Cisatracurium besylate

Cisatracurium besylate

Cisatracurium besylate is a non-depolarizing neuromuscular-blocking drug used in 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.

Pharmacology

Cisatracurium besylate works by blocking the action of acetylcholine at the neuromuscular junction, preventing depolarization of the muscle cell membrane and subsequent muscle contraction. It is an intermediate-duration muscle relaxant, with effects lasting approximately 30 to 60 minutes.

Metabolism and Elimination

Cisatracurium is unique among neuromuscular-blocking agents because it undergoes Hofmann elimination, a process that is independent of renal and hepatic function. This makes it particularly useful in patients with renal failure or hepatic impairment.

Clinical Use

Cisatracurium besylate is commonly used in various clinical settings, including:

• General anesthesia for surgical procedures
• Intensive care units for patients requiring prolonged mechanical ventilation
• Rapid sequence induction of anesthesia

Side Effects

Common side effects of cisatracurium besylate include:

• Hypotension
• Bradycardia
• Flushing
• Histamine release (less common compared to other neuromuscular-blocking agents)

Dosage and Administration

The dosage of cisatracurium besylate varies depending on the intended use, patient weight, and clinical condition. It is typically administered intravenously, with an initial dose followed by maintenance doses as needed.

Related Pages

• Neuromuscular-blocking drug
• Anesthesia
• Endotracheal intubation
• Mechanical ventilation
• Hofmann elimination
• Renal failure
• Hepatic impairment