Atracurium Besylate
Atracurium besylate
También conocido como: Tracrium · Abbottracurium · Faulcurium · Ifacur · Laurak · Mycurium · Relatrac · Sitrac · Trablok · 33A74 · atracurium besilate · BW-33A
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Critically ill patients when low concentrations of, or no inhalant anesthesia can be used | 0.2 mg/kg IV initial dose; subsequent doses 0.1 mg/kg IV | IV | every 20-30 minutes | — | 🌎 NA |
| Neuromuscular blockade augmentation during corneal surgery | 0.15 mg/kg IV | IV | Single dose | — | 🌎 NA |
| Muscle relaxant to facilitate intubation in patients with severe blunt trauma | 0.25 mg/kg IV push | IV | Single dose | — | 🌎 NA |
| Induction of respiratory muscle paralysis during mechanical ventilation | Loading dose: 0.2-0.5 mg/kg IV, then a constant rate infusion 5 minutes later of 3-9 micrograms/kg/min | IV | CRI | — | 🌎 NA |
- Critically ill patients when low concentrations of, or no inhalant anesthesia can be used: Do not dose more frequently than every 20-30 minutes unless a peripheral nerve stimulator is applied, or voluntary movement is observed. Positive pressure ventilation required.
- Muscle relaxant to facilitate intubation in patients with severe blunt trauma: Given if patient requires intubation after IV acepromazine (0.01 mg/kg) + butorphanol (0.1 mg/kg) + ketamine (1 mg/kg).
- Induction of respiratory muscle paralysis during mechanical ventilation: Use D5W or 0.9% sodium chloride for diluent; do not mix with other drugs. Respiratory and cardiovascular monitoring should be provided.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Induction dose | 0.22 mg/kg IV | IV | Single dose | — | 🌎 NA |
| Intraoperative dose | 0.11 mg/kg IV | IV | As needed | — | 🌎 NA |
| Induction of respiratory muscle paralysis during mechanical ventilation | Loading dose: 0.2-0.5 mg/kg IV, then a constant rate infusion 5 minutes later of 0.37 micrograms/kg/min | IV | CRI | — | 🌎 NA |
| Critically ill patients when low concentrations of, or no inhalant anesthesia can be used | 0.2 mg/kg IV initial dose; subsequent doses 0.1 mg/kg IV | IV | every 20-30 minutes | — | 🌎 NA |
- Induction dose: Give 1/10th to 1/6th of this dose initially as a 'priming' dose, followed 4-6 minutes later with the remainder and a sedative/hypnotic agent.
- Induction of respiratory muscle paralysis during mechanical ventilation: Use D5W or 0.9% sodium chloride for diluent; do not mix with other drugs.
- Critically ill patients when low concentrations of, or no inhalant anesthesia can be used: Do not dose more frequently than every 20-30 minutes unless a peripheral nerve stimulator is applied. Positive pressure ventilation required.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Paralysis for periophthalmic surgery (Rabbits) | 0.1 mg/kg | IV | Single dose | — | 🌎 NA |
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Intraoperative dose | 0.055 mg/kg IV | IV | As needed | — | 🌎 NA |
- Intraoperative dose: Note: ARCI UCGFS Class 2 Drug. Atracurium is more potent in horses than in other species.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El atracurio es un agente bloqueante neuromuscular no despolarizante de uso frecuente, empleado principalmente como coadyuvante en la anestesia general. Proporciona una relajación profunda del músculo esquelético para facilitar procedimientos quirúrgicos, la intubación endotraqueal y la ventilación mecánica.
Perlas clínicas clave:
- Eliminación independiente de órganos: El atracurio se elimina mediante la eliminación de Hofmann y la hidrólisis de ésteres, lo que lo hace excepcionalmente valioso para pacientes con enfermedad renal o hepática significativa.
- Sin analgesia ni sedación: Paraliza al paciente pero no proporciona ningún tipo de alivio del dolor ni pérdida de conciencia. Nunca debe utilizarse como agente único.
- Estabilidad cardiovascular: A dosis estándar, presenta efectos cardiovasculares mínimos en comparación con bloqueantes neuromusculares más antiguos, aunque ocasionalmente puede desencadenar la liberación de histamina.
- Sensibilidad según la especie: Es notablemente más potente en caballos que en otras especies.
Mecanismo de acción
Atracurium acts by competitively binding to nicotinic cholinergic receptors at the motor end-plate of the neuromuscular junction.
By occupying these receptors, it prevents acetylcholine (ACh) from binding → inhibits depolarization of the muscle cell membrane → results in flaccid paralysis of skeletal muscles.
