For muscle relaxation during surgery and diagnostic procedures (if there are facilities for endotracheal intubation and artificial lung ventilation).
Composition and form of release
Active ingredient: atracuria besylate (10 mg / ml).
Tracrium is produced in the form of a solution for injection.
It is a muscle relaxant with a peripheral mechanism of action. It is a highly selective (selective) non-depolarizing muscle relaxant, inhibits (competitively) acetylcholine receptors of the postsynaptic membrane. It inhibits the neuromuscular transmission of excitation impulses, causing relaxation of the skeletal muscles.
Trakrium is used:
- with the aim of relaxing skeletal muscles during diagnostic procedures, surgical interventions, artificial ventilation;
- as an aid for general anesthesia;
- to create conditions for tracheal intubation.
Trakrium is not used:
- with intolerance to the components;
- with myasthenia gravis;
- with severe electrolyte imbalance, incl. hypokalemia, hypocalcemia;
- with acidosis;
- with carcinomatosis.
Application during pregnancy and lactation
It is possible to use this drug in pregnant women if necessary. In obstetric practice, it is used as a muscle relaxant during a cesarean section.
It is not known whether the active substance and its metabolites are excreted in breast milk. If treatment is necessary, breastfeeding is discontinued.
Method of administration and dosage
Trakrium is used parenterally (intravenously only).
To prevent distress, it is not recommended to use the drug until the patient becomes unconscious.
The standard dose for adults in the form of a bolus injection is 0.3-0.6 mg / kg, depending on the required duration of the neuromuscular blockade, provides relaxation for 15-35 minutes. If it is necessary to lengthen the period of blocking action, an additional 0.1-0.2 mg / kg is administered. The restoration of neuromuscular transmission occurs in about 35 minutes.
The neuromuscular blockade caused by the use of the drug can be quickly leveled by the appointment of anticholinesterase drugs.
The standard dose for adults in the form of an infusion (after the initial bolus injection) to further maintain neuromuscular blockade is 0.3-0.6 mg / kg / hour.
It is possible to use the drug by intravenous infusion during coronary artery bypass grafting.
If hypothermia of the body is necessary, a decrease in the level of inactivation of the active substance should be taken into account, therefore, to maintain the neuromuscular blockade, in this case, the infusion rate is reduced.
The drug can be used in children older than one month in the same doses as for adults (calculated on the child’s body weight).
Symptoms: respiratory depression, apnea, collapse, hypotension, shock, prolonged paralysis (myoplegia).
Therapeutic measures: the introduction of antagonists – anticholinesterase drugs, artificial ventilation of the lungs under positive pressure, support for complete sedation of the patient. For shock, severe arterial hypotension, vasoconstrictors are used.
- Cardiovascular disorders: arterial hypotension (transient, moderate), skin hyperemia.
- Respiratory disorders: bronchospasm.
- Immune disorders: anaphylactic, anaphylactoid reactions.
- Neurological disorders: seizures (usually with a disposition to seizures – cerebral edema, head trauma, viral encephalitis, uremia, hypoxic encephalopathy).
- Musculoskeletal disorders: muscle weakness, myopathy, myopathy.
Storage conditions and periods
Store Trakrium for no more than 18 months at temperatures from +2 to +8 ° C. The prepared solution is suitable for use within eight hours. When the color of the solution changes, its fragmentation is prohibited.