Included in the formulation
АТХ:M.03.A.C Other quaternary ammonium compounds
M.03.A.C.04 Atracuria bezylate
Pharmacodynamics:It causes a neuromuscular block due to the interaction of the cationic centers of the molecule with the anionic structures of the skeletal muscle H-cholinergic receptors, causing a neuromuscular block. Curare-like medication of medium duration (20-30 minutes). Arthracuria bezylate begins to act 1-2 minutes after intravenous administration. Has a slight ganglion blocking effect, causes a moderate release of histamine.
Pharmacokinetics:After intravenous administration, it undergoes spontaneous hydrolysis in blood plasma, which takes place without the participation of enzymes at physiological values of body temperature and hydrogen index, and also due to ester hydrolysis by nonspecific plasma esterases. As a result, inactive metabolites are formed.
It binds to plasma proteins by 80%. PElimination half-life (half-life) of the drug is 20 minutes. Elimination by the kidneys in the form of metabolites. Do not cumulate.
Indications:Used to disable the respiratory muscles for artificial ventilation during surgical interventions. It is used to eliminate tonic convulsions with strychnine poisoning and tetanus.
XXI.Z40-Z54.Z40.9 Prophylactic surgical intervention, unspecified
Contraindications:Myasthenia gravis.
Individual intolerance to benzylisoquinoline derivatives, including myvacuria chloride.
Carefully:Hypersensitivity to histamine, expressed electrolyte disorders.
Pregnancy and lactation:Recommendations for Food and Drug Administration (US Food and Drug Administration) - Category C. It is used for surgical interventions, including cesarean section. Penetrates through the placental barrier in small amounts, not having clinical significance. There is no evidence of ingestion into breast milk, it is not recommended to use the drug in lactation.
Dosing and Administration:In order to provide muscle relaxation for 15-30 minutes, intravenously, 0.3-0.6 mg / kg.
The highest daily dose: 600 mg / kg.
The highest single dose: 600 mg / kg.
Use in children
It is used for emergency indications from any age.
Newborns: with 300-500 mcg / kg intravenously sprayed, followed by the introduction of 100-200 mcg / kg as needed.
From 1 year to 18 years: from 300-600 mcg / kg, then - at 100-200 mcg / kg with a dose adjustment depending on the response.
Side effects:Central and peripheral nervous system: rarely convulsions.
Cardiovascular system: transient arterial hypotension.
Allergic reactions.
Overdose:Stop breathing, prolonged paralysis, hypotension.
Antagonists - anticholinesterase drugs (neostigmine, physostigmine) - prevent the hydrolysis of acetylcholine, which displaces arthracurium from the connection with the N-holinoretseptorami, resulting in a restored neuromuscular transmission.
Interaction:The general inhalation analgesics prolong and intensify the effect: halothane (by 20%), enflurane, isoflurane (by 35%), ketamine, propranolol, benzohexonium, chlorpromazine; antibiotics (aminoglycosides, tetracyclines, spectomycin, clindamycin, lincomycin); diuretics (acetamisole, furosemide); ganglion blockers (hexamethonium, trimetaphane); magnesium sulfate, preparations of lithium salts.
Pharmaceutical incompatibility with barbiturates, alkaline solutions - it is unacceptable to mix with artacurium bezylate in one syringe.
Special instructions:Nondepolarizing muscle relaxant of medium duration.
It does not penetrate the blood-brain barrier, is eliminated by the kidneys, is metabolized by plasma esterases, and undergoes spontaneous degradation.
Do not cumulate. Specific antidote - neostigmine.