Atracurium besilate

Chemical structure of Atracurium besilate

Atracurium besilate is a non-depolarizing neuromuscular-blocking drug used in modern anesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. It is a member of the benzylisoquinolinium class of muscle relaxants.

Mechanism of Action

Atracurium besilate works by competitively inhibiting the action of acetylcholine at the neuromuscular junction. This inhibition prevents the depolarization of the muscle fiber membrane, leading to muscle relaxation. Unlike depolarizing muscle relaxants, atracurium does not cause initial muscle fasciculations.

Pharmacokinetics

Atracurium is unique among neuromuscular blockers because it undergoes Hofmann elimination, a chemical process that occurs at physiological pH and temperature, leading to its breakdown into inactive metabolites. This process is independent of renal or hepatic function, making atracurium a suitable choice for patients with renal failure or liver disease.

Clinical Use

Atracurium is commonly used in operating rooms and intensive care units to facilitate mechanical ventilation and to provide muscle relaxation during surgical procedures. It is administered intravenously and has an onset time of 2-3 minutes, with a duration of action of approximately 20-35 minutes.

Side Effects

Common side effects of atracurium include hypotension and flushing due to histamine release. Rarely, it can cause bronchospasm in susceptible individuals. Careful monitoring of neuromuscular function is recommended to avoid prolonged paralysis.

Related Pages

• Neuromuscular-blocking drug
• Anesthesia
• Endotracheal intubation
• Hofmann elimination