Atracurium Flashcards
1
Q
What is atracurium used for?
A
- to provide muscle relaxation to allow intubation, ventilation and surgery
- useful in those with renal and liver disease as not reliant on these for metabolism
2
Q
What is the absorption/distribution of atracurium?
A
- 15% protein bound
- Volume of distribution = 0.15 L/kg
3
Q
What is the MOA of atracurium?
A
- competitive inhibitor of ACh at nicotinic receptors at NMJ
- binds to alpha subunits of receptor but does not stimulate it to open ion channel
4
Q
What are the SEs of atracurium?
A
- can cause histamine release - precipitating hypotension and bronchospasm in susceptible individuals
- avoid use in asthmatics
- associated with critical illness myopathy
5
Q
What is atracurium?
A
- Benzyisoquinolinium non-depolarising muscle relaxant
- store at 4 degrees C to avoid Hoffman degradation
- clear colourless solution 10mg/ml
6
Q
What is the dose of atracurium?
A
0.5mg/kg - provides intubating conditions in 90-120 secs
7
Q
How is atracurium metabolised?
A
- 60% of dose by ester hydrolysis in plasma by non-specific esterases to laudanosine, a quaternary acid and alcohol
- Hofmann degradation (spontaneous breakdown to laudanosine and monoacrylate) which occurs at body temp and pH
- acidosis and cold slow Hoffman degradation
- laudanosine can cause seizures, but not at clinical levels
8
Q
What are the chemical properties of atracurium?
A
- 4 chiral centres
- made of 10 stereoisomers
- cis atracurium is available (single isomer which avoids unwanted histamine release)
9
Q
A
