Pancuronium bromide
Clinical data | |
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AHFS/Drugs.com | Monograph |
Pregnancy category |
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Routes of administration | Intravenous |
ATC code | |
Legal status | |
Legal status | |
Pharmacokinetic data | |
Bioavailability | NA |
Protein binding | 77 to 91% |
Metabolism | Hepatic |
Elimination half-life | 1.5 to 2.7 hours |
Excretion | Renal and biliary |
Identifiers | |
| |
ECHA InfoCard | 100.035.923 |
Chemical and physical data | |
Formula | C35H60N2O4 |
Molar mass | 572.875 g·mol−1 |
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Pancuronium (trademarked as Pavulon) is an aminosteroid muscle relaxant with various medical uses.[1] It is used in euthanasia and is used in some states as the second of three drugs administered during lethal injections in the United States.
Mechanism of action
Pancuronium is a typical
The effects of pancuronium can be at least partially reversed by anticholinesterasics, such as neostigmine, pyridostigmine, and edrophonium.
Development
Workers at Organon were inspired by the structure of the aminosteroid alkaloid malouetine to develop a series of aminosteroid neuromuscular blockers based on an androstane nucleus, culminating in the development of pancuronium bromide.[2][3][4]
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).
Uses in medicine
Pancuronium is used with
In Belgium and the Netherlands, pancuronium is recommended in the protocol for euthanasia. After administering sodium thiopental to induce coma, pancuronium is delivered in order to stop breathing.[5]
Uses in execution and suicide
Procedure
Pancuronium is also used as one component of a
Controversy
Like all non-depolarising muscle relaxants, pancuronium has no effect on level of consciousness. Therefore, if the
In 2007, Michael Munro, a Scottish
Amnesty International has objected to its use in lethal injections on the grounds that it "may mask the condemned prisoner's suffering during the execution,"[10] thereby leading observers to conclude that lethal injection is painless, or less cruel than other forms of execution.
Export limitations
The United Kingdom bans the export of pancuronium bromide to the United States due to its use in lethal injections, but not to the Netherlands or Belgium.[11]
Uses in crime
Pancuronium was used in Efren Saldivar's killing spree.[12] It was also used by the Skin Hunters to kill patients in the Polish city of Łódź. Pavulon was also used by Richard Angelo in 1987 to kill at least ten patients under his care at the Good Samaritan Hospital in New York.
References
- PMID 30855929.
- S2CID 2938040.
- PMID 4356139.
- S2CID 22476701.
- ^ "Administration and Compounding Of Euthanasic Agents". The Hague: Royal Dutch Society for the Advancement of Pharmacy. Archived from the original on 7 June 2008. Retrieved 15 July 2008 – via ERGO!.
- ^ "US court backs lethal injection". BBC News. 16 April 2008.
- ^ "Baby doctor cleared of misconduct". BBC News. 11 July 2007. Retrieved 2010-05-21.
- ^ "Doctor cleared over baby deaths". The Guardian. 11 July 2007.
- ^ "Doctor felt babies were suffering". BBC News. 9 July 2007. Retrieved 2010-05-21.
- ^ "UA 44/04 Death penalty". Amnesty International. 6 February 2004. Archived from the original on 17 May 2004.
- ^ "Provisions supplementing "the torture Regulation"". Article 4A of Export Control Order 2008, UK Statutory Instruments 2008 No. 3231 PART 2 Article 9. UK Legislation.
- ^ Ramsland K (9 April 2005). "Dark Rumors". Crimelibrary. Archived from the original on 9 April 2005.