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Atracurium

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Farwa Shabbir

Atracurium is a non-depolarizing neuromuscular blocking agent used for intubation and muscle relaxation during surgery. It has a quaternary ammonium structure and acts by competitively binding to nicotinic receptors at the motor end plate. Atracurium has a moderately rapid onset and duration of action. It is metabolized rapidly by Hofmann elimination and ester hydrolysis in the liver and excreted in urine. Common side effects include hypotension, tachycardia, and potential allergic reactions.

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ATRACURIUM DR.FARWA SHABBIR HOUSE OFFICER ANAESTHESIOLOGY
ROAD MAP ? INTRODUCTION ? STRUCTURE ? MODE OF ACTION ? PHARMACOKINETICS ? METABOLISM AND EXCRETION ? DOSAGE ? INDICATIONS ? SIDE EFFECTS
INTRODUCTION non-depolarizing Neuro-muscular blocking agent Metabolism Rapid Onset Moderately Rapid Duration Moderately Rapid Histamine release slow Vagal Blockade None
STRUCTURE ? Quaternary Ammonium compound ? benzylisoquinoline structure
PHARMACOKINETICS ? Bioavailability: poorly absorbed from the GI tract ? Half-life: approximately 20 minutes ? Distribution: into extracellular fluid, minimally crosses the placenta ? Elimination Route: excreted principally in urine and also in feces via biliary elimination
MODE OF ACTION
Atracurium
MODE OF REVERSAL
METABOLISM AND EXCRETION Ester Hydrolysis This action is catalyzed by nonspecific esterases Hofmann Elimination A spontaneous non-enzymatic chemical breakdown occurs at physiological pH and temperature.
DOSAGE AND ADMINISTRATION ? A dose of 0.5 mg/kg is administered intravenously for intubation ? incremental doses of 0.1 mg/kg every 10C20 min after administration of succinylcholine ? An infusion of 5C10 mcg/kg/min can effectively replace intermittent boluses
INDICATIONS Endotracheal Intubation Mechanical Ventilation Skeletal muscle relaxation during surgery
CONTRAINDICATIONS No documented contraindications except in such conditions; ?Allergy ?Myasthenia Gravis ?Asthma
CLINICAL SIDE EFFECTS Hypotension and Tachycardia Bronchospasm Laudanosine Toxicity Temperature and pH Sensitivity Chemical Incompatibility Allergic Reactions
Atracurium

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