Mivacurium Cisatracurium

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

By competition with acetylcholine (atracurium, cisatracurium, mivacurium, pancuronium, rocuro-nium, vecuronium). These drugs are competitive antagonists of acetylcholine. They do not cause depolarisation themselves but protect the endplate from depolarisation by acetylcholine. The result is a flaccid paralysis. 

Spontaneous or plasma ChE, intermediate-short duration Atracurium Cisatracurium Mivacurium... 

The effects of cisatracurium, mivacurium, pancuronium, rocuro-nium, tubocurarine, vecuronium, and probably other competitive neuromuscular blockers can be increased and prolonged by magnesium sulfate given parenterally. There is some evidence that magnesium may interact similarly with suxamethonium (succinylcholine), but also evidence from well-controlled trials that it does not. 

Clinically important, potentially hazardous interactions with cisatracurium, erythromycin, kaolin, mivacurium, rocuronium, saquinavir... 

Clinically important, potentially hazardous interactions with aminophylline, atracurium, cisatracurium, doxacurium, epinephrine, ergometrine, mivacurium, non-depolarizing muscle relaxants, oxprenolol, oxytocin, pancuronium, rapacuronium, rifampin, vecuronium, xanthines... 

NMBAs are further differentiated by their duration of action during anesthesia. Succinylcholine and mivacurium are common ultra-short-acting competitive NMBAs (5-10 min). An intermediate duration of action (30-45 min) is maintained with the use of atracurium, cisatracurium, rocuronium and vecuronium. A long-lasting duration of action (90-100 min) is observed with d-tubocurarine, doxacurium, metocurine, pancuronium and pipecuronium. 

Kim KS, Chun YS, Choi SU, Suh IK. Neuromuscular intemction between cisatracurium and mivacurium, atracurium, vecurcnium or rocuronium administered in combination. Anaesthesia (1998) 53, 872-8. 

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