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MUSCULO-SKELETAL SYSTEM › MUSCLE RELAXANTS › MUSCLE RELAXANTS, PERIPHERALLY ACTING AGENTS › Curare alkaloids
alcuronium
M03AA01
Forms & Strengths
- Intravenous injection: 5 mg/mL
Adult Dosing
- General anesthesia muscle relaxation: 0.2-0.25 mg/kg IV initial dose
- Maintenance dose: 0.05-0.1 mg/kg IV as needed
Pediatric Dosing
- Safety and efficacy in neonates and infants not well established
- Children >1 year: 0.2 mg/kg IV initial dose
Indications
- Adjunct to general anesthesia to facilitate endotracheal intubation
- Skeletal muscle relaxation during surgical procedures
Mechanism of Action
- Non-depolarizing neuromuscular blocking agent
- Competitively binds to nicotinic acetylcholine receptors at the neuromuscular junction
- Prevents depolarization by acetylcholine, causing skeletal muscle relaxation
Contraindications
- Hypersensitivity to alcuronium or diallylnortoxiferine derivatives
- Myasthenia gravis and other neuromuscular transmission disorders
- Severe electrolyte disturbances (e.g., severe hypokalemia)
Adverse Reactions
- Hypotension due to ganglionic blockade or histamine release
- Tachycardia
- Bronchospasm or excessive bronchial secretions
- Prolonged neuromuscular blockade and respiratory depression
Drug Interactions
- Inhalational anesthetics (e.g., isoflurane, sevoflurane) potentiate neuromuscular blockade
- Aminoglycoside antibiotics and polymyxins enhance neuromuscular block
- Other non-depolarizing or depolarizing neuromuscular blockers cause additive effects
- Diuretics may alter electrolyte balance and modify blockade duration
Curated Content: Needs Vetting Before Put to Clinical Use