Cisatracurium

Cisatracurium

File:Cisatracurium.svg
Clinical data
Pregnancy category	B
Routes of administration	IV only
ATC code	M03AC11 (WHO)
Pharmacokinetic data
Bioavailability	N/A - IV use only
Protein binding	Unknown due to rapid degradation
Metabolism	80% Hoffman elmination/ Hepatic
Elimination half-life	20-29 minutes
Excretion	10-15% unchanged
Identifiers
IUPAC name 5-[3-[(1R,2R)-1-[(3,4-dimethoxyphenyl)methyl]-6,7- dimethoxy-2-methyl-3,4-dihydro-1H-isoquinolin-2-yl] propanoyloxy]pentyl 3-[(1R,2R)-1-[(3,4-dimethoxy phenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro- 1H-isoquinolin-2-yl]propanoate
CAS Number	96946-42-8
PubChem CID	62887
DrugBank	APRD00874
E number	{{#property:P628}}
ECHA InfoCard	{{#property:P2566}}
Chemical and physical data
Formula	C53H72N2O12+2
Molar mass	929.145 g/mol

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.

Structure

It is a benzyl-isoquinolinium agent in the quaternary ammonium compound family.

Metabolism

80% is metabolized to laudanosine via Hoffman Elimination (which is dependent on the pH and the temperature of the 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.

External links

• Esmaoglu A, Akin A, Mizrak A, Turk Y, Boyaci A (2006). "Addition of cisatracurium to lidocaine for intravenous regional anesthesia". J Clin Anesth. 18 (3): 194–7. PMID 16731321.CS1 maint: Multiple names: authors list (link)
• Melloni C, Devivo P, Launo C, Mastronardi P, Novelli G, Romano E (2006). "Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia". Minerva Anestesiol. 72 (5): 299–308. PMID 16675938.CS1 maint: Multiple names: authors list (link)
• Serra C, Oliveira A (2006). "Cisatracurium: myographical and electrophysiological studies in the isolated rat muscle". Fundam Clin Pharmacol. 20 (3): 291–8. PMID 16671964.