Mivacurium chloride

Chemical name

[R[R*,R*-(E)]]-2,2'-[(1,8-Диоксо-4 -октен-1,8-диил)бис(окси -3,1-пропандиил)]бис[1,2,3, 4-тетрагидро-6,7-димето��си-2-метил-1-[(3,4,5-триме��оксифениил)метил]изо��инолиния dichloride; mixture of the three stereoisomers : trans-trans, tsis-trans (at 92-96%) and tsis-tsis

Gross

C58-H80-Cl2-N2-O14

Of drugs

The drugs-miorelaksirutee (nedepoliarizutee). It korotkovremennouu obratimuu blockade neiromyshecna transfer competes with the azetilholinom никотинчувствительны е holinoretseptora in skeletal muscular. Presinapticalkie block sodium channels and reduces the acetylcholine from the nerve endings. Has impact on the cardiovascular system, lowers AD and increases curves. After the on / in the off in the blood characterized by the rapid initial phase and the slow phase out. Heavy ions molecule is bad mivakuriya passing through membranes and restrict its distribution. Fully hydrolyses holinesterzoy plasma. Pharmacokinetics is independent of the liver and kidneys. However, kidney failure duration of the mivakuriya may be extended, as a decline in the level of activity and psevdoholinesterzy.

Indications

Relaxation of skeletal muscles during general anesthesia to facilitate tracheal intubations and IVL.

Contraindications

Hypersensitivity, gomozigotnosti on gene SARS cholinesterase, pregnancy.

Side-Effects

Hypotension, tachycardia, tides, bronhospazm, erythema, urticaria.

Patient interaction

Effect (neiromyshecnaya blockade) potenziruut 73.21 anaesthetics, aminoglikozida, polimiksin, tetratziklin, linkomicin, propranolol, calcium antagonists, lidocaine, procainamide, quinidine, furosemide, tiazidnye dioretiki, mannit, salt magnesium, lithium, ketamine, acetazolamide, trimetafan, pancuronium, gexametoni weakening - antiholinesteraznae drugs and the means with n-holinomimeticescoy activity bambuterol.

Overdosing

Symptoms : long paralysis muscles Gipotonia.lechenie : IVL amidst sedation, the introduction antiholinesteraznah preparations from atropinom (with the emergence of spontaneous respiration), as appropriate, vazopressornye funds.

Precautions

Are only with the mouth and trachea IVL. Against the backdrop of cardiovascular pathology, the high degree of sensitivity to gistaminu, gipovolemii initial dose should be slow (in the 60s). In patients with the terminal stage of liver and kidney failure, with myasthenia and cachexia dosing picked individually. It should not be combined with depoliarizutmi miorelaxanthami and confused in one sprite with vsokoshchelocnami Solutions (barbiturates).

Dosing and Administration

B / 386/1989 Adults : tracheal intubation be performed within 30 seconds, after the 0.2 mg / kg (possibly through 2-2.5 min), or 1.5-2 min with a 0.25 mg / kg 2 admission (0.15 mg / kg, 30 with a further 0.1 mg / kg). Introduction of bolusa - 0,07-0,25 mg / kg With the doses 0.07; 0.15; 0.20; 0.25 mg / kg length neiromyshecna effective blockade is 13, 16, 20 and 23 minutes respectively, in doses up to 0.15 mg / kg being with 5-15, in a high-30 s; A 0.1 mg / kg in the form of bolusa effect extends to 15 min. Infuzionno 8-10 µ g / kg / min. Children between the ages of 7 months to 12 years : in the form of bolusa 0.1-0.2 mg / kg within 15 seconds; Tracheal intubation performed within 2 minutes after 0.2 mg / kg Children 2-5 months : in the form of bolusa - 0.1-015 mg / kg within 15 seconds; Tracheal intubation is possible within 1.4 min after 0.15 mg / kg Speed Infusion against galotanovogo narcosis-11 µ g / kg / min (aged between 7 and 23 months), 13 µ g / kg / min (2-12 years).

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