Classification: Nondepolarizing skeletal muscle relaxant
See Also: See also Neuromuscular Blocking Agents.
Action/Kinetics: Prevents the action of acetylcholine by competing for the cholinergic receptor at the motor end plate. It may also release histamine, leading to hypotension. Onset: Within 2 min. Peak effect: 1-2 min. Duration: 20-40 min with balanced anesthesia. Recovery from blockade under balanced anesthesia begins about 20-35 min after injection; recovery is usually 95% complete within 60-70 min after injection. t 1/2: 20 min. Recovery occurs more rapidly than recovery from d-tubocurarine, metocurine, and pancuronium. Metabolized in the plasma.
Uses: Skeletal muscle relaxant during surgery; adjunct to general anesthesia; assist in ET intubation. Investigational: Treat seizures due to drugs or electrically induced.
Contraindications: In clients with myasthenia gravis, Eaton-Lambert syndrome, electrolyte disorders, bronchial asthma.
Special Concerns: Use with caution during labor and delivery and when significant histamine release would be dangerous (e.g., CV disease, asthma). Safety and efficacy have not been determined during lactation. Children up to 1 month of age may be more sensitive to the effects of atracurium. No known effect on pain threshold or consciousness; use only with adequate anesthesia.
Additional Side Effects: CV: Flushing, tachycardia. Dermatologic: Rash, urticaria, reaction at injection site. Musculoskeletal: Prolonged block, inadequate block. Respiratory: Dyspnea, laryngospasm. Hypersensitivity: Allergic reactions. Other side effects may be due to histamine release and include flushing, erythema, wheezing, urticaria, bronchial secretions, BP and HR changes.
Overdose Management: Symptoms: Hypotension, enhanced pharmacologic effects. Treatment: CV support. Ensure airway and ventilation. An anticholinesterase reversing agent (e.g., neostigmine, edrophonium, pyridostigmine) with an anticholinergic agent (e.g., atropine, glycopyrrolate) may be used.
Additional Drug Interactions:
How Supplied: Injection: 10 mg/mL