Acurmil
Acurmil Uses, Dosage, Side Effects, Mechanism of Action, How Long Does it Take to Work? Acurmil is a brand name. Its generic name is Atracurium.
Acurmil
Acurmil Besylate (ATB) is a nondepolarizing neuromuscular-blocking agent (NMBA) that is administered intravenously (IV) to facilitate neuromuscular relaxation during diagnostic or surgical procedures. It is chemically and structurally related to d-tubocurarine, but its effects are shorter and might be less cardiotoxic and nephrotoxic. The trade name of atracurium is Tracrium.
Uses For
Acurmil is used for the temporary relaxation of skeletal muscles during tracheal intubation, abdominal surgery and other procedures. It is used as a adjuvant to general anesthesia and in the management of neuromuscular blocking agents administration during anesthetic and intensive care.
Mechanism of Action
Acurmil binds to cholinergic receptors at the neuromuscular junction and causes competitive blockade at the mechanistic level. This produces a reversible, dose-dependent blockade of neuromuscular transmission andCross bridge cycling inhibition. This means that muscle contraction can no longer be stimulated regardless of the number of potential action potentials, resulting in a reversible skeletal muscle paralysis.
How long does it take to work?
Acurmil takes effect within 1-2 minutes after IV administration and one dose will last for 30-60 minutes.
Absorption
Acurmil is not well absorbed from the gastrointestinal (GI) tract and is administered solely through intravenous (IV) injection. The drug is metabolised by the liver.
Route of Elimination
Acurmil is metabolised by the liver into inactive by-products; approximately 70% of the drug is metabolised by Hoffman elimination with the remainder metabolised by Hofmann degradation.
Dosage
Acurmil is typically given as an IV bolus in an initial dose of 0.1-0.3mg/kg. The dose may be repeated every 5-10 minutes or as needed in order to maintain the desired level of relaxation. The maximum cumulative dose should not exceed 1.5mg/kg.
Administration
Acurmil is administered intravenously either as a bolus or continuous infusion depending on the patient’s response. It is typically administered as a single bolus injection or as a continuous infusion, with the recommended initial dose of 0.1-0.3mg/kg.
Side Effect
The most common side effects of atracurium are low blood pressure, breathing difficulty, and bradycardia. More serious side effects include anaphylaxis, cardiac arrhythmias, allergic dermatitis or urticaria, as well as exaserbation of myasthenia gravis.
Toxicity
Acurmil has low toxic potential, with serum concentrations of atracurium resulting in firmness of muscle of less than 20 ug/ml associated with myocardial depression.
Precaution
Acurmil should be used with caution in patients with liver or kidney impairment, obstructive airway disease, myasthenia gravis, severe cardiovascular disease, seizure disorders. It should be used with extreme caution in pediatric patients.
Interaction
Acurmil is known to interact with other drugs like succinyl-choline, aminoglycosides, amiodarone, cimetidine, clindamicin, erythromycin, lithium and phenobarbital.
Disease Interaction
Acurmil may increase the risk of muscle weakness, bradycardia and hypotension in patients with underlying myasthenia gravis. It may also aggravate existing heart, renal and hepatic diseases.
Drug Interaction
Acurmil may interact with other drugs such as succinyl-choline, aminoglycosides, amiodarone, cimetidine, clindamycin, erythromycin, lithium and phenobarbital.
Food Interactions
Acurmil is not known to interact with any certain foods, but medications containing alcohol may interact with the drug. It may also interact with iron supplements or acidic foods.
Pregnancy Use
Acurmil is not recommended for use during the 3rd trimester of pregnancy due to the potential for fetal harm. It can also be used with caution in the first two trimesters.
Lactation Use
Acurmil is excreted in breast milk and should not be used in nursing mothers.
Acute Overdose
Acute overdose of atracurium may lead to respiratory depression, hypotension and muscle weakness. Treatment of acute overdose includes supportive care including oxygenation and ventilation, as well as anticholinergic drugs such as atropine and glycopyrrolate.
Contraindication
Acurmil should not be used in patients with known hypersensitivity to the drug or its components, and in patients with myasthenia gravis.
Use Direction
Acurmil is intended for intravenous use only and must be mixed with compatible fluids prior to injection. The mixed solution of the drug should be used immediately and any unused solution should be discarded.
Storage Condition
Acurmil should be stored in a cool, dry place away from direct light and moisture, and at room temperature between 15-25°C.
Volume of Distribution
The volume of distribution of atracurium is approximately 15-20L/kg.
Half Life
The elimination half-life of atracurium is approximately 10-20 minutes.
Clearance
Acurmil has a clearance of approximately 5-10mL/kg/min.
Here you find in details version of Acurmil