Tubocurarine (Cl)

Tubocurarine is an alkaloid isolated from the bark and stems of Chondodendron tomentosum. The drug tubocurarine was introduced into clinical practice in the early 1940s. Tubocurarine is a skeletal muscle relaxant and structural analogue of acetylcholine. Tubocurarine (Cl) is a non-depolarizing competitive neuromuscular blocking agent. It blocks passage of impulses at the neuromuscular junction. Tubocurarine (Cl) is administered intravenously. The neuromuscular blocking agents have significantly increased the safety of anesthesia ,since less anesthetic is required to produce muscle relaxation.

Brands
Adult Dose
Dose: 0.1 to 0.3 mg/kg
Single Dose: 0.2 (0.2)
Frequency: As recommended.
Route: Slow IV
Instructions: As Required
Neonatal
Dose: 0.3 to 0.5 mg/kg
Single Dose: 0.4 (0.4)
Frequency: As recommended.
Route: Intra Venous
Instructions: As Required
Paedriatic
Dose: 0.3 to 0.5 mg/kg
Single Dose: 0.4 (0.4)
Frequency: As recommended.
Route: Intra Venous
Instructions: As Required
Characteristics
belongs to Tubocuranium. It belongs to Cholinergic nicotinic antagonist pharmacological group on the basis of mechanism of action and also classified in Muscle Relaxants pharmacological group.The Molecular Weight of Tubocurarine (Cl) is 681.70. Its pKa is 8.0.
Contraindications
Tubocurarine (Cl) is contraindicated in conditions like Hypovolaemia,Myasthenia gravis,Renal failure,Malignant hyperthermia.
Effects
The severe or irreversible adverse effects of Tubocurarine (Cl), which give rise to further complications include Anaphylactoid reactions.Tubocurarine (Cl) produces potentially life-threatening effects which include Apnea, Cardiovascular collapse, Ganglionic blockage, Postoperative respiratory failure. which are responsible for the discontinuation of Tubocurarine (Cl) therapy.The symptomatic adverse reactions produced by Tubocurarine (Cl) are more or less tolerable and if they become severe, they can be treated symptomatically, these include Urticaria, Erythema, Itching, Hypotension, Bronchospasm.
Indications
Tubocurarine (Cl) is primarily indicated in conditions like Myasthenia gravis diagnosis, Surgical muscle relaxant, and can also be given in adjunctive therapy as an alternative drug of choice in Surgical anaesthesia.
Interactions
Tubocurarine (Cl) is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementBendrofluazideChlorothiazideChlorthalidoneEthacrynic AcidFlunarizine (HCl)Frusemide or FurosemideHalothaneHalothane potentiate the effect of tubocurarine.ModerateDose of tubocurarine should be reduced. Halothane should be administer only by specially trained health care providers.HydrochlorothiazideHydroflumethiazideLithiumLithium exacerbate the pharmacological effects of tubocurarineresults in prolonged apnea and delayed recovery from anesthesia.ModerateClosely monitor for respiratory depression and life support should be readily available in case of emergencyMagnesium Oxides and HydroxidesMagnesium SulphateNeomycinPolythiazideTobramycinBoth are neuromuscular blocking agents so, concomitant use result in severe or prolonged respiratory depression.MajorClosely monitor the vital signs and adjust the dose of drugs accordingly. Ventilatory support should be readily available in case of respiratory arrest. 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 Paediatrics, Pregnant Mothers, Geriatrics, 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
IV Inj, IM Inj Store at room temperature. Do not Freeze.
Warnings
Tubocurarine should be used with caution in patients with respiratory depression, impaired cardiovascular, kidney or liver or endocrine function.
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