<unk>  operates by competing for the cholinoceptors at the motor end plate, thereby exerting its muscle-relaxing properties, which are used adjunctively to general anesthesia. Under balanced anesthesia, the time to recovery to 25% of control (clinical duration) is approximately 25 to 40 minutes after injection and recovery is usually 95% complete approximately 45 to 65 minutes after injection of an intubating dose. The neuromuscular blocking action of<unk>  is slightly enhanced in the presence of potent inhalation anesthetics. If<unk>  is first administered more than 5 minutes after the start of the inhalation of enflurane, isoflurane, or halothane, or when a steady state has been achieved, the intubating dose of<unk>  may be decreased by approximately 15%.<unk>  has an active metabolite, 3-desacetyl-vecuronium, that has 80% of the effect of<unk> . Accumulation of this metabolite, which is cleared by the kidneys, can prolong the duration of action of the drug, particularly when an infusion is used in a person with kidney failure. Reversal of<unk>  can be accomplished by administration of sugammadex which is a γ-cyclodextrin which encapsulates<unk>  preventing it from binding to receptors. Reversal can also be accomplished with neostigmine or other cholinesterase inhibitors, but their efficacy is lower than that of sugammadex.
Vecuronium bromide
Pancuronium bromide
Rocuronium bromide
Rapacuronium bromide
Alcuronium chloride
Suxamethonium chloride
Gantacurium chloride
Mivacurium chloride