Atracurium and cisatracurium. Medical search. Frequent questions

In this multicenter, double-blind trial, 340 patients presenting to the intensive care unit (ICU) with an onset of severe ARDS within the previous 48 hours were randomly assigned to receive, for 48 hours, either cisatracurium besylate (178 patients) or placebo (162 patients). (nih.gov)
Atracurium besilate, also known as atracurium besylate, is a medication used in addition to other medications to provide skeletal muscle relaxation during surgery or mechanical ventilation. (wikipedia.org)
NIMBEX (cisatracurium besylate) is a nondepolarizing skeletal neuromuscular blocker for intravenous administration. (mdtodate.com)
Cisatracurium besylate is one of 10 isomers of atracurium besylate and constitutes approximately 15% of that mixture. (mdtodate.com)
The molecular formula of cisatracurium as the besylate salt is C 65 H 82 N 2 O 18 S 2 and the molecular weight is 1243.50. (mdtodate.com)
The log of the partition coefficient of cisatracurium besylate is -2.12 in a 1-octanol/distilled water system at 25°C. (mdtodate.com)
The 5 mL single-dose vials contain 2 mg/mL cisatracurium, equivalent to 2.68 mg/mL cisatracurium besylate. (mdtodate.com)
The 10 mL multiple-dose vials contain 2 mg/mL cisatracurium, equivalent to 2.68 mg/mL cisatracurium besylate, and 0.9% benzyl alcohol as a preservative. (mdtodate.com)
atracurium besylate 10mg/ml muscle relaxant inj. (tendersinmaharashtra.com)
atracurium besylate 10 mg/ml 2.5 ml ampoule 30 inj. (tendersinmaharashtra.com)

Cis-atracurium besilate (Cisa) is a new type of muscle relaxant. (pumch.cn)

cisatracurium (Nimbex), for example, is one such agent that does not elicit histamine release even up to 5×ED95 doses. (wikipedia.org)

1997. [The clinical pharmacology of new benzylisoquinoline-diester compounds, with special consideration of cisatracurium and mivacurium]. . (cornell.edu)

Because atracurium undergoes Hofmann elimination as a primary route of chemodegradation, one of the major metabolites from this process is laudanosine, a tertiary amino alkaloid reported to be a modest CNS stimulant with epileptogenic activity and cardiovascular effects such a hypotension and bradycardia. (wikipedia.org)
Indeed, because laudanosine is cleared primarily via renal excretion, a cat study modelling anephric patients went so far as to corroborate that EEG changes, when observed, were evident only at plasma concentrations 8 to 10 times greater than those observed in humans during infusions of atracurium. (wikipedia.org)

We also perform custom synthesis and purification of Atracurium Impurity 1 impurity from mg to gm scale. (blogspot.com)

Atracurium is in the neuromuscular-blocker family of medications and is of the non-depolarizing type. (wikipedia.org)

The molecular formula of the cisatracurium parent bis-cation is C 53 H 72 N 2 O 12 and the molecular weight is 929.2. (mdtodate.com)

Atracurium is available as a generic medication. (wikipedia.org)

Patients received 0.15 mg/kg cisatracurium and were randomized to receive 0.07 mg/kg neostigmine on reappearance of the first (group I), second (group II), third (group III), or fourth (group IV) tactile TOF response (16 patients per group). (silverchair.com)

This study assessed the MACEI of sevoflurane combined with cisatracurium in neonates. (medscimonit.com)
No Repression of the Functional Recovery of Muscle and Respiration by Residual Cis-atracurium During Re-transfusion of Intraoperative Blood Salvage: A Single-center Prospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 138-142. (pumch.cn)

Targeted drugs were sedatives and neuromuscular blocking agents, massively used to manage severe COVID-19 pneumonia but also essential for anesthesia practice, namely: propofol, midazolam, cisatracurium, atracurium and rocuronium. (biomedcentral.com)
The status of stocks of targeted drugs (propofol, midazolam, atracurium, cisatracurium, rocuronium) was already registered in the "MaPUI" software (MaPUI Labs, Cesson Sévigné, France), created for this purpose by a French start-up. (biomedcentral.com)
These are either aminosteroids such as rocuronium and vecuronium, or benzylisoquinoliniums such as atracurium. (anaestheasier.com)

The two reverse ester linkages in the bridge between the two isoquinolinium groups make atracurium and cisatracurium poor targets for plasma cholinesterase, unlike mivacurium which has two conventional ester linkages. (wikipedia.org)
1997. [The clinical pharmacology of new benzylisoquinoline-diester compounds, with special consideration of cisatracurium and mivacurium]. . (cornell.edu)

