Atracurium (Besylate)

The first drug that was found capable of blocking the skeletal neuromuscular junction was curare, which the native hunters of the Amazon in the South America used to paralyze prey. Atracurium is a skeletal muscle relaxant and structural analog of acetylcholine. Atracurium (Besylate) is iso-quinoline non-depolarizing competitive neuromuscular blocking agent. The neuromuscular blocking agents have significantly increased the safety of anesthesia , since less anesthetic is required to produce muscle relaxation.

Brands
ATRELAX ATRELAX ACURON ACURON TRACRIUM TRACRIUM ATRAMED ATRAMED RELAXTRON TRARIUM TRARIUM TRACUR TRACUR A-CARE CURIM EFACURIM EFACURIM
Adult Dose
Dose: 0.3 to 0.6 mg/ kg
Single Dose: 0.45 (0.45)
Frequency: As recommended.
Route: IV
Instructions: Initial Bolus Dose
Neonatal
Dose: 0.005 to 0.01 mg/kg.min
Single Dose: 0.0075 (0.0075)
Frequency: As recommended.
Route: Infusion
Instructions: Dose for children over 1 month
Paedriatic
Dose: 0.3 to 0.6 mg/kg
Single Dose: 0.45 (0.45)
Frequency: As recommended.
Route: Intra Venous
Instructions: As Required
Characteristics
. It is of Synthetic origin and belongs to Benzene Sulphonate. It belongs to Cholinergic nicotinic antagonist pharmacological group on the basis of mechanism of action and also classified in Muscle Relaxants and Neuromuscular Blocking Agent, Nondepolarizing pharmacological group.The Molecular Weight of Atracurium (Besylate) is 1243.40.
Contraindications
Atracurium (Besylate) is contraindicated in conditions like Hypersensitivity.
Effects
Atracurium (Besylate) produces potentially life-threatening effects which include Anaphylactic reactions. which are responsible for the discontinuation of Atracurium (Besylate) therapy.The signs and symptoms that are produced after the acute overdosage of Atracurium (Besylate) include Respiratory muscle paralysis.The symptomatic adverse reactions produced by Atracurium (Besylate) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Histamine release, Bradycardia, Wheezing, Reaction at injection site.
Indications
Atracurium (Besylate) is primarily indicated in conditions like Adjunct to anesthesia, Muscle relaxation, Muscle relaxation during intensive care, Muscle relaxation for surgery or intubation, Neuromuscular blockade.
Interactions
Atracurium (Besylate) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementActinomycin DAprotininCarbamazepineNeuromuscular blocking effect of Atracurium is reduced by carbamazepine.ModerateNeuromuscular blocking effect should be closely monitor. DesfluraneEnfluraneEnflurane may increases the effect of atracurium.ModerateAtracurium dosage must be reduced.Fentanyl (Citrate)GentamicinCoadministartoin results in severe respiratory depression by decreasing the release of acetylcholine at neuromuscular junction by interfering with calcium influx.MajorCoadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary. Coadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary. Coadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary.HalothaneHalothane may increases the effect of atracurium.ModerateAtracurium dosage must be reduced.IsofluraneLignocaineLincomycin (HCl)NeomycinCoadministartoin results in severe respiratory depression by decreasing the release of acetylcholine at neuromuscular junction by interfering with calcium influx.MajorCoadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary.Piperacillin (Na)Piperacillin may prolong the effect of atracurium.ModerateClose observation for respiratory depression and muscle weakness is recommended.Polymyxin B (Sulphate)Procainamide (HCl)QuinidineSevofluraneStreptomycinCoadministartoin results in severe respiratory depression by decreasing the release of acetylcholine at neuromuscular junction by interfering with calcium influx.MajorCoadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary. Coadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary.Sufentanil (Citrate)Suxamethonium (Cl)Tamoxifen (Citrate)Tetracycline (HCl)TobramycinCoadministartoin results in severe respiratory depression by decreasing the release of acetylcholine at neuromuscular junction by interfering with calcium influx.MajorCoadministration must be avoided. Vital signs should closely monitored and dose adjustment is necessary.Verapamil (HCl) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Pregnant Mothers, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store in refrigerator. Do not Freeze.
Warnings
Exercise special caution, especially when histamine release would be hazardous, especially in patients with significant cardiovascular diseases. Use atracurium with caution in patients with bronchial asthma.
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