Atracurium

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Atracurium
Systematic (IUPAC) name
5-[3-[1-[(3,4-dimethoxyphenyl)methyl]- 6,7-dimethoxy-2-methyl-3, 4-dihydro-1H-isoquinolin- 2-yl] propanoyloxy] pentyl 3-[1-[(3,4-dimethoxyphenyl)methyl]- 6,7-dimethoxy-2-methyl- 3,4-dihydro-1H-isoquinolin-2-yl] propanoate
Identifiers
CAS number	64228-79-1
ATC code	M03AC04
PubChem	9751
DrugBank	APRD00806
Chemical data
Formula	C₅₃H₇₂N₂O₁₂²⁺
Mol. mass	929.145 g/mol
Pharmacokinetic data
Bioavailability	100% (IV)
Protein binding	82%
Metabolism	Hoffman elimination (retro-Michael addition) and ester hydrolysis
Half life	17-21 minutes
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status	POM (UK)and worldwide
Routes	IV

Atracurium is a neuromuscular-blocking drug or skeletal muscle relaxant in the category of non-depolarising neuromuscular blocking agents, used adjunctively in anaesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Side effects owing to histamine liberation are rash, reflex increase in heart rate, low blood pressure and bronchospasm.

It is a bisbenzyltetrahydroisoquinolinium mixture of 10 Stereoisomers. Atracurium was first synthesized, in 1974 by George H. Dewar, in John B. Stenlake's medicinal chemistry research group at Strathclyde University, Scotland. It is the first non-depolarising non-steroidal skeletal muscle relaxant rationally designed to undergo chemodegradation in vivo. Atracurium was licensed to Burroughs Wellcome Co., which developed atracurium and eventually marketed it (as a mixture of all ten stereoisomers)under the name Tracrium. Atracurium's rate of degradation in vivo is influenced by pH and temperature.

Atracurium was succeeded by cisatracurium, which is the R-cis R-cis isomer constituent of atracurium. The pharamcodynamic and adverse effect profile of cisatracurium proved to be superior to that of atracurium. Cisatracurium was made available worldwide as Nimbex, with its clinical development solely undertaken by Burroughs Wellcome Co.

Atracurium is classified as an intermediate-acting neuromuscular blocking agent.

v • d • e Muscle relaxants (M03)
Peripherally acting	Alcuronium, Atracurium, Cisatracurium, Dimethyltubocurarine, Doxacurium chloride, Fazadinium bromide, Gallamine, Hexafluronium, Mivacurium chloride, Pancuronium, Pipecuronium bromide, Rocuronium bromide, Suxamethonium, Tubocurarine, Vecuronium
Centrally acting	Baclofen, Carisoprodol, Chlormezanone, Chlorzoxazone, Cyclobenzaprine, Febarbamate, Mephenesin, Methocarbamol, Orphenadrine, Phenprobamate, Phenyramidol, Pridinol, Styramate, Tetrazepam, Thiocolchicoside, Tizanidine, Tolperisone
Directly acting	Dantrolene