Cisatracurium Besylate Injection, USP is a non-depolarizing skeletal muscle relaxant for intravenous administration. (nih.gov)
Cisatracurium Besylate Injection, USP is a sterile, non-pyrogenic aqueous solution provided in 5 mL, 10 mL, and 20 mL vials. (nih.gov)
Atracurium Besylate Injection, USP is indicated, as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. (ncats.io)
These highlights do not include all the information needed to use CISATRACURIUM BESYLATE INJECTION safely and effectively. (nih.gov)
See full prescribing information for CISATRACURIUM BESYLATE INJECTION. (nih.gov)

Consider using a cisatracurium product that has no benzyl alcohol preservative. (nih.gov)

Moreover, cisatracurium represents approximately 15% of the atracurium mixture. (wikipedia.org)
Cisatracurium besylate is one of 10 isomers of atracurium besylate and constitutes approximately 15% of that mixture. (nih.gov)

Cisatracurium is one of the ten isomers of the parent molecule, atracurium. (wikipedia.org)
The generic name cisatracurium was conceived by scientists at Burroughs Wellcome Co. (now part of GlaxoSmithKline) by combining the name "atracurium" with "cis" [hence cisatracurium] because the molecule is one of the three cis-cis isomers comprising the ten isomers of the parent, atracurium. (wikipedia.org)
The pharmacological research of cisatracurium and the other individual isomers was then developed further primarily by R. Brandt Maehr and William B. Wastila, PhD (both of whom were pharmacologists within the Division of Pharmacology at Burroughs Wellcome Co.) in collaboration with John J. Savarese MD (who at the time was an anesthesiologist in the Dept. of Anesthesia, Harvard Medical School at the Massachusetts General Hospital, Boston, MA). (wikipedia.org)
1996. Comparative pharmacology of cisatracurium (51W89), atracurium, and five isomers in cats. . (cornell.edu)

An atracurium besylate dose of 0.4 to 0.5 mg/kg (1.7 to 2.2 times the ED95), given as an intravenous bolus injection, is the recommended initial dose for most patients. (ncats.io)
Cis-atracurium benzalkonium.The degradation of cisatracurium for injection in lactated Ringer's injection are faster, so it is not recommended to use lactated Ringer's injection as a diluent for cisatracurium for injection. (wamin.com)

We also perform custom synthesis and purification of Atracurium Impurity V (Mixture of Diastereomers) impurity from mg to gm scale. (blogspot.com)

The average ED 95 (dose required to produce 95% suppression of the adductor pollicis muscle twitch response to ulnar nerve stimulation) of cisatracurium is 0.05 mg/kg (range: 0.048 to 0.053) in adults receiving opioid/nitrous oxide/oxygen anesthesia. (nih.gov)
The pharmacodynamics of 2 x ED 95 to 8 x ED 95 doses of cisatracurium administered over 5 to 10 seconds during opioid/nitrous oxide/oxygen anesthesia are summarized in Table 1. (nih.gov)
In long surgical procedures during enflurane or isoflurane anesthesia, less frequent maintenance dosing, lower maintenance doses, or reduced infusion rates of cisatracurium may be necessary. (nih.gov)
The onset, duration of action, and recovery profiles of cisatracurium during propofol/oxygen or propofol/nitrous oxide/oxygen anesthesia are similar to those during opioid/nitrous oxide/oxygen anesthesia. (nih.gov)
Cisatracurium in different doses versus atracurium during general anesthesia for abdominal surgery. (ncats.io)

Atracurium is an intermediate-duration, nondepolarizing, skeletal muscle relaxant for intravenous administration. (ncats.io)

As the secondary pharmacology of atracurium was being developed, it became clear that the primary clinical disadvantage of atracurium was likely to be its propensity to elicit histamine release. (wikipedia.org)
To address this issue, a program was initiated to investigate the individual isomer constituents of atracurium to identify and isolate the isomer(s) associated with the undesirable histamine effects as well as identify the isomer that might possibly retain the desirable properties without the histamine release. (wikipedia.org)

As is evident with the parent molecule, atracurium, cisatracurium is also susceptible to degradation by Hofmann elimination and ester hydrolysis as components of the in vivo metabolic processes. (wikipedia.org)
citation needed] See the atracurium page for information on Hofmann elimination in vivo versus the Hofmann degradation chemical reaction. (wikipedia.org)
Because Hofmann elimination is a temperature- and plasma pH-dependent process, cisatracurium's rate of degradation in vivo is highly influenced by body pH and temperature just as it is with the parent molecule, atracurium: thus, an increase in body pH favors the elimination process,[citation needed] whereas a decrease in temperature slows down the process. (wikipedia.org)

