mivacurium (Mivacron)

Introduction

Tradename: Mivacron.

Indications

• skeletal muscle relaxation during surgery after induction of general anesthesia
• increased pulmonary compliance during assisted respiration
• facilitates endotracheal intubation

Contraindications

Caution:

• ventilation must be supported during neuromuscular blockade
• electrolyte balance alters blockade
• small doses may have profound effects in patients with myasthenia gravis
• patients with pulmonary, hepatic or renal disease

pregnancy category = c

safety in lactation = ?

Dosage

• adults: 0.15 mg/kg IV bolus over 5-15 seconds
• children 2-12 years: 0.2 mg/kg IV over 5-15 seconds

Injection: (vials of 10, 20 & 25 mg).

Pharmacokinetics

• peak effect: within 2-3 minutes of IV injection
• duration: 20 minutes
• hydrolysis by plasma cholinesterases

elimination via plasma

Adverse effects

• common (> 10%)
  • flushing of face
• less common (1-10%)
  • hypotension
• uncommon (< 1%)
  • bradycardia, tachycardia, cutaneous erythema, endogenous histamine release, dizziness, muscle spasms, rash, reaction at site of injection, bronchospasm, wheezing, hypoxemia

More general terms

• neuromuscular blocker (paralyzing agent)

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=104803
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5281042
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=71315
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5281080
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5284588
• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=25432