Drug Index

Cisatracurium

 
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Mechanism :

Cisatracurium Besylate binds to the nicotinic acetylcholine (cholinergic) receptors in the motor endplate and blocks access to the receptors. In the process of binding, the receptor is actually activated - causing a process known as depolarization. Since it is not degraded in the neuromuscular junction, the depolarized membrane remains depolarized and unresponsive to any other impulse, causing muscle paralysis.


Indication :

• Adjunct to general anaesthesia provide skeletal muscle relaxation.


Contraindications :

Hypersensitivity to cisatracurium (or benzyl alcohol if 10 mL vial is used).

RSI (due to intermediate onset).


Dosing :

Neuromuscular blockade:

1-24 months: 0.15 mg/kg IV over 5-10 seconds during halothane/opioid anaesthesia.

2-12 years: 0.1-0.15 mg/kg IV over 5-15 seconds during halothane/opioid anaesthesia.

IV infusion (During extended surgery):

<2 years: Safety and efficacy not established.

>2 years: 3 mcg/kg/min post IV bolus (for prevention of rapid spontaneous recovery of NM blockade), followed by 1-2 mcg/kg/min of maintenance dose (dose range of 0.5-10 mcg/kg/min).

Infusion rate to be decreased by 30-40% in case given during stable isoflurane or enflurane anaesthesia.


Adverse Effect :

Histamine release associated bradycardia and bronchospasm, flushing, hypotension, rash.


Interaction :

Aminoglycosides: May potentiate, prolong neuromuscular blockade.


08/11/2019 20:45:46 Cisatracurium
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