Atravell

Atracurium besilate

Endotracheal intubation & muscle relaxation in general anaesth for surgical procedures; aid controlled ventilation.

Adult IV 0.3-0.6 mg/kg (depending on the duration of full block required) & will provide relaxation for about 15-35 min. Endotracheal intubation 0.5-0.6 mg/kg (accomplished w/in 90 sec). Infusion Adult Neuromuscular block maintenance during long surgical procedures After an initial bolus dose of 0.3-0.6 mg/kg, administer as a continuous infusion at rates 0.3-0.6 mg/kg/hr. Childn >1 mth Adult dose on a body wt basis. Patient w/ CV disease Administer initial dose over a period of 60 sec. ICU patient Neuromuscular block maintenance After an initial bolus dose of 0.3-0.6 mg/kg, administer as a continuous infusion at rates between 11 & 13 mcg/kg/min.

Hypersensitivity.

Myasthenia gravis, other forms of neuromuscular disease & severe electrolyte imbalance. Patients unusually sensitive to fall in arterial BP eg, hypovolemic patients. Not be administered into the infusion line of blood transfusion. Resistance may develop in patients suffering from burns.

Skin flushing, mild transient hypotension or bronchospasm.

Increased neuromuscular block w/ inhalation anaesth eg, halothane, isoflurane & enflurane. Increase in the magnitude &/or duration of nondepolarizing neuromuscular block w/ antibiotics including aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin & clindamycin; antiarrhythmic drugs (propranolol, Ca channel blockers, lignocaine, procainamide & quinidine); diuretics (furosemide & possibly mannitol, thiazide diuretics & acetazolamide); Mg sulfate; ketamine; lithium salts; ganglion-blocking agents (trimetaphan, hexamethonium). Rarely, may aggravate or unmask latent myasthenia gravis or induce myasthenia syndrome in concomitant use w/ procainamide, quinidine, antirheumatic drugs (eg, chloroquine, D-penicillamine), trimetaphan, chlorpromazine, steroids, phenytoin, lithium. Lengthened onset of nondepolarizing neuromuscular block & shortened duration of block w/ chronic anticonvulsant therapy. Prolonged & complex block w/ depolarizing muscle relaxant eg, suxamethonium Cl, difficult to reverse w/ anticholinesterase drugs. Must not be mixed in the same syringe w/ thiopentone or any alkaline agent.

Neuromuscular Blocking Agents

M03AC04 - atracurium ; Belongs to the class of other quaternary ammonium-containing agents used as peripherally-acting muscle relaxants.

Rx