metocurine; dimethyl tubocurarine (Metubine Iodide)

Introduction

Tradename: Metubine Iodide.

Indications

• skeletal muscle relaxation during surgery

Contraindications

• hypersensitivity to iodide

Caution:

• myasthenia gravis
• renal insufficiency
• prolonged apnea
• respiratory depression
• muscle weakness

Dosage

• adjunct to anesthesia: 0.2-0.4 mg/kg IV followed by 0.1-0.25 mg/kg every 25-90 min
• neonates:
  • start: 0.25-0.5 mg/kg
  • repeat once if paralysis not achieved in 3 minutes
  • maintenance: repeat previous dose as soon as movement is observed

Injection: 2 mg/mL (20 mL)

Adverse effects

• not common (1-10%)
  • cardiac arrhythmias, bradycardia, hypotension
• uncommon (< 1%)
  • hypersensitivity reactions

Drug interactions

• aminoglycosides
• certain general anesthetics
• quinidine
• magnesium
• other muscle relaxants

• drug interaction(s) of lithium carbonate with iodide salts

Mechanism of action

(by analogy with tubocurarine)

• non-depolarizing neuromuscular junction blocker
• skeletal muscle relaxation produced by blocking response to acetylcholine at the myoneural junction
• blocks access of acetylcholine to the motor end-plate

More general terms

• heterocyclic compound, 4 or more rings
• skeletal muscle relaxant (tranquilizer)

Additional terms

• tubocurarine (Tubarine)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=24244
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=21233
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=457808
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=14955