Cisatracurium
Chemical
Benzylisoquinolinium
Cis-cis isomer of atracurium
Use
Paralysis
Presentation
Clear, colourless,
5mg/ml
Refridgerated
Dose
0.15mg/kg
4xpotency of Atracurium, so given at smaller dose & onset is longer
Route
IV
Onset
2mins
DoA
Intermediate
MoA
Post-junctional competitive inhibition nAChR
PD
CVS – bradycardia, hypotension, cutaneous flushing
RESP – bronchospasm
PK
D
Small
Large MW
V polar
M
Hoffman degradation
E
Metabolites in urine & feces
t1/2b 30 mins
Adverse Effects
Hypotension, bradycardia
Bronchospasm
Anaphylactoid reactions
Critical illness myopathy (IV infusions)