Drugs that potentiate the effect of pancuronium:14
1. Anaesthetics: Halothane, ether, enflurane, isoflurane, methoxyflurane, thiopentone, methohexitone, ketamine and fentanyl.
2. Other drugs: neomycin, streptomycin, kanamycin, gentamicin, bacitracin, polymixins, tetracyclines, piperacillin, diazepam, propranolol, thiamine (high dose), intravenous lignocaine (high dose), magnesium sulfate, lithium carbonate, monoamine oxidase inhibitors (MAOIs), quinine, quinidine, protamine, diuretics, phenytoin, alpha-adrenergic blocking agents, beta-adrenergic blocking agents, calcium channel blockers, imidazoles, metronidazole and magnesium salts, magnesium ions and citrate anticoagulated blood
3. Drugs which are associated with a significant risk of hypokalaemia (e.g. amphotericin B, cisplatin, corticosteroids, loop diuretics, thiazide diuretics)
4. Suxamethonium—prior administration can potentiate the effect of pancuronium
Drugs that decrease the effect of pancuronium
1. Neostigmine, edrophonium, adrenaline (epinephrine), azathioprine, theophylline (high dose), potassium chloride, sodium chloride and calcium chloride
2. Hydrocortisone and prednisone can decrease the effect of pancuronium
Cardiac glycosides—pancuronium increases the risk of developing arrhythmias.
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