Cisatracurium
- Atc Codes:M03AC11
- CAS Codes:96946-42-8
- PHARMGKB ID:96946-42-8
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Nimbex; Belgium: Nimbex; Cyprus: Nimbex; Czech Republic: Nimbex; Denmark: Nimbex; Finland: Nimbex; France: Nimbex; Germany: Nimbex; Greece: Nimbex; Hungary: Nimbex; Ireland: Nimbex; Italy: Nimbex; Latvia: Nimbex; Lithuania: Nimbex; Luxembourg: Nimbex; Malta: Nimbex; Netherlands: Nimbex; Poland: Nimbex; Portugal: Nimbex; Romania: Nimbex; Slovenia: Nimbex; Spain: Nimbex; Sweden: Nimbex; UK: Nimbex.
North America
Canada: Nimbex; USA: Nimbex.
Latin America
Brazil: Nimbium; Mexico: Nimbex.
Drug combinations
Chemistry
Cisatracurium Besylate: C~65~H~82~N~2~O~18~S~2~. Mw: 1243.48. (1) Isoquinolinium, 2,2′-[1,5-pentanediylbis[oxy(3-oxo-3,1-propanediyl)]]bis[1-[(3,4-dimethoxyphenyl)methyl]-1,2,3,4-tetrahydro-6,7-dimethoxy-2-methyl-, dibenzenesulfonate, [1R-[1α,2α(1’R*,2’R*)]]-; (2)(1R,2R)-2-(2-Carboxyethyl)-1,2,3,4-tetrahydro-6,7-dimethoxy-2-methyl-1-veratrylisoquinolinium benzenesulfonate, pentamethylene ester. CAS-96946-42-8 (1995).
Pharmacologic Category
Skeletal Muscle Relaxants; Neuromuscular Blocking Agents, Nondepolarizing. (ATC-Code: M03AC11).
Mechanism of action
Shows high affinity for ACh receptor sites and competitively blocks access of ACh to motor end-plate of myoneural junction; may affect ACh release. Produces skeletal muscle relaxation. Blocks the effects of both the small quantities of ACh that maintain muscle tone and the large quantities of ACh that produce voluntary skeletal muscle contraction. Exhibits minimal, if any, cardiovascular effects. Exhibits little histamine-releasing activity at usual therapeutic doses.
Therapeutic use
Adjunct to general anesthesia to facilitate endotracheal intubation and to relax skeletal muscles during surgery. To facilitate mechanical ventilation (does not relieve pain or produce sedation).
Pregnancy and lactiation implications
Not known whether use during labor or delivery has effects on the fetus. Not known whether cisatracurium is distributed into milk. Caution advised if used in nursing women.
Unlabeled use
Contraindications
Hypersensitivity to cisatracurium besylate or any component of the formulation.
Warnings and precautions
Bradycardia is common. Cross-sensitivity with other neuromuscular-blocking agents may occur (use extreme caution in previous anaphylactic reactions). Resistance may occur in burn patients (>30% of body) for period of 5-70 days postinjury. Alkalosis, hypercalcemia, demyelinating lesions, peripheral neuropathies, denervation, infection, muscle trauma, and diabetes mellitus may result in antagonism of neuromuscular blockade. Electrolyte abnormalities, severe hyponatremia, severe hypocalcemia, severe hypokalemia, hypermagnesemia, neuromuscular diseases, acidosis, acute intermittent porphyria, Eaton-Lambert syndrome, myasthenia gravis, renal failure, and hepatic failure may result in potentiation of neuromuscular blockade. Use with caution in the elderly (effects and duration are more variable). Resistance may occur in patients who are immobilized. Risk of «gasping syndrome» (potentially fatal) in neonates due to consumption of benzoic acid (present in cisatracurium besylate injection).