Rocuronium
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- Classification: Muscle Relaxers > NDMR (quaternary amines) > Aminosteroids (-curONium) > Rapid-onset -curonium (i.e. ROcuronium)
- Indications: facilitate endotracheal intubation, paralysis
- Contraindications: nerve monitoring (e.g. ENT, spinal cases), allergy (NDMR are a common cause of anaphylaxis in the OR 1:2500), RSI (relative), patient not sedated
- MOA: Competitive antagonist of ACh, only needs to block one of two ACh binding sites (between α1/δ, α1/γ or α1/ε), causes non-depolarizing paralysis.
- Target: N1 (muscle-type) nAChR at the NMJ
- Dose: 0.45-0.9 (normal induction), or 0.6-1.2 (RSI)
- Onset: 0.5-1.5 min
- Duration: 30-60 min (activators of CYP450 such as AEDs can markedly decrease duration of action)
- Clearance: Hepato-biliary (70%), Renal (10%)
- Reversal: Suggamadex (neostigmine)
- Other: Weak vagolytic effect