To date, cisatracurium has not been reported to elicit bronchospasm at doses that are clinically prescribed. (wikipedia.org)
The time to maximum block is up to 2 minutes longer for equipotent doses of cisatracurium compared to atracurium besylate. (nih.gov)
The clinically effective duration of action and rate of spontaneous recovery from equipotent doses of cisatracurium and atracurium besylate are similar. (nih.gov)
Isoflurane or enflurane administered with nitrous oxide/oxygen to achieve 1.25 MAC [Minimum Alveolar Concentration] may prolong the clinically effective duration of action of initial and maintenance doses, and decrease the average infusion rate requirement of cisatracurium. (nih.gov)
Fifteen to 30 minutes of exposure to 1.25 MAC isoflurane or enflurane had minimal effects on the duration of action of initial doses of cisatracurium and therefore, no adjustment to the initial dose should be necessary when cisatracurium is administered shortly after initiation of volatile agents. (nih.gov)
In additionele onderzoeken bij ratten werden foetale afwijkingen en maternale toxiciteit waargenomen na toediening van subcutane doses die leidden tot aciclovirplasmaspiegels van 100 microgram/ml (meer dan tienmaal hoger dan na een enkelvoudige toediening van 2.000 mg valaciclovir bij mensen met een normale nierfunctie) [SKP Zelitrex 09 2020]. (cybele.be)

To compare the hemodynamic effects of Atracurium versus Cisatracurium in Cardiac Patients Undergoing coronary artery bypass graft Surgery. (pafmj.org)

Atracurium itself was invented at Strathclyde University and licensed to Burroughs Wellcome Co., Research Triangle Park, NC, for further development and subsequent marketing as Tracrium. (wikipedia.org)

Cisatracurium besylate slowly loses potency with time at a rate of approximately 5% per year under refrigeration (5°C). Cisatracurium should be refrigerated at 2° to 8°C (36° to 46°F) in the carton to preserve potency. (nih.gov)
The rate of loss in potency increases to approximately 5% per month at 25°C (77°F). Upon removal from refrigeration to room temperature storage conditions (25°C/77°F), use cisatracurium within 21 days, even if rerefrigerated. (nih.gov)

Thereafter, the entire clinical development of cisatracurium was completed in a record short period from 1992 to 1994: the team of scientists was led by J. Neal Weakly PhD, Martha M. Abou-Donia PhD, and Steve Quessy PhD, in the Division of Clinical Neurosciences at Burroughs Wellcome Co., Research Triangle Park, NC. (wikipedia.org)

The 5 mL and 10 mL vials each contain cisatracurium besylate, equivalent to 2 mg/mL cisatracurium. (nih.gov)

Leakage of LDH was directly related to the concentration of atracurium in the medium (250 to 800 microM). (ncats.io)
When atracurium was added to the medium and the medium immediately added to hepatocytes, the leakage of LDH increased as the concentration of atracurium increased (P (ncats.io)

Group-A patients were induced with 0.5mg/kg of Atracurium, followed by infusion @ 10μg/kg/min whereas group C patients received Cisatracurium @ 0.2mg/kg at induction, followed by infusion @ 2μg/kg/min during the maintainence phase. (pafmj.org)

Cisatracurium found to be more suitable drug in maintaining the stable hemodynamics and preventing fluctuations in pressure in cardiac patients undergoing on-pump bypass surgery. (pafmj.org)

For comparison, the average ED 95 for atracurium when also expressed as the parent bis-cation is 0.17 mg/kg under similar anesthetic conditions. (nih.gov)

One of the metabolites of cisatracurium via Hofmann elimination is laudanosine - see the atracurium page for further discussion of the issue regarding this metabolite. (wikipedia.org)

citation needed] In vitro studies using human plasma indicated that cisatracurium spontaneously degrades at physiological pH via Hofmann elimination to yield laudanosine and the quaternary monoacrylate. (wikipedia.org)
In rat plasma, cisatracurium is also metabolized by non-specific carboxylesterases (a rate-limiting step) to the monoquaternary alcohol and the monoquaternary acid. (wikipedia.org)

The molecular formula of the cisatracurium parent bis-cation is C 53 H 72 N 2 O 12 and the molecular weight is 929.2. (nih.gov)

Anatomy1

Chemicals and Drugs21

Analytical, Diagnostic and Therapeutic Techniques and Equipment7

Phenomena and Processes3

Health Care1

Besylate10

Besilate1

Nimbex1

Mivacurium1

Laudanosine2

Impurity1

Neuromuscular1

Molecular Weight1

Medication1

Patients1

Study2

Rocuronium3

Mivacurium2

Besylate Injection5

Benzyl alcohol1

Approximately 152

Isomers4

Injection2

Mixture1

Anesthesia5

Skeletal muscle relaxant for intravenous adminis1

Histamine release2

Degradation3

Doses6

Versus1

Tracrium1

Potency2

Clinical1

Vials1

Concentration2

Infusion1

SURGERY1

Similar1

Page1

Plasma2

Parent1