They act peripherally, not centrally and the site of action is neuromuscular junction, where these competitive blockers have affinity for the nicotinic (N2) cholinergic receptors at the muscle end-plate but have no intrinsic activity. Ach released from motor nerve endings is not able to combine with its receptors to generate end-plate potential. When the magnitude of EPP falls below a critical level, it is unable to trigger propagated muscle action potential and muscle fails to contract in response to nerve impulse.
Medium acting non-depolarising muscle relaxation in surgical anaesthesia.
Depressed respiration, Inadequate general anaesthesia. Obstetrics prior to delivery. Hypersensitivity.
Myasthenia gravis. Myopathy. Depolarising drugs, Pancuronium. Severe cardiovascular disease. Severe obesity. Renal insufficiency. Pregnancy, hypertension. Hepatic disease. Electrolyte disturbances.
Bronchospasm, flushing, hypotension.
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