Atracurium

C3H3CIO 814-68-6) see Atracurium besilate Ac-Thr-Gly-Trp-Met-Asp-Phe-NH2.HCI (C37H49C1NhO ( S 17664-80-1) see Ceruletide adamantane... 

C5 H N20 2 64228-77-9) see Atracurium besilate iV-[2-(3,4-dimethoxyphenyl)-l-methylethyl]-4-ethoxy-3-methoxybenzeneacetamide (C22H29NO5 93-31-2) see Dimoxyline... 

C20H25NO4 73074-37-2) see Atracurium besilate (/t)-tetrabydropapaverine 7V-acetyl-L-leucinate (C2gH4(,N207 141109-12-8) see Cisatracurium besylate ( )-tetrabydropapaverine bydrocbloride (C20H26CINO4 6429-04-5) see Cisatracurium besylate [ -( , 5 )]-2,3,4,9-tetrabydro-7V-(l-phenylethyt)-lff-carbazol-3-amine sulfate (1 1)... 

The rate of non-lgE-mediated immediate hypersensitivity reactions usually varies between 20 and 50% [1-7, 9], They are assumed to result from direct non-specific mast cell and basophil activation, which causes direct histamine release [19], Histamine release is predominantly found with the use of the benzylisoquinoUnes d-tubocurarine, atracurium and mivacurium, and the aminosteroid rapacuronium. Severe bronchospasm related to rapacuronium administration has been reported in children and adults. It might be related to the higher affinity of rapacuronium for M2 versus M3 muscarinic receptors [20]. Rapacuronium has been withdrawn from the market in the USA. 

Online detection using 4H nuclear magnetic resonance (NMR) is a detection mode that has become increasingly practical. In a recent application, cell culture supernatant was monitored on-line with 1-dimensional NMR for trehalose, P-D-pyranose, P-D-furanose, succinate, acetate and uridine.33 In stopped-flow mode, column fractions can also be analyzed by 2-D NMR. Reaction products of the preparation of the neuromuscular blocking compound atracurium besylate were separated on chiral HPLC and detected by 4H NMR.34 Ten isomeric peaks were separated on a cellulose-based phase and identified by online NMR in stopped-flow mode. 

Mistry, N., Roberts, A.D., Tranter, G.E., Francis, P., Barylski, I., Ismail, I.M., Nicholson, J.K., and Lindon, J.C., Directly coupled chiral HPLC-NMR and HPLC-CP spectroscopy as complementary methods for structural and enantiomeric isomer identification application to atracurium besylate, Anal. Chem., 71, 2838, 1999. 

Cisatracurium or atracurium in the presence of renal and/or hepatic dysfunction... 

Up to 30-min time to recovery with an intermediate-acting neuromuscular blocker (i.e., atracurium, cisatracurium, rocuronium, and vecuronium)... 

Angiotensin converting enzyme inhibitors, atracurium, P-lactams, heparin, iron (parenteral), losartan, and streptokinase... 

Avoid drugs that cause histamine release (e.g., morphine sulfate, codeine, atracurium, metocurine, mivacurium, and tubocurarine)... 

Draw a 5 s period of tetany followed by a 3 s pause. Note that the tetanic stimulus fails to reach 100% response as this test is being used in cases of profound muscle relaxation. Next draw single standard twitches at a frequency of 1 Hz 20 stimuli are given in total. Using atracurium, a single twitch on the TOF should appear in approximately 4 min if there are four post-tetanic twitches evident. 

Vecuronium Rocuronium Pancuronium Atracurium Cis-atracurium Mivacurium Gallamine Tubocurare... 

Atracurium is a non-depolarising muscle relaxant, which may cause respiratory depression as a side-effect. 

Atracurium, a curare-like muscle relaxant that is metabolized via an elimination reaction... 

Recent developments have led to agents with a built-in functional group that allows more rapid metabolism. Initially, the presence of ester groupings, as in suxamethonium, allowed fairly rapid metabolism in the body via esterase enzymes that hydrolyse these linkages. The enzyme involved appears to be a non-specific serum acetylcholinesterase (see Box 13.4). Even better is the inclusion of functionalities that allow additional degradation via an elimination reaction. Such an agent is atracurium. 

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