Flaxedil

Flaxedil Uses, Dosage, Side Effects, Mechanism of Action, How Long Does it Take to Work? Flaxedil is a brand name. Its generic name is Gallamine Triethiodide.

Introduction

Gallamine triethiodide (GT) is a potent neuromuscular blocking agent that is structurally identical to neostigmine and used primarily for the induction of general anaesthesia. It is a quaternary ammonium compound, which exhibits non-depolarizing competitive neuromuscular blocking activity and is also known as Flaxedil, Flaxedom, Fluxedil, and Thiocurare.

Uses

Gallamine triethiodide is used for the induction of general anaesthesia. It can also be used to facilitate procedures such as tracheal intubation or neurosurgical operations, and to reduce the intensity of autonomous skeletal muscle function.

Mechanism of Action

The mechanism of action of gallamine triethiodide involves competition between the drug molecules and the acetylcholine molecules for the post-synaptic sites within the neuromuscular junction. When gallamine triethiodide binds to the post-synaptic sites, it prevents the binding of acetylcholine and reduces the amount of acetylcholine that is available for binding. This reduces the amount of acetylcholine that can stimulate the post-synaptic receptors, effectively blocking the transmission of nerve impulses to the muscles and resulting in muscle relaxation.

How Long Does it Take to Work?

Gallamine triethiodide typically takes 15-30 minutes to take effect when administered intravenously. It begins to work within 1-2 minutes when administered intramuscularly.

Absorption

Gallamine triethiodide is rapidly and completely absorbed when administered intravenously and intramuscularly.

Route of Elimination

Gallamine triethiodide is eliminated from the body primarily in the urine as unchanged drug and its metabolites. Approximately 10% of the administered dose is eliminated in the feces.

Dosage

The dose of gallamine triethiodide varies based on the individual’s age, weight, and condition. Typically, the adult dosage range is 1.5-3.5 mg/kg administered intravenously or intramuscularly. Pediatric doses should be administered under the supervision of a healthcare provider.

Administration

Gallamine triethiodide must be administered intravenously or intramuscularly by a healthcare professional with 3-5 ml sterile water for injection.

Side Effects

Some common adverse reactions to gallamine triethiodide include hypotension, arrhythmias, bradycardia, bronchospasm, and respiratory depression. Rarely, anaphylactic reactions have been reported.

Toxicity

The anticholinergic effects of gallamine triethiodide may cause increased risk of toxicity, particularly in patients with compromised respiratory, hepatic, or renal function.

Precaution

Before administering gallamine triethiodide, a thorough evaluation of the patient’s medical history should be completed, including any past use of any neuromuscular blocking agents. Additionally, precautions should be taken to ensure proper and prompt aspiration of the drug.

Interaction

Gallamine triethiodide may interact with other drugs, such as barbiturates, anti-depressants, beta-blockers, benzodiazepines, and anticholinergics, which can increase the risk for adverse effects.

Disease Interaction

Patients with chronic respiratory and/or renal diseases should be cautious when using gallamine triethiodide as it may worsen symptoms. Additionally, gallamine triethiodide should not be used in patients with Amyotrophic lateral sclerosis or Myasthenia gravis.

Drug Interactions

Gallamine triethiodide may interact with other drugs, such as barbiturates, anti-depressants, beta-blockers, benzodiazepines, and anticholinergics, which can increase the risk for adverse effects.

Food Interactions

Gallamine triethiodide should not be administered with food or any other liquids.

Pregnancy Use

Gallamine triethiodide is classified as Pregnancy Category C and should only be used if the potential benefit justifies the potential risk to the fetus.

Lactation Use

Gallamine triethiodide has been known to appear in breast milk and it should be used with caution in nursing mothers.

Acute Overdose

An acute overdose of gallamine triethiodide may lead to prolonged respiratory depression and muscle paralysis, which may require intensive respiratory support and neuromuscular blockade reversal.

Contraindication

Gallamine triethiodide is contraindicated in patients with known hypersensitivity to the drug, cardiac arrhythmias, myasthenia gravis, and Amyotrophic lateral sclerosis.

Use Direction

The dose of gallamine triethiodide should be injected directly intravenously or intramuscularly with 3-5 mL of sterile water for injection over a period of 1-2 minutes.

Storage Conditions

Gallamine triethiodide should be stored at room temperature, away from light and moisture.

Volume of Distribution

Gallamine triethiodide has a volume of distribution of 0.47-0.57 L/kg.

Half Life

The elimination half-life of gallamine triethiodide is approximately 5 hours.

Clearance

The clearance of gallamine triethiodide is 6.21 mL/min/kg.

Here you find in details version of Flaxedil

Some Frequently Asked Questions About Flaxedil