Cis-atracurium

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

Tobias JD, Johnson JO, Sprague K, Johnson G. Effects of rapacuronium on respiratory function during general anesthesia a comparison with cis-atracurium. Anesthesiology 2001 95(4) 908-12. 

Agent Tubocuranine Pancuronium Vecuronium Atracurium Rocuronium Cisatracurium Mivacurium Cis-trans isomer Trans-trans isomer C/s-c/s isomer... 

Welch RM, Brown A, Ravitch J, Dahl R. The in vitro degradation of cisatracurium, the R, cis-R -isomer of atracurium, in human and rat plasma. Clin Pharmacol Ther 1995 58(2) 132-42. 

Boyd AH, Eastwood NB, Parker CJ, Hunter JM. Pharmacodynamics of the IR cis-TR cis isomer of atracurium (51W89) in health and chronic renal failure. Br J Anaesth 1995 74(4) 400. ... 

One report suggests that recovery from the neuromuscular blocking effects of suxamethonium (succinyichoiine) is prolonged by ci-metidine, but this may possibiy have been due to the presence of metociopramide. Four other reports say that no interaction occurs between suxamethonium and either cimetidine, famotidine or ranitidine. Cimetidine, but not ranitidine, has been reported to increase the effects of vecuronium. Cimetidine does not aiter the effects of atracurium or rocuronium and ranitidine does not aiter the effects of atracurium. 

R-cis R-cis isomer of atracurium. It is degraded by Hofmann elimination just like atracurium. However, plasma concentrations of laudanosine do not reach such high levels as in the case of atracurium, leading to fewer cardiac side effects. Cisatracurium also releases less histamine from tissue stores. The potency and duration of action are similar in both drugs. Cisatracurium besilate is provided in sterile injections with a concentration equivalent to 2 mg/mL of cisatracurium in 5- or 10-mL vials, or 10 mg/mL of cisatracurium in 20-mL vials intended for use in ICUs only. 

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