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dimethyltubocurarine

M03AA04

Forms & Strengths

Injectable solution: 1 mg/mL and 2 mg/mL

Adult Dosing

General endotracheal intubation: 0.1 to 0.2 mg/kg IV initial
Surgical relaxation maintenance: 0.04 to 0.05 mg/kg IV increments as needed

Pediatric Dosing

Safety and efficacy in pediatric patients not fully established
Use with extreme caution, individualize dosage based on weight and response

Indications

Adjunct to general anesthesia to facilitate endotracheal intubation
Skeletal muscle relaxation during surgery or mechanical ventilation

Mechanism of Action

Nondepolarizing neuromuscular blocking agent
Competes with acetylcholine for cholinergic receptors at the motor end-plate

Contraindications

Hypersensitivity to dimethyltubocurarine or tubocurarine derivatives
Conditions where histamine release is hazardous
Severe cardiovascular disease or unstable hemodynamics

Adverse Reactions

Profound skeletal muscle weakness and prolonged apnea
Hypotension secondary to ganglionic blockade and histamine release
Bronchospasm and excessive bronchial secretions
Tachycardia or bradycardia

Drug Interactions

Inhalation anesthetics (e.g., isoflurane, sevoflurane) potentiate neuromuscular blockade
Antibiotics (aminoglycosides, polymyxins) enhance neuromuscular blockade
Opioids increase risk of respiratory depression and bradycardia
Other neuromuscular blocking agents produce additive or synergistic effects

Curated Content: Needs Vetting Before Put to Clinical Use