presentation on the drug atracurium from anesthesia point of view

1. ATRACURIUM
DR.FARWA SHABBIR
HOUSE OFFICER ANAESTHESIOLOGY

2. ROAD MAP
• INTRODUCTION
• STRUCTURE
• MODE OF ACTION
• PHARMACOKINETICS
• METABOLISM AND EXCRETION
• DOSAGE
• INDICATIONS
• SIDE EFFECTS

3. INTRODUCTION
non-depolarizing
Neuro-muscular blocking agent
Metabolism Rapid
Onset Moderately Rapid
Duration Moderately Rapid
Histamine release slow
Vagal Blockade None

4. STRUCTURE
• Quaternary Ammonium
compound
• benzylisoquinoline structure

5. PHARMACOKINETICS
• Bioavailability: poorly absorbed from the GI
tract
• Half-life: approximately 20 minutes
• Distribution: into extracellular fluid, minimally
crosses the placenta
• Elimination Route: excreted principally in
urine and also in feces via biliary elimination

6. MODE OF ACTION

8. MODE OF REVERSAL

9. METABOLISM AND EXCRETION
Ester Hydrolysis
This action is catalyzed by nonspecific esterases
Hofmann Elimination
A spontaneous non-enzymatic chemical breakdown
occurs at physiological pH and temperature.

10. DOSAGE AND ADMINISTRATION
• A dose of 0.5 mg/kg is administered
intravenously for intubation
• incremental doses of 0.1 mg/kg every 10–20
min after administration of succinylcholine
• An infusion of 5–10 mcg/kg/min can
effectively replace intermittent boluses

11. INDICATIONS
Endotracheal Intubation
Mechanical Ventilation
Skeletal muscle relaxation during surgery

12. CONTRAINDICATIONS
No documented contraindications except in such
conditions;
Allergy
Myasthenia Gravis
Asthma

13. CLINICAL SIDE EFFECTS
Hypotension and Tachycardia
Bronchospasm
Laudanosine Toxicity
Temperature and pH Sensitivity
Chemical Incompatibility
Allergic Reactions