{"id":1655,"date":"2023-06-25T17:29:05","date_gmt":"2023-06-25T17:29:05","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/atracurium-besilate\/"},"modified":"2023-06-25T19:46:51","modified_gmt":"2023-06-25T19:46:51","slug":"atracurium-besilate","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/atracurium-besilate\/","title":{"rendered":"Atracurium besilate"},"content":{"rendered":"

<\/p>\n

Atracurium besilate<\/h1>\n

CLINICAL USE<\/h3>\n

Non-depolarising muscle relaxant of short to medium duration<\/p>\n

DOSE IN NORMAL RENAL FUNCTION<\/h3>\n
  • Initially: 300\u2013600 mcg\/kg, depending on duration of full block required<\/li>\n
  • Maintenance: 100\u2013200 mcg\/kg as required or
    \n

    IV infusion<\/h4>\n

    : 300\u2013600 mcg\/kg\/hour<\/li>\n

  • Intensive care: Initially, 300\u2013600 mcg\/kg then by infusion: 4.5\u201329.5 mcg\/kg\/minute (usual dose: 11\u201313 mcg\/kg\/minute)
    \n

    PHARMACOKINETICS<\/h3>\n<\/li>\n
  • Molecular weight                           :1243.5<\/li>\n
  • %Protein binding                           :82<\/li>\n
  • %Excreted unchanged in urine     : 0<\/li>\n
  • Volume of distribution (L\/kg)       :0.16<\/li>\n
  • half-life \u2013 normal\/ESRD (hrs)      :Approx 20 minutes\/unchanged
    \n

    DOSE IN RENAL IMPAIRMENT<\/h3>\n

    GFR (mL\/MIN)<\/h4>\n<\/li>\n
  • 20 to 50     : Dose as in normal renal function<\/li>\n
  • 10 to 20     : Dose as in normal renal function<\/li>\n
  • <10           : Dose as in normal renal function
    \n

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES<\/h3>\n<\/li>\n
  • CAPD                :Unlikely to be dialysed. Dose as in normal renal function<\/li>\n
  • HD                     :Unlikely to be dialysed. Dose as in normal renal function<\/li>\n
  • HDF\/high flux   :Unknown dialysability. Dose as in normal renal function<\/li>\n
  • CAV\/VVHD      :Unlikely to be dialysed. Dose as in normal renal function
    \n

    IMPORTANT DRUG INTERACTIONS<\/h3>\n

    Potentially hazardous interactions with other drugs<\/li>\n

  • Anaesthetics: enhanced effect with volatile liquid general anaesthetics<\/li>\n
  • Anti-arrhythmics: procainamide enhances muscle relaxant effect<\/li>\n
  • Antibacterials: aminoglycosides, clindamycin, polymyxin, piperacillin enhance effect of atracurium<\/li>\n
  • Atracurium enhances the neuromuscular block produced by botulinum toxin (risk of toxicity)
    \n

    ADMINISTRATION<\/h3>\n

    Reconstition<\/h4>\n

    \u2013<\/p>\n

    Route<\/h4>\n

    IV bolus,<\/li>\n

  • IV infusion Rate of Administration<\/li>\n
  • IV infusion : Initial bolus dose of 0.3\u20130.6 mg\/kg over 60 seconds, then administer as a continuous infusion at rates of 0.3\u20130.6 mg\/kg\/hour
    \n

    Comments<\/h4>\n

    Stable in sodium chloride 0.9% for 24 hours, and glucose 5% for 8 hours when diluted to concentrations of 0.5 mg\/mL or above<\/li>\n","protected":false},"excerpt":{"rendered":"

    Atracurium besilate CLINICAL USE Non-depolarising muscle relaxant of short to<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-1655","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1655","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=1655"}],"version-history":[{"count":1,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1655\/revisions"}],"predecessor-version":[{"id":2866,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/1655\/revisions\/2866"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=1655"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=1655"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=1655"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}