Tracrium

Atracurium besylate

Adjunct to general anesth to enable tracheal intubation, to relax skeletal muscles during surgery or controlled ventilation & to facilitate mechanical ventilation in ICU patients.

IV Adult 0.3-0.6 mg/kg. Endotracheal intubation 0.5-0.6 mg/kg. Supplementary dose: 0.1-0.2 mg/kg as required. Infusion Neuromuscular block during long surgery Initially 0.3-0.6 mg/kg bolus inj by continuous infusion rates of 0.3-0.6 mg/kg/hr. Patient w/ CV disease Initial dose should be administered over a 60 sec period. ICU patient After an optional initial bolus dose of 0.3-0.6 mg/kg bolus inj used to maintain neuromuscular block by continuous infusion rates of 0.65-0.78 mg/kg/hr or 0.27-1.77 mg/kg/hr. Childn >1 mth Adult dose on body wt basis.

Hypersensitivity to atracurium, cisatracurium or benzenesulfonic acid.

History of increased sensitivity to histamines & other neuromuscular blocking agents. Myasthenia gravis, other neuromuscular disease & severe electrolyte imbalance; hypovolemia. Do not mix in the same syringe w/ thiopentone or any alkaline agent. Do not administer in the infusion line same as blood transfusion. Patients suffering from burns. Pregnancy & lactation.

Hypotension (mild, transient), skin flushing.

May increase neuromuscular block w/ inhalational anesth eg, halothane, isoflurane & enflurane. Increased magnitude &/or duration w/ antibiotics, including aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin & clindamycin; antiarrhythmics (propranolol, Ca channel blockers, lidocaine, procainamide & quinidine); diuretics (furosemide & possibly mannitol, thiazides & acetazolamide); Mg sulfate; ketamine; lithium salts; ganglion blocking agents (trimetaphan, hexamethonium). May aggravate or unmask latent myasthenia gravis or induce myasthenic syndrome w/ antibiotics, β-blockers (propranolol, oxprenolol), antiarrhythmics (procainamide, quinidine), anti-rheumatics (chloroquine, D-penicillamine), trimetaphan, chlorpromazine, steroids, phenytoin & lithium. Onset is likely to be lengthened & shortened the duration block in patients receiving chronic anti-convulsant therapy. Prolonged & complex block w/ suxamethonium. May shorten duration & diminish magnitude w/ donepezil.

Neuromuscular Blocking Agents

M03AC04 - atracurium ; Belongs to the class of other quaternary ammonium-containing agents used as peripherally-acting muscle relaxants.

Rx