ATRACURIUM

 ATRACURIUM

BRAND NAME:- TRACRIUM 10mg /ml inj in 2ml vial.

PHARMACODYNAMIC:-

ATRACURIUM is a skeletal muscle relaxant & neuromuscular blocking agent. It is an intermediate action. That act peripherally at neuromuscular junction/muscle fibres itself or centrally in the cerebrospinal axis to reduce muscle tone and/ or cause paralysis. The neuromuscular blocking agents are used primarily in conjunction with general anaesthetics to provide muscle relaxation for surgery, while centrally acting muscle relaxant are used mainly for painful muscle spasms and spastic neurological conditions.

Atracurium  belongs to a group of medicines called muscle relaxants. It is used along with general anesthesia or sedatives to provide skeletal muscle relaxation during surgical procedures. It is also used to facilitate emergency airway management in patients in intensive care.

MECHANISM OF ACTION:-

Atracurium antagonizes the neurotransmitter action of acetylcholine by binding competitively with cholinergic receptor sites on the motor end-plate. This antagonism is inhibited, and neuromuscular block reversed, by acetylcholinesterase inhibitors such as neostigmine, edrophonium, and pyridostigmine. 

USED:-Skeletal muscle relaxation during surgery.

For use, as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

SIDE EFFECTS:-Skin flush, erythema, pruritus, urticaria, wheezing, increased bronchial secretions, bronchospasm, cyanosis, angioedema, CV effects (e.g. bradycardia); wheals and erythema at inj site.

Potentially Fatal: Anaphylaxis.

• Erythema (skin redness)
• Injection site reactions (pain, swelling, redness)

DOSES:-

Intravenous

Endotracheal intubation, Facilitate mechanical ventilation in intensive care, Muscle relaxant in general anaesthesia

Adult: Initially, 300-600 mcg/kg as bolus inj, w/ subsequent doses of 100-200 mcg/kg by inj every 15-25 min or 5-10 mcg/kg/min by infusion in prolonged procedures. Higher infusion rate may be used in patients undergoing controlled ventilation in intensive care.

Child: >1 mth Same as adult dose.

PRECAUTIONS:-

Patient w/ CV disease, burn injury, asthma; conditions which may antagonise neuromuscular blockade (e.g. resp alkalosis, hypercalcaemia, demyelinating lesions, peripheral neuropathies, denervation, muscle trauma); conditions which may potentiate neuromuscular blockade (e.g. electrolyte abnormalities, neuromuscular diseases, metabolic acidosis, resp acidosis, Eaton-Lambert syndrome, myasthenia gravis). Pregnancy and lactation. 

:In national essential medicine (2011), INDIA(I)

: including in WHO model list of essential medicine March 2011(WHO