Doxacurium

Up to 60-min time to recovery with a long-acting neuromuscular blocker (i.e., pancuronium, doxacurium)... 

In addition to the medicines mentioned above, a number of opiate- and non-opiate-based analgesics, including COX-2 inhibitors, anaesthetics (e.g. propofol, desflurane, sevoflurane, ropivacaine, levobupivacaine and remifentanil), neuromuscular blockers (e.g. rocuronium bromid, zemuron, cisatracuiium, doxacurium. 

In a study of 54 patients, plasma histamine concentrations increased by 200% following doxacurium in two patients, but there were no changes in heart rate or blood pressure (4). Indeed, cardiovascular stability has been reported in several studies (1,4) and only minor clinically insignificant changes have been seen with doses up to 0.08 mg/kg, even in cardiac patients (AHA classes III-IV) (5,6). 

Basta SJ, Savarese JJ, Ali HH, Embree PB, Schwartz AF, Rudd GD, Wastila WB. Clinical pharmacology of doxacurium chloride. A new long-acting nondepolarizing muscle relaxant. Anesthesiology 1988 69(4) 478-86. 

Scott RP, Norman J. Doxacurium chloride a prehminaiy clinical trial. Br J Anaesth 1989 62(4) 373-7. 

Reich DL. Transient systemic arterial hypotension and cutaneous flushing in response to doxacurium chloride. Anesthesiology 1989 71(5) 783-5. 

Murray DJ, Mehta MP, Choi WW, Forbes RB, Sokoll MD, Gergis SD, Rudd GD, Abou-Donia MM. The neuromuscular blocking and cardiovascular effects of doxacurium chloride in patients receiving nitrous oxide narcotic anesthesia. Anesthesiology 1988 69(4) 472-7. 

Stoops CM, Curtis CA, Kovach DA, McCammon RL, Stoelting RK, Warren TM, Miller D, Abou-Donia MM. Hemodynamic effects of doxacurium chloride in patients receiving oxygen sufentanil anesthesia for coronary artery bypass grafting or valve replacement. Anesthesiology 1988 69(3) 365-70. 

Reich DL, Konstadt SN, Thys DM, Hillel Z, Raymond R, Kaplan JA. Effects of doxacurium chloride on biventricular cardiac function in patients with cardiac disease. Br J Anaesth 1989 63(6) 675-81. 

Cashman JN, Luke JJ, Jones RM. Neuromuscular block with doxacurium (BW A938U) in patients with normal or absent renal function. Br J Anaesth 1990 64(2) 186-92. 

Cook DR, Freeman JA, Lai AA, Robertson KA, Kang Y, Stiller RL, Aggarwal S, Abou-Donia MM, Welch RM. Pharmacokinetics and pharmacodynamics of doxacurium in normal patients and in those with hepatic or renal failure. Anesth Analg 1991 72(2) 145-50. 

Renal excretion is the main route of elimination of doxacurium, and its duration of action would be expected to be prolonged in patients with renal dysfunction. There have been two reports of the use of doxacurium in patients with chronic renal insufficiency. In the first it was reported that the action of doxacurium (0.025 mg/kg bolus dose) was markedly but not statistically prolonged the mean time to 25% recovery of the twitch height was 121 minutes in... 

Doxacurium Chloride. The mnlecular structure of dox-acurium chloride, l,2,3,4-ictrahydro-2-(3-hydroxypropyl)-6,7,8-trimethoxy2-methyl-l-(3,4,5-trimeihnxybenzyl) iso-quinolinium chloride succinate (Nuromax), provides the... 

Clinically important, potentially hazardous interactions with adefovir, aldesleukin, aminoglycosides, atracurium, bumetanide, cephalexin, doxacurium, ethacrynic acid, furosemide, succinylcholine, teicoplanin, torsemide... 

Clinically important, potentially hazardous interactions with acetylcysteine, adenosine, aprepitant, aripiprazole, buprenorphine, caffeine, charcoal, clarithromycin, clobazam, dorazepate, clozapine, darunavir, dasatinib, delavirdine, dexamethasone, diltiazem, doxacurium, erythromycin, felodipine, fesoterodine, fosamprenavir, imatinib, influenza vaccines, lacosamide, lapatinib, levetiracetam, lopinavir, methylprednisolone, midazolam, nelfinavir, nilotinib, piracetam, prednisolone, propoxyphene, ritonavir, rivaroxaban, rufinamide, solifenacin, St John s wort, telithromycin, temsirolimus, terbinafine, tolvaptan, troleandomycin, verapamil, voriconazole... 

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