Re: Ineffective Norcuron

[James.J.Misuraca@Hitchcock.ORG (James J. Misuraca)]

As Larry noted the Norcuron can be sensative to its enviorment. In storage, in
its dry state, it should be relatively stable. Never the less our outdoor
enviorment is more variable than the in-house enviorment. I have also had
isolated situations were Norcuron did not produce complete NMB and have
wondered about the summer enviorments' effect on our stored  meds. 

Was this individual being treated with other anti-convulsants (ie Dilantin,
Phenobarbitol etc...)? Individuals recieving chronic anti-siezure drugs may
have raised hepatic enzymes and may be resistant to many of the drugs we give
for sedation. In the PICU we occasionally had cases where children on chronic
siezure medication were resistant to sedation and NMB. 

Versed, due to its rapid onset and short half life have been known to stimulate
siezure activity when used in bolus form. 

Just a couple of thoughts,

Jim Misuraca, RN CCRN
DHART

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