Atracurium

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Atracurium Brand Name– Tracrium

What is Atracurium

Atracurium is an intermediate-acting, nondepolarizing, neuromuscular blocking agent. It is used as an adjunct to general anesthesia during surgery or mechanical ventilation to provide skeletal muscle relaxation.

It is also used as an aid to tracheal intubation. Atracurium produces mild to moderate histamine release.

Atracurium produces less histamine release than does tubocurarine, and recovery is more rapid with atracurium than with tubocurarine or pancuronium.

Atracurium is less potent than either pancuronium or vecuronium. Unlike succinylcholine, atracurium cannot be administered by IM injection.

Atracurium was approved by the FDA in 1983. Under the General Agreement on Tariffs and Trade (GATT), the patent expired on December 9, 1996.

Indications

  • endotracheal intubation
  • neuromuscular blockade
  • shaking chills

Side Effects

  1. anaphylactoid reactions
  2. angioedema
  3. apnea
  4. bradycardia
  5. bronchospasm
  6. cardiac arrest
  7. dyspnea
  8. edema
  9. erythema
  10. flushing
  11. hypotension
  12. injection site reaction
  13. laryngospasm
  14. muscle paralysis
  15. myopathy
  16. pruritus
  17. rash
  18. respiratory depression
  19. seizures
  20. sinus tachycardia
  21. urticaria
  22. weakness
  23. wheezing

Monitoring Parameters

  • arterial blood gases (ABGs)
  • peripheral nerve stimulation
  • serum electrolytes
  • serum magnesium

Contraindications

  • accidental exposure
  • acid/base imbalance
  • adrenal insufficiency
  • asthma
  • benzyl alcohol hypersensitivity
  • bradycardia
  • breast-feeding
  • burns
  • cardiac disease
  • chronic obstructive pulmonary disease (COPD)
  • dehydration
  • electrolyte imbalance
  • geriatric
  • hypercalcemia
  • hypermagnesemia
  • hypocalcemia
  • hypokalemia
  • hypothermia
  • intramuscular administration
  • labor
  • malignant hyperthermia
  • metabolic acidosis
  • metabolic alkalosis
  • myasthenia gravis
  • myopathy
  • neonates
  • neuromuscular blocking agent hypersensitivity
  • neuromuscular disease
  • obesity
  • obstetric delivery
  • pregnancy
  • premature neonates
  • pulmonary disease
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory acidosis
  • respiratory alkalosis
  • respiratory depression
  • respiratory insufficiency

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Acetazolamide
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Ambenonium Chloride
  • Amide local anesthetics
  • Aminoglycosides
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Apomorphine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Bacitracin
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Benzonatate
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Botulinum Toxins
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Calcium
  • Capreomycin
  • Carbamazepine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cholinesterase inhibitors
  • Clozapine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colistimethate, Colistin, Polymyxin E
  • Corticosteroids
  • Cyclophosphamide
  • Cyclosporine
  • Demeclocycline
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Donepezil
  • Donepezil; Memantine
  • Doxycycline
  • Edrophonium
  • Enalapril; Felodipine
  • Ester local anesthetics
  • Estrogens
  • Felodipine
  • Fentanyl
  • Fosphenytoin
  • Galantamine
  • General anesthetics
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Indapamide
  • Irinotecan
  • Irinotecan Liposomal
  • Isradipine
  • Ketorolac
  • Levomethadyl
  • Levorphanol
  • Lincosamides
  • Lithium
  • Loop diuretics
  • Magnesium
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Methadone
  • Methazolamide
  • Methohexital
  • Minocycline
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Neostigmine
  • Nicardipine
  • Nimodipine
  • Nisoldipine
  • Oxycodone
  • Oxymorphone
  • Perindopril; Amlodipine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Physostigmine
  • Polymyxin B
  • Polymyxins
  • Procainamide
  • Promethazine
  • Propoxyphene
  • Pyridostigmine
  • Quinidine
  • Quinine
  • Remifentanil
  • Rivastigmine
  • Sedating H1-blockers
  • Skeletal Muscle Relaxants
  • Sufentanil
  • Tacrine
  • Tapentadol
  • Tetracycline
  • Thalidomide
  • Thiazide diuretics
  • Thiopental
  • Trandolapril; Verapamil
  • Vancomycin
  • Verapamil

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