A molecule of pipecuronium

Pipecuronium is not pronounced "pipe"-curonium, but rather "pip-eh"-curonium, like "pip" as in "pipsqueak" and "eh" as in "meh." Despite this pronuncitation, pipecuronium is not a pipsqueak, being the largest of the steroid structured NMB in terms of molecular weight and number of atoms (MW 602.891 and 105 atoms, not counting the bromide, beating out rapacuronium by just 1 atom and 5.000 g/mol molecular weight). It was FDA approved on June 26, 1990. It is classified as a non-depolarizing steroid structured long duration neuromuscular blocking agent. It's awesome, has less side effects than pancuronium, but people are still much more familiar with pancuronium and its effects, and pipecuronium is longer lasting than pancuronium. It's not really used in the US.

It's also got 4 nitrogens (even though it's bis-quaternary). Chemical formula is C35H62N4O4.