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Atracurium besilate blocks neural transmission at the neuromuscular junction by competitive binding at the cholinergic receptor sites on the motor end plate. (1,2,3)

Used adjunctively in anaesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation s (1,2,3)

Hypersensitivity (1,2,3)

Cutaneous reactions; Bradycardia, transient hypotension in patients with CVS disorders Dyspnoea, bronchospasm Rash and urticaria. (1,2,3)

Mixed block with suxamethonium which is difficult to reverse with anticholinergic drugs. Ketamine may potentiate the effects of atracurium. Concurrent use with tamoxifen or danazol may prolong effects of atracurium. (1,2,3)

Intravenous injection Adult and child over 1month- Surgery or intubation: 300 to 600 µg/kg body weight, maintenance by 100 to 200 µg as required. Intensive care: 300 to 600 µg/kg body weight. Adult and child-5 to 10 µg/kg body weight/min (300 to 600 µg/kg/h) (1,2,3)

1. Brunton LL, Chabner BA, Knollmann BC, editors. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 12th ed. China: McGraw Hill; 2011 2. Katzung BG, Masters SB, Trevor AJ, editors. Basic & Clinical Pharmacology. 12th ed. New York: McGraw Hill; 2012 3. National Formulary of India. 4 th ed. Government of India, Ministry of Health and Family Welfare. India: Indian Pharmacopoeia Commission; 2011