What causes the cardiovascular effects observed with pancuronium? (Select 3)

The cardiovascular effects observed with pancuronium are primarily due to vagal blockade. Pancuronium is a neuromuscular blocker that can cause a competitive antagonism at the neuromuscular junction, but it also has some non-specific effects on the autonomic nervous system, including blockade of the vagus nerve. This leads to a reduced parasympathetic tone, which can result in an increase in heart rate and potentially other cardiovascular changes.

In addition to vagal blockade, pancuronium can affect cardiovascular function through other mechanisms that were not selected, such as its influence on catecholamine dynamics or the heart muscle itself. However, in this case, selecting only vagal blockade captures the main mechanism behind the cardiovascular effects noted with pancuronium.

Understanding that pancuronium does not stimulate cardiac muscarinic receptors, nor does it cause direct myocardial stimulation helps to clarify why these responses are not noted among the options. While some neuromuscular blockers can cause direct cardiovascular effects, pancuronium's primary concern lies with its vagolytic properties.