Medication 7-812 - Rocuronium (Zemuron)

CMH EMS & MIH Protocols

Scope of Practice:

• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• IO, IV,

Pharmacodynamics (class and mechanism of action):

• Non-depolarizing paralytic. (Neuromuscular blockade. Binds to post-synaptic muscle receptor sites. Antagonizes acetylcholine at the motor end plate, producing skeletal muscle paralysis.)

Pharmacokinetics:

• Half-life: 66-80 minutes.
• Onset time: 1 minute.
• Peak action time:
• Adults: 1-3.7 minutes.
• Pediatrics: 0.5-1 minute.
• Duration of action:
• Adults: 31 minutes.
• Pediatrics: 26-40 minutes.

• Peak	3	6	9	12	15	18	21	24	27	30	33	36	minutes
  Duration	3	6	9	12	15	18	21	24	27	30	33	36	minutes

Dosing:

• Use IDEAL body weight for dosing, NOT actual body weight.
• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-044 - Airway: RSI.

Contraindications:

• Unable to ventilate the patient.
• Sensitivity to bromides.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• None.

Precautions and Adverse Effects:

• Calculate dose based on IDEAL body weight.
• Patient will be paralyzed and apneic for up to 30 minutes.
• Use caution with heart disease and liver disease.
• May cause muscle paralysis, apnea, Dyspnea, respiratory depression, Tachycardia, and/or uticaria.

Antidote:

• None.

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

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CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.