Cisatracurium, chemically an isomer of atracurium, is a benzylisoquinolinium-type muscle relaxant with an intermediate duration of action. Early clinical reports have shown that cisatracurium does not cause histamine release or clinically significant cardiovascular effects at doses of eight times its ED95(0.4 mg/kg).
What is Cisatracurium used for?
Cisatracurium injection is used before and during surgery to provide muscle relaxation and make intubation easier. This medicine must be given only by or under the direct supervision of your doctor.
What class of drug is Cisatracurium?
Cisatracurium besylate is an intermediate-acting, non-depolarizing neuromuscular blocking drug (NMBD).
Which muscle relaxants cause histamine release?
The results showed that gallamine, pancuronium, vecuronium, atracurium, tubocurarine and alcuronium produced concentration-dependent contractions in the rat ileum, gallamine and pancuronium being the most effective agents in producing muscle contraction.
Does succinylcholine release histamine?
As with other neuromuscular blocking agents, the potential for releasing histamine is present following succinylcholine administration. Signs and symptoms of histamine-mediated release such as flushing, hypotension, and bronchoconstriction are, however, uncommon in normal clinical usage.
Can you reverse Cisatracurium?
Cisatracurium binds to cholinergic receptors on the motor end-plate to antagonise the action of acetylcholine, resulting in a competitive block of neuromuscular transmission. This action is readily reversed by anti-cholinesterase agents such as neostigmine or edrophonium.
How long does it take for Cisatracurium to wear off?
When administered during stable opioid/nitrous oxide/oxygen anesthesia, 0.15 mg/kg of NIMBEX produced maximum neuromuscular blockade in about 2 minutes (range: 1.3 to 4.3 minutes) with a clinically effective block (time to 25% recovery) for about 43 minutes (range: 34 to 58 minutes) [see Clinical Studies].
Does nimbex cause bradycardia?
Nimbex (cisatracurium besylate) is a skeletal muscle relaxant given before general anesthesia in preparation for surgery.
Table 3. Adverse Reactions in Clinical Trials of NIMBEX in Surgical Patients.
How is nimbex cleared?
Laudanosine is further metabolized to desmethyl metabolites which are conjugated with glucuronic acid and excreted in the urine. Organ-independent Hofmann elimination is the predominant pathway for the elimination of cisatracurium.
How is Cisatracurium metabolized?
Cisatracurium is primarily degraded by Hofmann degradation to laudanosine and a monoquaternary acrylate, which is hydrolyzed by plasma esterases. The by-products of metabolism have no neuromuscular blocking effect, and they are excreted by the liver and the kidneys (Neill et al., 1983).
Does vecuronium release histamine?
Vecuronium rarely produces significant release of endogenous histamine. Cannon and colleagues  noted that vecuronium resulted in direct release of large amounts of histamine in one of 20 patients in their study.
Which drugs cause histamine release?
Anaesthetic drugs that release histamine directly include atracurium, mivacurium, morphine and meperidine. Clinical evidence of histamine release, usually cutaneous, occurs in up to 30% of patients during anaesthesia.
Does rocuronium cause histamine release?
Rocuronium has been shown to activate the MRGPRX2 receptor on mast cells, inducing a non-IgE- mediated histamine release, which explains its potential for causing pseudoallergic reactions.
How long does it take for vecuronium to wear off?
|Onset of action||< 1 min|
|Elimination half-life||51–80 minutes (longer with kidney failure)|
|Duration of action||15 – 30 min|
How long does succinylcholine stay in your system?
In blood, SUX was usually detectable for up to 10 min post-injection, while detection of SMC was possible over the whole observation period of 6 h.
Which medicine causes paralysis?
- Cholinesterase Reactivators.
- Muscarinic Antagonists.
- Pralidoxime Compounds.
- Chlorpyrifos. pralidoxime.