Hydrocodone and acetaminophen and Pancuronium Bromide

• Generic Name: acetaminophen / hydrocodone
• Dosage Forms: n.a.
• Other Brand Names: Anexsia, Dolorex Forte, Hycet, Liquicet, Lorcet, Lortab, Maxidone, Norco, Polygesic, Stagesic, Vicodin, Xodol, Zamicet, Zydone, Verdrocet, Lortab 10/325, Lortab 5/325, Lortab 75/325, Lortab Elixir, Zyfrel

Hydrocodone and acetaminophen combination is used to relieve pain severe enough to require opioid treatment and when other pain medicines did not work well enough or cannot be tolerated.

Acetaminophen is used to relieve pain and reduce fever in patients. It does not become habit-forming when taken for a long time. But acetaminophen may cause other unwanted effects when taken in large doses, including liver damage.

Hydrocodone belongs to the group of medicines called narcotic analgesics (pain medicines). It acts on the central nervous system (CNS) to relieve pain, and stops or prevents cough.

When hydrocodone is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Hydrocodone and acetaminophen is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program.

• Generic Name: pancuronium
• Dosage Forms: n.a.
• Other Brand Names:

Production of skeletal muscle relaxation during surgery after general anesthesia has been induced.

Facilitation of endotracheal intubation; however, a neuromuscular blocking agent with a rapid onset of action (e.g., succinylcholine, rocuronium) generally preferred in emergency situations when rapid intubation is required.

Also used to facilitate mechanical ventilation in the ICU; however, manufacturer states insufficient data available to support dosage recommendations for such use. Whenever neuromuscular blocking agents are used in the ICU, consider benefits versus risks of such therapy and assess patients frequently to determine need for continued paralysis. (See Intensive Care Setting under Cautions.)

Compared with other neuromuscular blocking agents, pancuronium has a slow onset and long duration of action; therefore, not appropriate for emergency intubation but may be used for other indications (e.g., mechanical ventilation in the ICU) in which rapid onset and short duration of action are not as important.

Because of prominent vagolytic effects, generally should not be used in patients with preexisting tachycardia or in patients who cannot tolerate an increase in heart rate (e.g., those with cardiovascular disease).