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Atracurium besilate
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Atracurium besilate
Atracurium besilate, also known as atracurium besylate, is a medication used in addition to other medications to provide skeletal muscle relaxation during surgery or mechanical ventilation. It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.
Common side effects include flushing of the skin and low blood pressure. Serious side effects may include allergic reactions; however, it has not been associated with malignant hyperthermia. Prolonged paralysis may occur in people with conditions like myasthenia gravis. It is unclear if use in pregnancy is safe for the baby. Atracurium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles.
Atracurium was approved for medical use in the United States in 1983. It is on the World Health Organization's List of Essential Medicines. Atracurium is available as a generic medication.
Atracurium is a medication used in addition to other medications in to provide skeletal muscle relaxation during surgery or mechanical ventilation. It can be used to help with endotracheal intubation but takes up to 2.5 minutes to result in appropriate intubating conditions.
Neuromuscular-blocking agents can be classified in accordance to their duration of pharmacological action, defined as follows:
The tetrahydroisoquinolinium class of neuromuscular blocking agents, in general, is associated with histamine release upon rapid administration of a bolus intravenous injection. There are some exceptions to this rule; cisatracurium (Nimbex), for example, is one such agent that does not elicit histamine release even up to 5×ED95 doses. The liberation of histamine is a dose-dependent phenomenon such that, with increasing doses administered at the same rate, there is a greater propensity for eliciting histamine release and its ensuing sequelae. Most commonly, the histamine release following administration of these agents is associated with observable cutaneous flushing (facial face and arms, commonly), hypotension and a consequent reflex tachycardia. These sequelae are very transient effects: the total duration of the cardiovascular effects is no more than one to two minutes, while the facial flush may take around 3–4 minutes to dissipate. Because these effects are so transient, there is no reason to administer adjunctive therapy to ameliorate either the cutaneous or the cardiovascular effects.
Bronchospasm has been reported on occasion with the use of atracurium. However, this particular undesirable effect does not appear to be observed nearly as often as that seen with rapacuronium, which led to the latter's withdrawal of approval for clinical use worldwide.
The issue of bronchospasm acquired prominence in the neuromuscular-blocking agents arena after the withdrawal from clinical use of rapacuronium (Raplon - a steroidal neuromuscular-blocking agent marketed by Organon) in 2001 after several serious events of bronchospasm, including five unexplained fatalities, following its administration. Bronchospasm was not an unknown phenomenon prior to rapacuronium: occasional reports of bronchospasm have been noted also with the prototypical agents, tubocurarine and succinylcholine, as well as alcuronium, pancuronium, vecuronium, and gallamine.
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Atracurium besilate
Atracurium besilate, also known as atracurium besylate, is a medication used in addition to other medications to provide skeletal muscle relaxation during surgery or mechanical ventilation. It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.
Common side effects include flushing of the skin and low blood pressure. Serious side effects may include allergic reactions; however, it has not been associated with malignant hyperthermia. Prolonged paralysis may occur in people with conditions like myasthenia gravis. It is unclear if use in pregnancy is safe for the baby. Atracurium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. It works by blocking the action of acetylcholine on skeletal muscles.
Atracurium was approved for medical use in the United States in 1983. It is on the World Health Organization's List of Essential Medicines. Atracurium is available as a generic medication.
Atracurium is a medication used in addition to other medications in to provide skeletal muscle relaxation during surgery or mechanical ventilation. It can be used to help with endotracheal intubation but takes up to 2.5 minutes to result in appropriate intubating conditions.
Neuromuscular-blocking agents can be classified in accordance to their duration of pharmacological action, defined as follows:
The tetrahydroisoquinolinium class of neuromuscular blocking agents, in general, is associated with histamine release upon rapid administration of a bolus intravenous injection. There are some exceptions to this rule; cisatracurium (Nimbex), for example, is one such agent that does not elicit histamine release even up to 5×ED95 doses. The liberation of histamine is a dose-dependent phenomenon such that, with increasing doses administered at the same rate, there is a greater propensity for eliciting histamine release and its ensuing sequelae. Most commonly, the histamine release following administration of these agents is associated with observable cutaneous flushing (facial face and arms, commonly), hypotension and a consequent reflex tachycardia. These sequelae are very transient effects: the total duration of the cardiovascular effects is no more than one to two minutes, while the facial flush may take around 3–4 minutes to dissipate. Because these effects are so transient, there is no reason to administer adjunctive therapy to ameliorate either the cutaneous or the cardiovascular effects.
Bronchospasm has been reported on occasion with the use of atracurium. However, this particular undesirable effect does not appear to be observed nearly as often as that seen with rapacuronium, which led to the latter's withdrawal of approval for clinical use worldwide.
The issue of bronchospasm acquired prominence in the neuromuscular-blocking agents arena after the withdrawal from clinical use of rapacuronium (Raplon - a steroidal neuromuscular-blocking agent marketed by Organon) in 2001 after several serious events of bronchospasm, including five unexplained fatalities, following its administration. Bronchospasm was not an unknown phenomenon prior to rapacuronium: occasional reports of bronchospasm have been noted also with the prototypical agents, tubocurarine and succinylcholine, as well as alcuronium, pancuronium, vecuronium, and gallamine.
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