Drug reference

Atracurium Besilate

Neuromuscular Blocker · Anaesthesia Adjuvant, Muscle Relaxant

Also known as Atracurium besylate, Tracrium

Neuromuscular BlockerAnaesthesia Adjuvant, Muscle Relaxant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

—

not curated

Mechanism

Atracurium is a bisquaternary competitive blocker that produces muscle relaxation by antagonizing acetylcholine receptors at the neuromuscular junction. It is uniquely inactivated in plasma by spontaneous non-enzymatic degradation (Hofmann elimination) in addition to metabolism by cholinesterases. This dual elimination pathway contributes to its intermediate duration of action.

Indications

Neuromuscular blockade (short to intermediate duration) for surgery and intubationNeuromuscular blockade during intensive carePreferred muscle relaxant for liver/kidney disease patientsPreferred muscle relaxant for neonates and the elderly

Dosing

Adult: Neuromuscular blockade for surgery and intubation: Initially 300–600 micrograms/kg by intravenous injection; then 100–200 micrograms/kg by intravenous injection as required; alternatively, initially 300–600 micrograms/kg by intravenous injection, followed by 300–600 micrograms/kg/hour by intravenous infusion.…
Geriatric: Preferred muscle relaxant for the elderly. To avoid excessive dosage in obese patients, dose should be calculated on the basis of ideal body-weight.