular blockers when there is no further need for pharmacologic paralysis.[1,2,5]

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