سعر اتراكوريوم بيسيلات 25 مجم / 2.5 مل 5 امبولات 2022

Atracurium besylate 25 mg/2.5 ml, 5 ampoules (Hospira) (Hospira Inc.-UK > Pfizer Scientific Office): atracurium besilate 25 mg/2.5 ml (10 mg/ml) per ampoule, a non-depolarising, intermediate-acting neuromuscular blocking agent given intravenously as an adjunct to general anaesthesia; pack of 5 ampoules.

• Adjunct to general anaesthesia to relax skeletal muscles and facilitate tracheal intubation and controlled ventilation during surgical and other proceduresPopulation: Adults and children over 1 monthelectronic medicines compendium (emc), UK
• Facilitation of mechanical ventilation in intensive carePopulation: Adults and children over 1 monthelectronic medicines compendium (emc), UK
• Adjunct to general anaesthesia to facilitate endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilationDailyMed (U.S. National Library of Medicine)

• Common: tachycardia, mild transient hypotension, bronchospasm/wheezing, urticaria and skin flushing (mostly related to histamine release).International label, same formulation · electronic medicines compendium (emc), UK
• Very rare: severe anaphylactic/anaphylactoid reactions including shock, circulatory failure and cardiac arrest; laryngospasm; seizures in ICU patients; myasthenia and/or myopathy after prolonged ICU use.International label, same formulation · electronic medicines compendium (emc), UK
• US label: in clinical trials (875 patients) skin flush occurred in 5% overall (29% at initial doses of 0.6 mg/kg or more); erythema, itching, wheezing/bronchial secretions and hives were uncommon; postmarketing reports include prolonged or inadequate block, hypotension, bradycardia, dyspnoea, laryngospasm, rash and injection-site reactions.International label, equivalent formulation · DailyMed (U.S. National Library of Medicine)

• Hypersensitivity to atracurium besilate or to any of the excipients.International label, same formulation · electronic medicines compendium (emc), UK
• Hypersensitivity to cisatracurium.International label, same formulation · electronic medicines compendium (emc), UK

• Paralyses respiratory and other skeletal muscles but has no effect on consciousness: give only with adequate general anaesthesia (or adequate sedation in ICU), by an experienced anaesthetist with facilities for intubation and artificial ventilation and a reversal agent immediately available.International label, same formulation · electronic medicines compendium (emc), UK
• Histamine release may occur in susceptible patients (flushing, transient hypotension, bronchospasm, especially with a history of allergy or asthma); minimise by slow injection or divided doses over at least 60 seconds, particularly in hypovolaemic patients or those sensitive to falls in blood pressure.International label, same formulation · electronic medicines compendium (emc), UK
• Increased sensitivity is expected in myasthenia gravis, Eaton-Lambert syndrome and other neuromuscular diseases, and in severe acid-base/electrolyte disturbance or carcinomatosis: use reduced doses with a peripheral nerve stimulator. Resistance may develop in burn patients.International label, same formulation · electronic medicines compendium (emc), UK

• Inhalational anaesthetics (halothane, isoflurane, enflurane, sevoflurane, desflurane)May increase the neuromuscular block produced by atracurium.electronic medicines compendium (emc), UK
• Antibiotics (aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin, clindamycin, vancomycin)May increase the magnitude and/or duration of the non-depolarising block.electronic medicines compendium (emc), UK
• Antiarrhythmics (lidocaine, procainamide, quinidine), propranolol, calcium channel blockers, diuretics (furosemide, thiazides, possibly mannitol), acetazolamide, ketamine, dantroleneMay increase the magnitude and/or duration of the block.electronic medicines compendium (emc), UK

• Atracurium crosses the placenta but no adverse effects on the foetus or newborn have been demonstrated. As with all neuromuscular blockers, use in the first three months of pregnancy should be avoided and it should not be used in the second and third trimesters unless clearly necessary; it is suitable for maintaining muscle relaxation during caesarean section.International label, same formulation · electronic medicines compendium (emc), UK
• Transfer into milk is expected to be very low (high molecular weight, highly ionised, rapidly degraded), but because of possible respiratory depression in the neonate (especially premature) breast-feeding should be discontinued for 24 hours after administration.International label, same formulation · electronic medicines compendium (emc), UK

• Atracurium besilate: Competes with acetylcholine for nicotinic cholinergic receptors at the motor end-plate, preventing depolarisation and causing skeletal muscle paralysis; the block is reversed by anticholinesterases (e.g. neostigmine). Inactivated by Hofmann elimination and non-specific ester hydrolysis, independent of renal/hepatic function.