阿曲庫銨
Atracurium
Atracurium besylate
別名: Tracrium · Nimbex · Atracurium besilate · Atracurium besylate · cis-Atracurium
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Neuromuscular blockade during anaesthesia | 0.2-0.5 mg/kg initially, followed by increments of 0.2 mg/kg | IV | as needed | Intermediate duration (15-35 min) | 🌍 EU |
- Neuromuscular blockade during anaesthesia: Monitor with nerve stimulator
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Neuromuscular blockade during anaesthesia | 0.2-0.5 mg/kg initially, followed by increments of 0.2 mg/kg | IV | as needed | Intermediate duration (15-35 min) | 🌍 EU |
- Neuromuscular blockade during anaesthesia: Monitor with nerve stimulator
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
阿曲庫銨是一種中效非去極化神經肌肉阻斷劑，用於獸醫麻醉。它提供神經肌肉阻斷，透過肌肉鬆弛改善手術視野，促進正壓換氣，並特別適用於眼內手術（例如使眼球居中）。
其作用時間為中等（15-35分鐘），且因其獨特的非酵素降解途徑（霍夫曼消除）而不會在體內蓄積。由於其清除不依賴肝臟和腎臟功能，因此非常適合用於患有肝腎疾病的動物。
臨床提示： 阿曲庫銨不具備任何鎮痛或鎮靜作用，必須嚴格在患者完全麻醉的情況下使用。
作用機制
Atracurium acts as a competitive antagonist at the neuromuscular junction.
It inhibits the actions of acetylcholine → binds competitively to the nicotinic acetylcholine receptors on the post-junctional membrane of skeletal muscle → prevents acetylcholine from binding → prevents muscle cell depolarization → results in flaccid muscle paralysis.
安全性與警告
禁忌症
- Conscious or inadequately anesthetized animals
- Lack of positive pressure ventilation facilities
- Lack of trained personnel to monitor neuromuscular blockade
- Conscious animals (must NEVER be administered unless the animal is adequately anesthetized)
不良反應
- Histamine release (especially with rapid IV injection)
- Bronchospasm
- Hypotension
- Tachycardia
- Histamine release (especially with rapid IV administration)
注意事項
CRITICAL WARNING: Do not administer unless the animal is adequately anaesthetized and facilities to provide positive pressure ventilation are available.
- Histamine Release: Can precipitate the release of histamine after rapid IV administration, resulting in bronchospasm and hypotension. Diluting the drug in normal saline and giving it slowly IV minimizes these effects.
- Physiological Factors: Hypothermia, acidosis, and hypokalaemia will prolong the duration of action of the neuromuscular blockade.
- Myasthenia Gravis: Use the low end of the dose range in patients with myasthenia gravis.
- Monitoring: Monitoring (using a peripheral nerve stimulator) and pharmacological reversal of the neuromuscular blockade is strongly recommended to ensure complete recovery before the end of anaesthesia.
藥物相互作用
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
監測
- Respiratory rate and effort (mechanical ventilation parameters)
- End-tidal CO2 (capnography)
- Oxygen saturation (pulse oximetry)
- Heart rate and rhythm (ECG)
- Neuromuscular function (using a peripheral nerve stimulator/Train-of-Four monitor)
- Respiratory rate, effort, and end-tidal CO2
- Heart rate and blood pressure
- Core body temperature (hypothermia prolongs effect)
- Acid-base status and potassium levels
藥物動力學
半衰期
吸收
Administered intravenously; 100% bioavailability.
分佈
Limited volume of distribution, primarily restricted to the extracellular fluid space.
代謝
Undergoes non-enzymatic Hofmann elimination (dependent on normal body pH and temperature) and hydrolysis by non-specific plasma esterases. Metabolism is independent of hepatic and renal function.
排除
Metabolites (e.g., laudanosine) are excreted via urine and bile.
過量
Overdosage results in prolonged neuromuscular blockade and respiratory paralysis.
- Management: Requires continuous mechanical positive pressure ventilation until spontaneous recovery occurs.
- Reversal: Pharmacological reversal agents (e.g., neostigmine or edrophonium) combined with an anticholinergic (e.g., atropine or glycopyrrolate to prevent severe bradycardia) should be administered once signs of spontaneous recovery begin (confirmed via nerve stimulator).
可用產品
劑型
- Injectable: 10 mg/ml solution
人用標示
- Tracrium 10 mg/ml solution for injection
各地核准狀態
POM (Prescription Only Medicine)
POM (Prescription Only Medicine)
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store in a refrigerator (2°C - 8°C). Do not freeze. Protect from light. Once drawn up or diluted, it should be used promptly.
飼主須知
此藥物是一種專門的肌肉鬆弛劑，嚴格限制在醫院環境中於全身麻醉期間使用。它由獸醫在您的寵物完全熟睡並連接呼吸機的情況下給藥。它能確保肌肉完全放鬆，使外科醫生能夠安全地進行精細的手術。
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。