Doxacurium Brand Name– Nuromax
What is Doxacurium
Doxacurium is a long-acting, nondepolarizing, neuromuscular blocking agent.
Doxacurium is used to cause skeletal muscle relaxation as an adjunct to general anesthesia, for endotracheal intubation, or to facilitate mechanical ventilation.
Doxacurium antagonizes the action of acetylcholine by competitively binding to cholinergic receptors on the motor endplate.
Time to maximum peak and clinical duration of neuromuscular blockade is dose-dependent. Compared to pancuronium, another long-acting nondepolarizing agent, doxacurium is 2.5 to 3 times more potent, and at equipotent doses has a similar duration of action.
Doxacurium lacks significant histamine releasing properties and is not metabolized by plasma cholinesterase.
Due to its long duration of action and minimal cardiovascular effects, doxacurium may have an advantage for use in surgery of long duration, especially in patients with cardiac disease.
Like other neuromuscular blockers, significant variation in patient sensitivity and dosage requirements exist for doxacurium, requiring careful patient selection, dosage titration and monitoring.
Doxacurium was approved by the FDA on 3/7/91.
Indications
- endotracheal intubation
- neuromuscular blockade
For neuromuscular blockade, as an adjunct to general anesthesia, to facilitate endotracheal intubation, or to facilitate mechanical ventilation
Side Effects
- anaphylactoid reactions
- angioedema
- apnea
- bradycardia
- bronchospasm
- diplopia
- dyspnea
- fever
- flushing
- hypotension
- injection site reaction
- malignant hyperthermia
- muscle paralysis
- myocardial infarction
- respiratory depression
- urticaria
- ventricular fibrillation
- wheezing
Monitoring Parameters
- arterial blood gases (ABGs)
- serum electrolytes
- serum magnesium
Contraindications
- acid/base imbalance
- benzyl alcohol hypersensitivity
- breast-feeding
- burns
- chronic obstructive pulmonary disease (COPD)
- corticosteroid therapy
- dehydration
- electrolyte imbalance
- geriatric
- hepatic disease
- hypermagnesemia
- hypocalcemia
- hypokalemia
- hyponatremia
- intramuscular administration
- lung cancer
- malignant hyperthermia
- metabolic alkalosis
- myasthenia gravis
- myopathy
- neonates
- neuromuscular blocking agent hypersensitivity
- neuromuscular disease
- obesity
- pregnancy
- pulmonary disease
- renal disease
- renal failure
- renal impairment
- requires a specialized care setting
- requires an experienced clinician
- respiratory acidosis
- respiratory depression
- respiratory insufficiency
Interactions
- Acebutolol
- Acetazolamide
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- 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)
- Atenolol
- Atenolol; Chlorthalidone
- Bacitracin
- Bendroflumethiazide; Nadolol
- Beta-blockers
- Betaxolol
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Bisoprolol
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Botulinum Toxins
- Brimonidine; Timolol
- Calcium
- Calcium Acetate
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Calcium Chloride
- Calcium Gluconate
- Calcium-channel blockers
- Calcium; Vitamin D
- Capreomycin
- Carbonic anhydrase inhibitors
- Carteolol
- Carvedilol
- Chromium
- Clevidipine
- Colistimethate, Colistin, Polymyxin E
- Corticosteroids
- Cyclosporine
- Demeclocycline
- Dextromethorphan; Quinidine
- Diltiazem
- Dorzolamide; Timolol
- Doxycycline
- Enalapril; Felodipine
- Esmolol
- Ester local anesthetics
- Felodipine
- Fosphenytoin
- Hetastarch; Dextrose; Electrolytes
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Indapamide
- Isradipine
- Labetalol
- Levobetaxolol
- Levobunolol
- Lincosamides
- Lithium
- Loop diuretics
- Magnesium
- Methazolamide
- Metoprolol
- Minocycline
- Nadolol
- Nebivolol
- Nebivolol; Valsartan
- Nicardipine
- Nifedipine
- Nimodipine
- Nisoldipine
- Omadacycline
- Penbutolol
- Perindopril; Amlodipine
- Phenytoin
- Pindolol
- Polymyxin B
- Polymyxins
- Procainamide
- Propranolol
- Quinidine
- Quinine
- Sarecycline
- Sotalol
- Tetracycline
- Tetracyclines
- Theophylline, Aminophylline
- Thiazide diuretics
- Timolol
- Trandolapril; Verapamil
- Vancomycin
- Verapamil
