Intravenous Facilitate endotracheal intubation, Facilitate mechanical ventilation in intensive care, Muscle relaxant in general anaesthesia
Adult: Initially, 150 mcg/kg by inj. Maintenance: 30 mcg/kg by inj (each dose provides 20 min of additional block), may also be given by infusion at an initial rate of 3 mcg/kg/min followed by a rate of 1-2 mcg/kg/min. Child: 1-23 mth Initially, 150 mcg/kg by inj over 5-10 sec, during halothane or opiate anaesth; 2-12 yr Initially, 100-150 mcg/kg by inj over 5-10 sec, during halothane or opiate anaesth. Maintenance: 20 mcg/kg by inj (each dose provides 9 min of additional block), may also be given by infusion at an initial rate of 3 mcg/kg/min followed by a rate of 1-2 mcg/kg/min.
Dilute to desired concentration (e.g. 0.1-0.4 mg/mL) in a compatible IV soln (e.g. dextrose 5%, NaCl 0.9%).
Symptoms: Prolonged muscle paralysis. Management: Maintain pulmonary ventilation and arterial oxygenation. Recovery may be accelerated by admin of anti-cholinesterase agent (e.g. neostigmine, edrophonium).
Description: Cisatracurium antagonises the action of acetylcholine by binding to cholinergic receptors on the motor end-plate, resulting in a competitive block of neuromuscular transmission. Onset: 2-3 min. Pharmacokinetics: Absorption: Time to peak plasma concentration: 3-5 min. Distribution: Distributed into extracellular fluid and crosses the placenta. Volume of distribution: 121-161 mL/kg. Metabolism: Converted to laudanosine and monoquaternary acrylate metabolite by spontaneous degradation via Hofmann elimination. The monoquaternary acrylate undergoes ester hydrolysis by non-specific plasma esterases. Excretion: Via urine and bile, mostly as metabolites. Half-life: 22-29 min.
Store between 2-8°C. Protect from light. Do not freeze.
M03AC11 - cisatracurium ; Belongs to the class of other quaternary ammonium-containing agents used as peripherally-acting muscle relaxants.
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