同: Norcuron

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/09/18 21:16:42」(JST)

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Vecuronium (Norcuron) is a muscle relaxant in the category of non-depolarizing blocking agents. Vecuronium bromide is indicated as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Although vecuronium bromide is often thought of as a muscle relaxant, it may be more accurate to classify it as a paralyzing agent. It is commercially available as ampoules containing 4 or 10 mg of the drug in powder form which needs to be dissolved in distilled water prior to administration to the patient.

Development[edit source | edit]

Vecuronium's structure is derived from the same aminosteroid structure as pancuronium, but it is missing the methyl group on the piperidine nitrogen that is attached to the 'A' ring, making it monoquaternary, like D-tubocurarine. It has the same configuration at all ten stereocentres as pancuronium, and is a single-isomer preparation.

Clinical pharmacology[edit source | edit]

Vecuronium operates by competing for the cholinoceptors at the motor end plate thereby exerting its muscle-relaxing properties which are used adjunctively to general anesthesia. Under balanced anesthesia, the time to recovery to 25% of control (clinical duration) is approximately 25 to 40 minutes after injection and recovery is usually 95% complete approximately 45 to 65 minutes after injection of intubating dose. The neuromuscular blocking action of vecuronium is slightly enhanced in the presence of potent inhalation anesthetics. If vecuronium is first administered more than 5 minutes after the start of the inhalation of enflurane, isoflurane, or halothane, or when a steady state has been achieved, the intubating dose of vecuronium may be decreased by approximately 15%.

Vecuronium is an aminosteroid.

Media[edit source | edit]

In 2001, Japanese nurse Daisuke Mori was reported to have murdered 10 patients using vecuronium bromide.^[1] He was convicted of murder and was sentenced to life imprisonment.^[2]

References[edit source | edit]

^ "Japanese nurse kills 10 patients, says wanted to trouble hospital". The Indian Express. 2001-01-10. Retrieved 2008-03-22.
^ "Nurse gets life for patient slaying". The Japan Times Weekly. April 10, 2004. Retrieved October 26, 2011.

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1. 重症患者における神経筋遮断剤の使用 use of neuromuscular blocking medications in critically ill patients
2. 重症筋無力症患者に対する麻酔 anesthesia for the patient with myasthenia gravis
3. 眼の待機手術に対する麻酔 anesthesia for elective eye surgery
4. 小児における、アデノイド切除同時施行例を含む扁桃摘出に対する麻酔 anesthesia for tonsillectomy with or without adenoidectomy in children
5. 成人における選択的脊椎手術のための麻酔 anesthesia for elective spine surgery in adults

English Journal

Presynaptic muscarinic and adenosine receptors involved in 2 Hz-induced train-of-four fade caused by antinicotinic neuromuscular relaxants in the rat.

Pereira M, Bornia E, Correia-de-Sa P, Alves-Do-Prado W.SourceDepartment of Pharmacology and Therapeutic, State University of Maringa, Parana, Brazil. Laboratorio de Farmacologia e Neurobiologia / UMIB, Instituto de Ciencias Biomedicas de Abel Salazar Universidade do Porto, Porto, Portugal.
Clinical and experimental pharmacology & physiology.Clin Exp Pharmacol Physiol.2011 Aug 16. doi: 10.1111/j.1440-1681.2011.05588.x. [Epub ahead of print]
1. Train-of-four fade (TOF(fade) ) is a clinically useful parameter to monitor the degree of neuromuscular transmission block in curarized patients. Experimentally, TOF(fade) has been attributed to the blockade of facilitatory nicotinic receptors on motor nerve terminals. There is less information r
PMID 21848867

Allergy to rocuronium: from clinical suspicion to correct diagnosis.

