Cisatracurium
From Wikipedia, the free encyclopedia
Cisatracurium
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Systematic (IUPAC) name | |
5-[3-[(1R,2R)-1-[(3,4-dimethoxyphenyl)methyl]-6,7- dimethoxy-2-methyl-3,4-dihydro-1H-isoquinolin-2-yl] propanoyloxy]pentyl 3-[(1R,2R)-1-[(3,4-dimethoxy phenyl)methyl]-6,7-dimethoxy-2-methyl-3,4-dihydro- 1H-isoquinolin-2-yl]propanoate |
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Identifiers | |
CAS number | |
ATC code | M03 |
PubChem | |
DrugBank | |
Chemical data | |
Formula | C53H72N2O12+2 |
Mol. mass | 929.145 g/mol |
Pharmacokinetic data | |
Bioavailability | N/A - IV use only |
Protein binding | Unknown due to rapid degradation |
Metabolism | 80% Hoffman elmination/ Hepatic |
Half life | 20-29 minutes |
Excretion | 10-15% unchanged |
Therapeutic considerations | |
Pregnancy cat. |
B |
Legal status | |
Routes | IV only |
Cisatracurium (usually as cisatracurium besilate, trade name Nimbex) is a neuromuscular-blocking drug. It is one of the ten isomers of atracurium. Its active metabolites contain less laudanosine which cause hypotension, central nervous system excitement, and seizures than that of atracurium. It is considered an intermediate-acting agent in terms of duration of action.
[edit] Structure
It is a benzyl-isoquinolinium agent in the quaternary ammonium compound family.
[edit] Metabolism
80% is metabolized to laudanosine via Hofmann elimination (which is dependent on the pH and the temperature of the plasma) and 20% is metabolized hepatically or excreted renally. Since Hofmann elimination is organ-independent, the use of cisatracurium may pose less risk in patients with liver or renal disease than other neuromuscular blockers. 10-15% of the dose is excreted unchanged in the urine.
[edit] External links
- Esmaoglu A, Akin A, Mizrak A, Turk Y, Boyaci A (2006). "Addition of cisatracurium to lidocaine for intravenous regional anesthesia.". J Clin Anesth 18 (3): 194–7. doi: . PMID 16731321.
- Melloni C, Devivo P, Launo C, Mastronardi P, Novelli G, Romano E (2006). "Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/fentanyl/N2O anesthesia.". Minerva Anestesiol 72 (5): 299–308. PMID 16675938.
- Serra C, Oliveira A (2006). "Cisatracurium: myographical and electrophysiological studies in the isolated rat muscle.". Fundam Clin Pharmacol 20 (3): 291–8. doi: . PMID 16671964.
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