Cisatracurium
Administration
- Type: Neuromuscular blocker, Non-depolarizing
- Dosage Forms: Injection (2mg/mL, 10mg/mL)
- Routes of Administration: IV
- Common Trade Names: Nimbex
Adult Dosing
General
- Intubation: 0.15-0.2mg/kg IV
- Maintenance: 0.03mg/kg IV q20min PRN, or 1-3mcg/kg/min infusion
Indications by Condition
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Acute respiratory distress syndrome | 0.15mg/kg load, then 1-3mcg/kg/min | Neuromuscular blockade to prevent barotrauma/vent dyssynchrony | IV | Adult |
Pediatric Dosing
General
- Intubation: 0.1-0.15mg/kg IV
- Maintenance: 1-2mcg/kg/min infusion
Special Populations
- Pregnancy Rating: B
- Lactation risk: Not defined
Renal Dosing
- No adjustment required (Hofmann elimination)
Hepatic Dosing
- No adjustment required
Contraindications
- Allergy to class/drug
- Caution with myasthenia gravis
Adverse Drug Reactions
Serious
- Prolonged paralysis
- Bronchospasm (rare)
Common
- Flushing
- Bradycardia
Pharmacology
- Onset of action: 2-3 minutes
- Duration: 40-60 minutes
- Half-life: 22-29 minutes
- Metabolism: Hofmann elimination (organ-independent)
- Excretion: Renal and biliary
Mechanism of Action
- Competitive antagonist at nicotinic acetylcholine receptors at the neuromuscular junction
- Undergoes Hofmann elimination (spontaneous degradation at physiologic pH and temperature)