Leysen J, Bridts CH, De Clerck LS, Vercauteren M, Lambert J, Weyler JJ, Stevens WJ, Ebo DG.SourceDepartment of Immunology, University of Antwerp, Antwerp, Belgium.
Allergy.Allergy.2011 Aug;66(8):1014-9. doi: 10.1111/j.1398-9995.2011.02569.x. Epub 2011 Mar 6.
BACKGROUND: Allergy to rocuronium can be life-threatening. Correct diagnosis is a prerequisite because of serious consequences of diagnostic error.OBJECTIVE: To assess skin testing, quantification of specific IgE (sIgE) and flow-assisted activation of basophils [basophil activation test (BAT)] in th
PMID 21375539

Japanese Journal

家兎摘出灌流肺におけるベクロニウムおよびパンクロニウムの肺循環への影響

舩木一美
米子医学雑誌 62(1), 21-30, 2011-01
NAID 40018707632

フェニトインの長期内服が筋弛緩薬に対する抵抗性の一因として疑われた精神発達遅滞の1症例

吉良慎一郎
麻酔 60(1), 80-83, 2011-01
NAID 40017424757

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リンク元	「薬理学」「ベクロニウム」
拡張検索	「vecuronium bromide」

「薬理学」

Vecuronium bromide
Systematic (IUPAC) name
	[(2S,3S,5S,8R,9S,10S,13S,14S,16S,17S)-; 17-acetyloxy-10,13-dimethyl-16-(1-methyl-3,4,; 5,6-tetrahydro-2H-pyridin-1-yl)-2-(1-piperidyl)-; 2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-; 1H-cyclopenta[a]phenanthren-3-yl] acetate
Clinical data
AHFS/Drugs.com	monograph
Pregnancy cat.	C (US)
Legal status	℞-only (US)
Routes	Intravenous
Pharmacokinetic data
Bioavailability	100% (IV)
Metabolism	liver 30%
Half-life	51–80 minutes (longer with renal failure)
Excretion	Fecal (40-75%) and renal (30% as unchanged drug and metabolites)
Identifiers
CAS number	50700-72-6
ATC code	M03AC03
PubChem	CID 39765
UNII	7E4PHP5N1D
ChEMBL	CHEMBL1201219
Chemical data
Formula	C34H57N2O4+
Mol. mass	557.827 g/mol
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英: pharmacology
関: drug entries

定義

生物系と化学物質の選択的な相互作用を研究する学問 (SPC.2)

生物系と薬の相互作用

薬の生物系に対する相互作用：薬理作用 <-化学の視点
生物系の薬に対する相互作用：薬物動態 <-生物の視点

薬品の命名

Ending of the drug name	Category	Example
～afil	Erectile dysfunction	sildenafil
～ane	Inhalatinal general anesthetic	halothane
～azepam	Benzodiaizepine	diazepam
～azine	Phenothiazine (neuroleptic, antiemetic)	chlorpromazine
～azole	Ailtifungal	ketoconazole
～barbital	Barbiturate	phenobarbital
～caine	Local anesthetic	lidocaine
～cillin	Penicillin	methicillin
～cycline	Antibiotic, protein syntlesis inhibitor	tetracycline
～ipramine	TCA	iimipramine
～navir	Protease inhibitor	saquinavir
～olol	β-antagonist	propranolol
～operidol	Butyrophenone ( neuroleptic )	haloperidol
～oxin	Cardiac glycoside ( inotropic agent )	digoxin
～phylline	Methylxanthine	theophylline
～pril	ACE inhibitor	captopril
～terol	β₂ agonist	albuterol
～tidine	H₂ antagonist	cimtidine
～triptyline	TCA	amitriptyline
～tropine	Pituitary hormone	somatotropine
～zosin	a₁ antagonist	prazosin

薬一覧

薬物代謝

薬理動態

神経伝達物質

貧血治療薬

甲状腺関連物質

甲状腺ホルモン製剤

レボチロキシン levothyroxine
リオチニシン liothyronine

抗甲状腺薬

痛風治療薬

痛風発作予防薬

コルヒチン colchicine

尿酸排泄促進薬

尿酸生成抑制薬

アロプリノール allopurinol

「ベクロニウム」

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英: vecuronium
化: 臭化ベクロニウム vecuronium bromide Vb
商: マスキュラックス
関: 筋弛緩薬

非脱分極性筋弛緩薬

「vecuronium bromide」

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臭化ベクロニウム

関: vecuronium

[1] "Japanese nurse kills 10 patients, says wanted to trouble hospital". The Indian Express. 2001-01-10. Retrieved 2008-03-22.

[2] "Nurse gets life for patient slaying". The Japan Times Weekly. April 10, 2004. Retrieved October 26, 2011.

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vecuronium