Atracurium

presentation on the drug atracurium from anesthesia point of view

1. ATRACURIUM DR.FARWA SHABBIR HOUSE OFFICER ANAESTHESIOLOGY

2. ROAD MAP INTRODUCTION STRUCTURE MODE OF ACTION PHARMACOKINETICS METABOLISM AND EXCRETION DOSAGE INDICATIONS SIDE EFFECTS

3. INTRODUCTION  non-depolarizing Neuro -muscular blocking agent   Metabolism Rapid Onset Moderately Rapid Duration Moderately Rapid Histamine release slow Vagal Blockade None

4. STRUCTURE Quaternary Ammonium compound benzylisoquinoline structure

5. PHARMACOKINETICS Bioavailability: poorly absorbed from the GI tract Half-life: approximately 20 minutes Distribution: into extracellular fluid, minimally crosses the placenta Elimination Route: excreted principally in urine and also in feces via biliary elimination

6. MODE OF ACTION

7. MODE OF REVERSAL

8. METABOLISM AND EXCRETION Ester Hydrolysis This action is catalyzed by nonspecific esterases Hofmann Elimination A spontaneous non-enzymatic chemical breakdown occurs at physiological pH and temperature.

9. DOSAGE AND ADMINISTRATION A dose of 0.5 mg/kg is administered intravenously for intubation incremental doses of 0.1 mg/kg every 10–20 min after administration of succinylcholine An infusion of 5–10 mcg/kg/min can effectively replace intermittent boluses

10. INDICATIONS Endotracheal Intubation Mechanical Ventilation Skeletal muscle relaxation during surgery

11. CONTRAINDICATIONS No documented contraindications except in such conditions; Allergy Myasthenia Gravis Asthma

12. CLINICAL SIDE EFFECTS Hypotension and Tachycardia Bronchospasm Laudanosine Toxicity Temperature and pH Sensitivity Chemical Incompatibility Allergic Reactions