Mivacurium chloride

Generic Medicine Info
Patients known or suspected to be homozygous for the atypical plasma cholinesterase gene.
Special Precautions
Patient with previous anaphylactic reaction to other neuromuscular blockers; clinically significant CV disease; conditions that may antagonise neuromuscular blockade (e.g. hypercalcaemia, respiratory alkalosis, peripheral neuropathies, demyelinating lesions, denervation, muscle trauma); conditions that may diminish plasma cholinesterase activity (e.g. anaemia, myxoedema, collagen diseases, peptic ulcer); conditions that may potentiate neuromuscular blockade (e.g. myasthenia gravis, neuromuscular disease, metabolic or respiratory acidosis, electrolyte abnormalities, Eaton-Lambert syndrome); asthma, hypovolaemia. Burn injury, obese or immobilised patients. Renal and hepatic impairment. Children and elderly. Pregnancy and lactation. Monitoring Parameters Monitor vital signs (e.g. blood pressure, heart and respiratory rate); degree of muscle paralysis (e.g. ventilator asynchrony, shivering, presence of spontaneous movement).
Adverse Reactions
Significant: Bradycardia, neuromuscular cross-sensitivity. Cardiac disorders: Transient tachycardia. General disorders and administration site conditions: Inj site reactions. Musculoskeletal and connective tissue disorders: Muscle spasms. Nervous system disorders: Dizziness. Respiratory, thoracic and mediastinal disorders: Bronchospasm, wheezing. Skin and subcutaneous tissue disorders: Erythema, urticaria, rash. Vascular disorders: Flushing, hypotension.
Potentially Fatal: Severe anaphylactic reactions.
Drug Interactions
Increased neuromuscular blocking effects with inhalational anaesthetics (e.g. enflurane, isoflurane, sevoflurane, halothane), antibiotics (e.g. aminoglycosides, polymyxin, tetracyclines, clindamycin), antiarrhythmics (e.g. quinidine, lidocaine, Ca channel blockers), diuretics (e.g. furosemide, acetazolamide), ganglion blocking agents (e.g. hexamethonium, trimetaphan), Mg salts, ketamine, and lithium salts. Prolonged neuromuscular blocking effects with antimitotic drugs, MAOIs, organophosphates, anticholinesterases, bambuterol, SSRIs. May result in a prolonged and complex block with depolarising relaxant (e.g. suxamethonium chloride).
CIMS Class
Neuromuscular Disorder Drugs
ATC Classification
M03AC10 - mivacurium chloride ; Belongs to the class of other quaternary ammonium-containing agents used as peripherally-acting muscle relaxants.
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