Because it is a competitive antagonist, its effects can be reversed by increasing the concentration of ACh at the neuromuscular junction (e.g., by administering acetylcholinesterase inhibitors like neostigmine or edrophonium).
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to atracurium
- Relative contraindication: Myasthenia gravis
- Lack of ventilatory support (must have mechanical ventilation available)
Efectos adversos
- Allergic reactions
- Inadequate or prolonged neuromuscular block
- Hypotension
- Vasodilation
- Bradycardia
- Tachycardia
- Dyspnea
- Bronchospasm
- Laryngospasm
- Rash
- Urticaria
- Injection site reaction
Precauciones
CRITICAL WARNING: Atracurium has NO analgesic or sedative/anesthetic actions. Patients must be appropriately sedated/anesthetized and provided with analgesia.
- Ventilation: Positive pressure ventilation (preferably mechanical) is absolutely required when using this drug.
- Histamine Release: May rarely cause significant histamine release; use with caution in patients where this would be hazardous (e.g., severe cardiovascular disease, asthma).
- Myasthenia Gravis: Use with extreme caution, or not at all, in patients suffering from myasthenia gravis.
- Vagal Tone: Has minimal cardiac effects and will not counteract bradycardia or vagal stimulation induced by other anesthetic agents.
Interacciones farmacológicas
May enhance the neuromuscular blocking activity of atracurium
May enhance and prolong the neuromuscular blocking activity
May enhance neuromuscular blocking activity
May enhance neuromuscular blocking activity
May enhance neuromuscular blocking activity
May enhance neuromuscular blocking activity
May enhance neuromuscular blocking activity
Reported to decrease both the effects and duration of neuromuscular blockade
May cause a synergistic or antagonistic effect
May speed the onset of action and enhance the neuromuscular blocking actions of atracurium. Do not give atracurium until succinylcholine effects have diminished.
Monitorización
- Level of neuromuscular blockade (recommend use of a peripheral nerve stimulator to evaluate 'train of 4' twitches)
- Spontaneous ventilation and voluntary muscle movement (if nerve stimulator is unavailable)
- Cardiac rate and blood pressure
- Core body temperature and acid-base status (can affect drug metabolism)
Farmacocinética
Absorción
After IV injection, maximal neuromuscular blockade generally occurs within 3-5 minutes. Duration of blockade generally persists for 20-35 minutes.
Metabolismo
Metabolized by ester hydrolysis and Hofmann elimination that occur independently of renal or hepatic function. Physiologic pH and temperature can affect elimination (increased body temp enhances elimination; decreased pH enhances ester hydrolysis but reduces Hofmann elimination).
Eliminación
Eliminated via Hofmann degradation and ester hydrolysis. Systemic alkalosis may diminish the degree and duration of blockade; acidosis potentiates it.
Sobredosis
Overdosage increases the risks of hypotension, histamine release, and prolonged duration of muscle blockade. Overdose possibilities can be minimized by monitoring muscle twitch responses to peripheral nerve stimulation.
Treatment:
- Treat conservatively with mechanical ventilation, oxygen, and IV fluids.
- Reversal of blockade: May be accomplished by administering an anticholinesterase agent such as edrophonium (0.5 mg/kg IV) or neostigmine (0.02-0.04 mg/kg IV) combined with an anticholinergic (atropine or glycopyrrolate) to prevent severe bradycardia.
- Reversal is usually complete within 8-10 minutes. Because the duration of action of atracurium may be longer than the reversal agent, careful observation is required, and readministration of the reversal agent may be necessary.
Productos disponibles
Formulaciones
- Injection
Etiquetado para humanos
- Atracurium Besylate Injection: 10 mg/mL in 5 mL single-use & 10 mL multiuse vials (Tracrium, generic)
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store in the refrigerator (2-8°C) and protect against freezing. At room temperature, approximately 5% potency loss occurs each month; when refrigerated, a 6% potency loss occurs over a year's time. Incompatible when mixed with alkaline drugs (e.g., barbiturates, sodium bicarbonate), propofol, diazepam, thiopental, aminophylline, cefazolin, heparin, ranitidine, and sodium nitroprusside.
Información para el cliente
Este medicamento es un relajante muscular altamente especializado utilizado exclusivamente por profesionales veterinarios durante la anestesia general o en cuidados intensivos con ventilación mecánica.
- Asegura que su mascota permanezca perfectamente inmóvil durante cirugías delicadas (como cirugías oculares) o ayuda a que respire en sincronía con un ventilador si se encuentra en estado crítico.
- Debido a que solo relaja los músculos y no proporciona alivio del dolor ni sueño, siempre se administra junto con analgésicos potentes y sedantes o anestésicos para garantizar que su mascota esté completamente inconsciente y cómoda.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.