Actracurium

Mode of Action

Actracurium works by inhibiting the binding of acetylcholine (ACh) to nicotinic receptors located at the neuromuscular junction. This blockage prevents depolarization of the muscle membrane, leading to muscle relaxation or paralysis. The effect is reversible, and the blockade can be reversed with anticholinesterase drugs (e.g., neostigmine).

Indications

General Anesthesia: Used to induce muscle relaxation during surgery, allowing for easier manipulation of tissues.
Facilitation of Intubation: Helps in the relaxation of the laryngeal and respiratory muscles, facilitating endotracheal intubation.
Adjunct in Intensive Care: Occasionally used in critical care to provide muscle relaxation in ventilated patients.

Doses

Induction: 0.5–1 mg/kg IV for intubation.
Maintenance: 1–2 mcg/kg/min IV infusion for continued relaxation.
Adjustments: Modify for elderly or patients with cardiovascular concerns.

Description

Actracurium is a non-depolarizing neuromuscular blocking agent used in anesthesia to induce muscle relaxation during surgery or facilitate endotracheal intubation. It belongs to the class of benzylisoquinolinium compounds and has an intermediate duration of action. Unlike depolarizing agents, atracurium does not cause an initial muscle contraction but instead prevents acetylcholine from activating muscle fibers.