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| {{drugbox
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| | IUPAC_name = 5-[3-[(1''R'',2''R'')-1-[(3,4-dimethoxyphenyl)methyl]-6,7-<br>dimethoxy-2-methyl-3,4-dihydro-1''H''-isoquinolin-2-yl]<br>propanoyloxy]pentyl 3-[(1''R'',2''R'')-1-[(3,4-dimethoxy<br>phenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro-<br>1''H''-isoquinolin-2-yl]propanoate
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| | image = Cisatracurium.svg
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| | width = 300
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| | CAS_number = 96946-42-8
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| | ATC_prefix = M03
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| | ATC_suffix = AC11
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| | ATC_supplemental =
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| | PubChem = 62887
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| | DrugBank = APRD00874
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| | C = 53 | H = 72 | N = 2 | O = 12 | charge = +2
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| | molecular_weight = 929.145 g/mol
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| | bioavailability = N/A - IV use only
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| | protein_bound = Unknown due to rapid degradation
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| | metabolism = 80% Hoffman elmination/ Hepatic
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| | elimination_half-life = 20-29 minutes
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| | excretion = 10-15% unchanged
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| | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->
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| | pregnancy_US = <!-- A / B / C / D / X -->
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| | pregnancy_category = B
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| | legal_AU = <!-- Unscheduled / S2 / S4 / S8 -->
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| | legal_UK = <!-- GSL / P / POM / CD -->
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| | legal_US = <!-- OTC / Rx-only -->
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| | legal_status =
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| | routes_of_administration = IV only
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| }}
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| __NOTOC__
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| {{SI}}
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| {{CMG}}
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| ==Overview==
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| '''Cisatracurium''' (usually as '''cisatracurium besilate''', trade name '''Nimbex''') is a [[neuromuscular-blocking drug]]. It is one of the ten [[isomers]] of [[atracurium]]. Its active [[metabolites]] contain less [[laudanosine]] which cause [[hypotension]], central nervous system excitement, and seizures than that of atracurium. It is considered an intermediate-acting agent in terms of duration of action.
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| ==Structure==
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| It is a benzyl-isoquinolinium agent in the [[quaternary ammonium compound]] family.
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| ==Metabolism==
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| 80% is metabolized to [[laudanosine]] via [[Hoffman Elimination]] (which is dependent on the [[pH]] and the temperature of the [[blood plasma|plasma]]) and 20% is metabolized hepatically or excreted renally. Since Hoffman elimination is organ-independent, the use of cisatracurium may pose less risk in patients with liver or renal disease than other neuromuscular blockers. 10-15% of the dose is excreted unchanged in the urine.
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| ==External links==
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| * {{cite journal | author = Esmaoglu A, Akin A, Mizrak A, Turk Y, Boyaci A | title = Addition of cisatracurium to lidocaine for intravenous regional anesthesia. | journal = J Clin Anesth | volume = 18 | issue = 3 | pages = 194-7 | year = 2006 | id = PMID 16731321}}
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| * {{cite journal | author = Melloni C, Devivo P, Launo C, Mastronardi P, Novelli G, Romano E | title = Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia. | journal = Minerva Anestesiol | volume = 72 | issue = 5 | pages = 299-308 | year = 2006 | id = PMID 16675938}}
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| * {{cite journal | author = Serra C, Oliveira A | title = Cisatracurium: myographical and electrophysiological studies in the isolated rat muscle. | journal = Fundam Clin Pharmacol | volume = 20 | issue = 3 | pages = 291-8 | year = 2006 | id = PMID 16671964}}
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| [[Category:Muscle relaxants]]
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| [[Category:Quaternary ammonium compounds]]
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