Tracrium (atracurium besylate) solution for injections 10 mg/ml. 2.5 ml. vials №5

Description

Tracrium (atracurium besylate) solution for injections 10 mg/ml. 2.5 ml. vials №5

Composition

active substance: atracurium besylate;

1 ml of solution contains 10 mg of atracurium besylate;

Excipients: benzenesulfonic acid solution, water for injections.

Dosage form

Solution for injection.

Basic physical and chemical properties: transparent solution of slightly yellowish color, practically free from mechanical inclusions.

Pharmacotherapeutic group

Muscle relaxants with a peripheral mechanism of action. Other Quaternary ammonium compounds.
ATX code M03A C04.

Pharmacological properties

It is a muscle relaxant with a peripheral mechanism of action. It is a highly selective (selective) non-depolarizing muscle relaxant, inhibits (competitively) acetylcholine receptors of the postsynaptic membrane. It inhibits the neuromuscular transmission of excitation impulses, causing relaxation of the skeletal muscles.

Indications

Tracrium solution is used:

• with the aim of relaxing skeletal muscles during diagnostic procedures, surgical interventions, artificial ventilation;
• as an aid for general anesthesia;
• to create conditions for tracheal intubation.

Contraindications

Tracrium solution is not used:

• with intolerance to the components;
• with myasthenia gravis;
• with severe electrolyte imbalance, incl. hypokalemia, hypocalcemia;
• with acidosis;
• with carcinomatosis.

Application during pregnancy and lactation

It is possible to use this drug in pregnant women if necessary. In obstetric practice, it is used as a muscle relaxant during a cesarean section.
It is not known whether the active substance and its metabolites are excreted in breast milk. If treatment is necessary, breastfeeding is discontinued.

Method of administration and dosage

Tracrium solution is used parenterally (intravenously only).
To prevent distress, it is not recommended to use the drug until the patient becomes unconscious.
The standard dose for adults in the form of a bolus injection is 0.3-0.6 mg / kg, depending on the required duration of the neuromuscular blockade, provides relaxation for 15-35 minutes. If it is necessary to lengthen the period of blocking action, an additional 0.1-0.2 mg / kg is administered. The restoration of neuromuscular transmission occurs in about 35 minutes.
The neuromuscular blockade caused by the use of the drug can be quickly leveled by the appointment of anticholinesterase drugs.
The standard dose for adults in the form of an infusion (after the initial bolus injection) to further maintain neuromuscular blockade is 0.3-0.6 mg / kg / hour.
It is possible to use the drug by intravenous infusion during coronary artery bypass grafting.
If hypothermia of the body is necessary, a decrease in the level of inactivation of the active substance should be taken into account, therefore, to maintain the neuromuscular blockade, in this case, the infusion rate is reduced.
The drug can be used in children older than one month in the same doses as for adults (calculated on the child’s body weight).

Overdose

Symptoms: respiratory depression, apnea, collapse, hypotension, shock, prolonged paralysis (myoplegia).
Therapeutic measures: the introduction of antagonists – anticholinesterase drugs, artificial ventilation of the lungs under positive pressure, support for complete sedation of the patient. For shock, severe arterial hypotension, vasoconstrictors are used.

Side effects:

• Cardiovascular disorders: arterial hypotension (transient, moderate), skin hyperemia.
• Respiratory disorders: bronchospasm.
• Immune disorders: anaphylactic, anaphylactoid reactions.
• Neurological disorders: seizures (usually with a disposition to seizures – cerebral edema, head trauma, viral encephalitis, uremia, hypoxic encephalopathy).
• Musculoskeletal disorders: muscle weakness, myopathy, myopathy.