Atracurium

Atracurium

{{drugbox | | IUPAC_name = 2,2'-{1,5-Pentanediylbis[oxy(3-oxo-3,1- propanediyl)]}bis[1-(3,4-dimethoxybenzyl) -6,7-dimethoxy-2-methyl-1,2,3,4- tetrahydroisoquinolinium] |- | image = Atracurium.svg | CAS_number = 64228-79-1 | ATC_prefix = M03 | ATC_suffix = AC04 | PubChem = 9751 | DrugBank = APRD00806 | C=53 | H=72 | N=2 | O=12 | charge=2+ | molecular_weight = 929.145 g/mol | bioavailability = 100% (IV) | protein_bound = 82% | metabolism = Hofmann elimination (retro-Michael addition) and ester hydrolysis | elimination_half-life = 17-21 minutes | excretion = | pregnancy_category = | legal_status = POM (UK)and worldwide | routes_of_administration = IV }} Atracurium is a neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarizing neuromuscular-blocking drugs, used adjunctively in anesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Side effects owing to histamine liberation are rash, reflex increase in heart rate, low blood pressure and bronchospasm.

It is a bisbenzyltetrahydroisoquinolinium mixture of 10 stereoisomers. Atracurium was first synthesized, in 1974 by George H. Dewar, in John B. Stenlake's medicinal chemistry research group at Strathclyde University, Scotland. It is the first non-depolarising non-steroidal skeletal muscle relaxant rationally designed to undergo chemodegradation in vivo. Atracurium was licensed to Burroughs Wellcome Co., which developed atracurium and eventually marketed it (as a mixture of all ten stereoisomers) under the name Tracrium. Atracurium's rate of degradation in vivo is influenced by pH and temperature.

Atracurium was succeeded by cisatracurium, which is the R-cis R-cis isomer constituent of atracurium. The pharmacodynamic and adverse effects profile of cisatracurium proved to be superior to that of atracurium. Cisatracurium was made available worldwide as Nimbex in 1995, with its clinical development solely undertaken by Burroughs Wellcome Co.

Atracurium is classified as an intermediate-acting non-depolarising neuromuscular blocking agent.

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