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Atracurium (Tracrium)

A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.

Also Known As:

Tracrium; 33 A 74; Atracurium Besilate; BW-33A; Glaxo Wellcome Brand of Atracurium Besilate; Pisa Brand of Atracurium Besilate; Relatrac; Wellcome Brand of Atracurium Besilate; A 74, 33; BW 33A; BW33A; Besilate, Atracurium; Atracurium Besylate; Atracurium Dibesylate; Isoquinolinium, 2,2'-(1,5-pentanediylbis(oxy(3-oxo-3,1-propanediyl)))bis(1-((3,4-dimethoxyphenyl)methyl))-1,2,3,4-tetrahydro-6,7-dimethoxy-2-methyl-

Networked: 393 relevant articles (11 outcomes, 34 trials/studies)

Relationship Network

Drug Context: Research Results

Heterocyclic Compounds: 60
- 2-Ring Heterocyclic Compounds
  - Isoquinolines: 16
    - Benzylisoquinolines: 2
      - Atracurium: 393
        cisatracurium: 105

Experts

1.	Martyn, J A Jeevendra: 5 articles (08/2013 - 01/2003)
2.	Blobner, Manfred: 5 articles (08/2013 - 01/2003)
3.	Fink, Heidrun: 4 articles (08/2013 - 01/2003)
4.	Gleed, Robin D: 3 articles (12/2010 - 01/2006)
5.	Dewachter, Pascale: 2 articles (09/2015 - 05/2011)
6.	Mouton-Faivre, Claudie: 2 articles (09/2015 - 05/2011)
7.	Richtsfeld, Martina: 2 articles (08/2013 - 06/2007)
8.	van Ramshorst, Bert: 2 articles (01/2011 - 01/2009)
9.	Campoy, Luis: 2 articles (12/2010 - 05/2008)
10.	Ludders, John W: 2 articles (12/2010 - 05/2008)

Related Diseases

1.	Critical Illness (Critically Ill) 08/15/1995 - "Cost-effective treatment of atracurium resistance in critically ill patients." 01/01/2000 - "Duration of action of atracurium when given by infusion to critically ill children." 01/01/1997 - "Increased infusion requirements were necessary during the prolonged administration of cis-atracurium to a critically ill infant. " 07/01/1995 - "Atracurium resistance in a critically Ill patient." 03/01/1995 - "Although some clinicians advocate routine administration of atracurium in critically ill patients due to the relative lack of reports of prolonged weakness, this may be premature. "
2.	Paralysis (Palsy) 05/01/2011 - "Our study gave the impression that more than two hours between the administration of a single intubating dose of an intermediate-acting nondepolarizing muscle relaxant (atracurium) and arrival to the PACU can probably guarantee the lack of a residual paralysis." 11/01/2010 - "Residual paralysis following a single dose of atracurium: results from a quality assurance trial." 01/01/1981 - "In vitro studies have shown that the non-enzymic decomposition of atracurium by "Hofmann Elimination" was enhanced by increasing pH. In vivo neuromuscular paralysis was significantly reduced when the arterial pH was increased. " 05/01/2008 - "To compare acceleromyography (AMG) with visual assessment of train-of-four (TOF) for monitoring neuromuscular blockade and detecting residual muscle paralysis in horses receiving atracurium. " 06/01/2007 - "The atracurium plasma concentration to maintain a steady state 50% paralysis was significantly reduced in the 10-U toxin group. "
3.	Fasciculation (Fasciculations) 08/01/1996 - "The incidence of fasciculations was less in the atracurium pretreatment group (group B) than in the group treated with normal saline (group A). " 12/01/1994 - "The use of atracurium reduced the incidence of myalgia by 60% (P < 0.001) and the severity of fasciculations (P < 0.001). " 11/01/1990 - "Fasciculations occurred in all patients who received saline and in 44% of those treated with atracurium. " 07/01/1990 - "Atracurium reduced the incidence of fasciculations from 100% observed in the control to between 0 and 40% in the atracurium groups. " 11/01/1990 - "These findings show that atracurium 5 mg i.v. is effective in preventing succinylcholine-induced fasciculations and postoperative myalgias, and suggest atracurium as the drug of choice for this purpose, particularly in muscular subjects."
4.	Seizures (Seizure) 01/01/1993 - "Patients pretreated with atracurium 0.5 mg/kg had significantly fewer ECT-induced moderate and vigorous convulsions when compared with patients receiving atracurium 0.3 mg/kg (16.7% vs. 78.4%, moderate; 0% vs. 8.3%, vigorous). " 05/01/1989 - "These results suggest that the routine use of atracurium is unlikely to provoke seizures, even in the presence of an epileptogenic focus." 01/01/1993 - "Whereas full neuromuscular blockade by atracurium 0.5 mg/kg i.v. is very effective in the modification of tonic-clonic convulsions induced by ECT, we suggest that a lower dose of atracurium (0.3 mg/kg i.v.) be used if one needs to ascertain the occurrence of ECT-induced seizures as indicated by minimum peripheral muscle activity at the time of EEG recording during MMECT." 01/01/2010 - "Laudanosine, a degradation of neuomuscular blocking agent atracurium, crosses the blood-brain barrier and is indicted to trigger seizures at high concentration. " 05/01/1998 - "Atracurium besylate and laudanosine cause excitement and seizures when introduced into the central nervous system of laboratory animals. "
5.	Renal Insufficiency (Renal Failure) 06/01/1987 - "Pharmacokinetics of atracurium were not significantly different in the renal failure group when compared with those obtained in a previous study on six normal patients. " 09/01/1990 - "The neuromuscular function was monitored by measuring the twitch tension of the adductor pollicis muscle elicited by stimulation of the ulnar nerve at 0.1 Hz. The total duration of neuromuscular blockade (51.8 +/- 11.5 minutes) and the recovery index (9.6 +/- 2.0 minutes) are shortened in patients with impaired renal function, compared with those with normal renal function (64.1 +/- 7.2 and 16.7 +/- 4.1 minutes, respectively), indicating that sensitivity to the neuromuscular blocking action of atracurium may be altered by renal failure." 09/01/1989 - "Use of atracurium in patients with or without renal failure." 10/19/1987 - "[Atracurium requirement in surgical patients with normally functioning kidneys and in those with terminal renal failure]." 06/01/1987 - "Pharmacokinetics of atracurium and its metabolites in patients with normal renal function, and in patients in renal failure."

Related Drugs and Biologics

1.	Succinylcholine (Suxamethonium Chloride)
2.	laudanosine
3.	Pancuronium (Pavulon)
4.	Neuromuscular Blocking Agents
5.	Propofol (Diprivan)
6.	Fentanyl (Sublimaze)
7.	cisatracurium (Nimbex)
8.	Creatinine
9.	Atropine (Hyoscyamine)
10.	Adrenal Cortex Hormones (Corticosteroids)

Related Therapies and Procedures

1.	Artificial Respiration (Mechanical Ventilation)
2.	Kidney Transplantation
3.	Anesthesia
4.	General Anesthesia
5.	Bariatric Surgery