Atracurium Besylate
Muscle Relaxant · Non-depolarising muscle relaxant
Indications
A muscle relaxant for a wide range of procedures and to facilitate controlled ventilation. For endotracheal intubation where subsequent muscle relaxation is required.
Dosage
Adults: IV: 0.3-0.6 mg/kg depending on the duration of full block required. This dosage provides relaxation for 15-35 min. Full block can be prolonged with supplementary doses of 0.1-0.2 mg/kg as required. Endotracheal intubation can usually be accomplished within 90 sec from the IV inj of 0.5-0.6 mg/kg. As an infusion: After an initial bolus dose of 0.3-0.6 mg/kg neuromuscular block can be maintained by administration as a continuous infusion at rates of 0.3-0.6 mg/kg/hr. Children: Not recommended for neonates. To avoid excessive dosage in obese children, dose should be calculated on the basis of ideal weight. Neuromuscular blockade (short to intermediate duration) for surgery: Neonate, initially by IV injection 300-500 mcg/kg followed either by IV injection, 100-200 mcg/kg repeated as necessary or by IV infusion, 300-400 mcg/kg/hr adjusted according to response; 1 mth-18 yr, initially…
Administration
IV: May be given undiluted as a bolus injection. Administration via infusion requires the use of an infusion pump. Use infusion solutions within 24 hours of preparation. Compatibility: Stable in D5W, NS, D5NS; incompatible with LR. At Y-site administration, incompatible with diazepam, propofol, thiopental. Stability: Refrigerate; unstable in alkaline solution.
Adverse Effects
Cutaneous flushing, rash, bradycardia, hypotension, bronchospasm, dyspnoea, erythema, increased bronchial secretions, inj site reaction, laryngospasm, pruritus, seizure, tachycardia, urticaria, wheezing.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Atracurium besylate hypersensitivity. Precautions: Should be administered only with adequate general anaesthesia and under the close supervision of an experienced anaesthetist and with adequate facilities for endotracheal intubation and artificial ventilation.
Interactions
Anticholinesterases, thiazide diuretics.
Advice to Patient
Before administration, patient is usually unconscious. Continuous monitoring is required during and after administration. After muscle tone becomes normal, do not change position and rise up without help. Contact prescriber if there is difficulty in breathing, muscle tremors, fast heartbeat, skin rash, hives.
Pharmacokinetics
Onset of action (dose dependent): 2 to 3 minutes; Peak effect: 3 to 5 minutes. Duration: Recovery begins in 20 to 35 minutes following initial dose of 0.4 to 0.5 mg/kg under balanced anesthesia; recovery to 95% of control takes 60 to 70 minutes. Metabolism: Undergoes ester hydrolysis and Hofmann elimination (nonbiologic process independent of renal, hepatic, or enzymatic function); Laudanosine is hepatically metabolized. Half-life elimination: Infants: 20 minutes. Children: 17 minutes. Adults: Biphasic: Initial(distribution): 2 minutes; Terminal: 20 minutes. Excretion: Urine (<5%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.