Cisatracurium

Question 1

What is the brand/trade name for cisatracurium?

Answer 1

• Nimbex

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 2

What is the pharmacologic category/class of cisatracurium?

Answer 2

• Nondepolarizing neuromuscular blocker
• Benzylisoquinolinium compound

_{Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1}

Question 3

What is the ED₉₅ dose of cisatracurium?

Answer 3

• 0.05 mg/kg

Dose that causes, on average, 95% supression of twitch height

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 4

What is the typical dose of cisatracurium to rapidly achieve good intubating conditions?

Answer 4

• 0.1 mg/kg IV

Intubating doses of NMBA are usually 2-3x the ED₉₅

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 5

What is the onset of action for cisatracurium?

Answer 5

• 2-4 minutes

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 6

What is the duration of action for cisatracurium?

Answer 6

• 30-60 minutes — intermediate acting

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 7

What is the mechanism of action of cisatracurium?

Answer 7

• competitive antagonism of acetylcholine at nicotinic receptors

_{Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1}

Question 8

Which organ(s) are responsible for cisatracurium’s clearance (metabolism/elimination)?

Answer 8

• Metabolism: Hoffman elimination (temperature and pH dependent reaction in the blood)
• Elimination: Kidneys

Toxic metabolite laudanosine is a CNS stimulant and may produce seizures

_{Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1
Nagelhout (7th ed.), pp. 157, 169 - Table 12.10}