Drug Index

Atracurium

 
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Mechanism :

Atracurium is a nondepolarizing skeletal muscle relaxant. Nondepolarizing agents antagonize the neurotransmitter action of acetylcholine by binding competitively with cholinergic receptor sites on the motor end-plate.


Indication :

• As an adjunct to general anaesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.


Contraindications :

Atracurium is contraindicated in patients known to have a hypersensitivity to it and in neonates. Its advantage is that, it does not require any dosage adjustment in renal or hepatic disease as it spontaneously degrades in the plasma.


Dosing :

1 month to 2 years: 0.3-0.4 mg/kg IV initially followed by maintenance dose of 0.3-0.4 mg/kg as and when needed to maintain neuromuscular blockade.

>2 years (same as adults): 0.4-0.5 mg/kg IV over 1 min, followed by 0.08-0.1 mg/kg 20-45 minutes after initial dose to maintain neuromuscular block. Repeat maintenance doses every 15-25 mins as and when required.


Adverse Effect :

Flushing, erythema, itching, wheezing, bronchial secretions, pruritus, urticaria and hives.


Interaction :

Enflurane; Isoflurane; Halothane; Certain Antibiotics, especially the Aminoglycosides and Polymyxins; Lithium; Magnesium Salts; Procainamide; and Quinidine: Enhance actions of atracurium.



Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in normal renal function
HDUnlikely to be dialysed. Dose as in normal renal function
HDF/High fluxUnknown dialysability. Dose as in normal renal function
CAV/VVHDUnlikely to be dialysed. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.
06/22/2020 03:26:48 Atracurium
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