Atracurium Hameln Injection
Atracurium Besylate
10mg/ml
ZAS Corporation
| Pack size | 2.5ml |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 242.00 AED |
Indications
Atracurium Hameln Injection is used for:
General anaesthesia, Endotracheal intubation, Aid controlled ventilation
Adult Dose
Intravenous
Muscle relaxant in general anaesthesia, Endotracheal intubation, Aid controlled ventilation
Adult: Initially, 300-600 mcg/kg as inj. Subsequently, 100-200 mcg/kg when necessary or every 15-25 minutes for maintenance in prolonged procedures. Alternatively, maintenance can also be achieved by continuous infusion at 5-10 mcg/kg/minute. Initial dose should be given over 60 seconds in patients with CV disease. Dose should be calculated based on ideal body-weight in obese patients.
Special Populations: For patients with significant CV disease or any history (e.g. severe anaphylactoid reactions or asthma) suggesting a greater risk of histamine release, an initial dose of 0.3-0.4 mg/kg should be given slowly or in divided doses over 1 min. For adults receiving atracurium following the use of succinylcholine for intubation under balanced anesthesia, an initial dose of 0.3-0.4 mg/kg is recommended. Dosage reductions may be necessary in patients with neuromuscular disease, severe electrolyte disorders or carcinomatosis in which potentiation of neuromuscular block or difficulties with reversal have been demonstrated.
Child Dose
Intravenous
Muscle relaxant in general anaesthesia, Endotracheal intubation, Aid controlled ventilation
Child: >2 mth: Initially, 400-500 mcg/kg as inj. Maintenance dose: 80-100 mcg/kg; first maintenance dose may be given 20-45 min after the initial dose, subsequently, may be repeated every 15-25 min.
For children 1 mth-2 yr: 300-400 mcg/kg may be used as initial dose in those who are under halothane anaesthesia. Maintenance doses may be admin more frequently in infant and children than adults.
Renal Dose
Renal Impairment
Dose adjustment not necessary
Administration
IV Preparation
Add to an empty Viaflex bag & infuse undiluted (10 mg/mL); however, if necessary, may be diluted in D5W, NS or dextrose-saline combinations
Dilution in LR not recommended
IV Administration
Not for IM injection due to tissue irritation
May be given undiluted as bolus injection
Administration via infusion requires use of an infusion pump
Use infusion solutions within 24 hr of preparation
Contra Indications
Hypersensitivity to drug or components; lack of ventilatory support, neuromuscular disease.
Precautions
Neonates; severe CVS disorders; renal or hepatic dysfunction; myasthenia gravis and other neuromuscular disorders; severe electrolyte imbalances; respiratory insufficiency or pulmonary disease, asthma; burns; cardiopulmonary bypass; smoking; pregnancy and lactation. Dosage for obese patients should be based on ideal body weight to prevent overdosing.
Monitoring Parameters
Closely monitor patients with bronchogenic carcinoma, dehydration, electrolyte imbalance, hypotension, hypothermia, myasthenia gravis, pulmonary disease.
Pregnancy-Lactation
Pregnancy Category: C
Lactation: excretion in milk unknown; use with caution
Interactions
In common with other non-depolarising neuromuscular blocking agents the magnitude and/or duration of a non-depolarising neuromuscular block may be increased as a result of interaction with:
Antibiotics, including the aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin and clindamycin.
Antiarrhythmic drugs: propranolol, calcium channel blockers, lignocaine, procainamide and quinidine.
Diuretics: frusemide and possibly mannitol, thiazide diuretics and acetazolamide.
Magnesium sulphate.
Ketamine.
Lithium salts.
Ganglion blocking agents: trimetaphan, hexamethonium.
If other muscle relaxants are used during the same procedure, the possibility of a synergistic or antagonistic effect should be considered.
The prior administration of suxamethonium does not enhance the duration, but quickens the onset and may increase the depth, of neuromuscular blockade induced by Atracurium Besylate. As with other non-depolarising neuromuscular blocking agents, it is advisable to await evidence of recovery from suxamethonium induced neuromuscular block before administering Atracurium Besylate.
Potentially Fatal: Neuromuscular blockade potentiated by parenteral Mg salts, anesthetics, aminoglycosides and polypeptide antibiotics, botulinum A toxin. Malignant hyperthermia with halogenated anesthetics and succinylcholine. MAOIs.
Contraindicated (0)
Serious - Use Alternative (29)
amikacin
amphotericin B deoxycholate
benzhydrocodone/acetaminophen
capreomycin
clindamycin
colistin
demeclocycline
doxycycline
fentanyl
fentanyl intranasal
fentanyl transdermal
fentanyl transmucosal
gentamicin
hydrocodone
lincomycin
minocycline
neomycin PO
omadacycline
oxytetracycline
paromomycin
polymyxin B
pramlintide
quinine
sarecycline
streptomycin
sufentanil SL
tetracycline
tobramycin
valerian
Adverse Effects
Side effects of Atracurium Besylate :
1-10%
Skin flush (5%)
<1%
Erythema (0.6%)
Wheezing (0.2%)
Increased bronchial secretions (0.2%)
Pruritus (0.2%)
Urticaria (0.1%)
Mechanism of Action
Atracurium besilate blocks neural transmission at the neuromuscular junction by competitive binding at the cholinergic receptor sites on the motor end plate.
Note
Atracurium Hameln 10mg/ml Injection manufactured by ZAS Corporation. Its generic name is Atracurium Besylate. Atracurium Hameln is availble in Bangladesh.
Farmaco BD drug index information on Atracurium Hameln Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.