Atracurium Besylate: Precautions and Warnings

 

Atracurium Besylate is a nondepolarizing neuromuscular blocker, also known as an immune suppressor. Atracurium Besylate is used in the treatment of lymphoma, multiple myeloma, leukaemia, ovarian cancer, breast cancer, small cell lung cancer, neuroblastoma, and sarcoma. Atracurium Besylate is supplied in 25 mg in 2.5ml single-use vials to administer intravenously. One should read the warnings and precautions associated with Atracurium Besylate, such as: 

Atracurium Besylate has been associated with residual paralysis. Patients with neuromuscular diseases and carcinomatosis may be at higher risk of residual paralysis. To prevent complications resulting from Atracurium Besylate-associated residual paralysis, extubation is recommended only after the patient has recovered sufficiently from neuromuscular blockade.

Serious adverse reactions, including “gasping syndrome”, can happen in neonates and infants treated with benzyl alcohol-preserved drugs, including Atracurium Besylate. When prescribing the doses of Atracurium Besylate vials in infants, consider the combined daily metabolic load of benzyl alcohol from all sources, including Atracurium Besylate and other drugs containing benzyl alcohol. 

Patients treated with Atracurium Besylate with renal or hepatic impairment might have higher metabolite concentrations than patients with normal renal and hepatic function. The level of neuromuscular blockade during long-term Atracurium Besylate administration should be monitored with a nerve stimulator to titrate the drug Atracurium Besylate administration to the patients’ needs and limit exposure to toxic metabolites.

There are reports of severe hypersensitivity reactions, including fatal and life-threatening anaphylactic reactions after administration of Atracurium Besylate injection. Due to the potential severity of such reactions, one should take appropriate precautions, such as the immediate availability of appropriate emergency treatment. 

Administration of Atracurium Besylate results in paralysis, leading to respiratory arrest and death, a progression that may likely happen in a patient for whom it is not intended. One should confirm the proper selection of the intended product and avoid confusion with other injectable solutions in critical care and other clinical settings.

Neuromuscular blockade in the conscious patient could lead to distress. Use Atracurium Besylate in the presence of appropriate sedation or general anaesthesia. One should monitor patients to ensure that the level of anaesthesia is adequate. 

Certain drugs might enhance the neuromuscular blocking action of Atracurium Besylate, including inhalational anaesthetics, antibiotics, magnesium salts, lithium, local anaesthetics, procainamide, and quinidine. One should use peripheral nerve stimulation and monitor the clinical signs of neuromuscular blockade to determine the adequacy of the level of neuromuscular blockade and the need to adjust the Atracurium Besylate dosage.

  

Note: All information mentioned in this article is provided just for informational, educational, and referential purposes only.