Atrelax (25mg/2.5ml) 5 Ampoule Injections

Atracurium is a non-depolarizing neuromuscular blocking agent used as a muscle relaxant during anesthesia. Its mechanism of action involves competitively blocking the nicotinic acetylcholine receptors (nAChRs) at the neuromuscular junction. Atracurium binds to these receptors, preventing the binding of acetylcholine, a neurotransmitter responsible for muscle contraction. By blocking the nAChRs, atracurium inhibits the transmission of nerve impulses to skeletal muscles, leading to muscle paralysis. This effect is reversible, and the duration of action is dose-dependent, with higher doses resulting in longer periods of muscle relaxation.

Atracurium 25mg

Neuromuscular blocking agent

Injection

The following are the uses of Atracurium 25mg injection:

• Used for skeletal muscle relaxation during surgery or mechanical ventilation.
• Used to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or intensive care unit (ICU) procedures.
• Used in patients with certain medical conditions such as multiple sclerosis or spinal cord injuries to relieve muscle stiffness and improve mobility.
• Used for rapid sequence induction, a technique used for emergency tracheal intubation.
• Used for patients with organophosphate poisoning to treat muscle weakness and paralysis.
• Used in managing status epilepticus, a prolonged seizure, to control muscle spasms and seizures.
• Used for neuromuscular monitoring to assess the depth of neuromuscular blockade during surgery.

In the case of an overdose of Atracurium 25mg injection, immediate medical intervention is necessary. Symptoms may include severe muscle weakness, respiratory distress, and potential paralysis. Prompt treatment involves mechanical ventilation to support breathing and close monitoring of vital signs. It is crucial to seek emergency medical care if an overdose is suspected, as timely intervention can significantly impact the patient's outcome and minimize potential complications.

In the case of a missed dose of Atracurium 25mg injection, it is important to consult your healthcare provider for guidance. As this medication is typically administered by trained medical professionals, it is unlikely that a dose will be missed. However, if for any reason a scheduled dose is not given, contact your doctor or healthcare team immediately for advice. They will determine the appropriate course of action, which may involve rescheduling the dose or adjusting the dosage for subsequent administrations. Do not attempt to self-administer or adjust the dosage without professional medical advice.

To administer Atracurium 25mg injection, prepare the medication by drawing the prescribed dose into a syringe, ensuring the needle is securely attached, and inject it slowly into the intravenous line, following the healthcare provider's instructions for the recommended infusion rate and duration.

Here are the conditions and situations when Atracurium 25mg injection should not be used:

• Should not be administered to individuals with known hypersensitivity or allergy to Atracurium or any of its components, including benzyl alcohol.
• Contraindicated in patients with a known history of malignant hyperthermia or a family history of susceptibility to malignant hyperthermia.
• Not recommended for patients with severe liver or kidney disease as it may impair the metabolism and excretion of the drug.
• Should not be used in patients with myasthenia gravis due to its potential to exacerbate muscle weakness.
• Contraindicated in patients with a known or suspected neuromuscular disease other than the condition being treated.
• Should not be used in patients with severe respiratory disorders or respiratory muscle weakness.
• Not suitable for patients with known or suspected esophageal, gastric, or duodenal ulcers.

The side effects of Atracurium 25mg injection may include:

• Allergic reactions, such as skin rash, itching, or hives
• Increased heart rate or irregular heartbeat
• Low blood pressure (hypotension)
• Muscle weakness or paralysis (if administered incorrectly or in excessive doses)
• Nausea and vomiting
• Redness or swelling at the injection site
• Difficulty breathing or respiratory depression
• Transient myalgia (muscle pain)

Following are the precautions and warnings:

• Atracurium 25mg injection should be used with extreme caution in patients with known allergies or sensitivities to muscle relaxants or any of the excipients in the injection.
• It is essential to monitor patients with kidney or liver disease, as the dosage may need adjustment in these cases.
• Atracurium should be administered by trained healthcare professionals only in controlled medical settings.
• This medication can cause respiratory depression, so close monitoring of respiratory function is crucial during and after administration.
• Patients with myasthenia gravis, Parkinson's disease, or other neuromuscular disorders may be more susceptible to the effects of Atracurium and should be closely monitored.
• Elderly patients may require lower doses as they are more prone to developing adverse effects.
• Pregnant and breastfeeding women should only use Atracurium if the potential benefits outweigh the risks, and under the strict supervision of a healthcare professional.
• Atracurium should be used with caution in patients undergoing surgery or procedures, and healthcare providers should be aware of its effects on muscle relaxation.

Following are the drug interactions for Atracurium 25mg injection:

• Antibiotics such as aminoglycosides and tetracyclines may enhance the neuromuscular blocking effects of Atracurium, leading to prolonged muscle relaxation.
• Concomitant use with general anesthetics can increase the risk of respiratory depression and hypotension.
• The effect of Atracurium may be reduced by enzyme inducers like phenytoin, requiring dosage adjustments.
• Drugs that prolong QT interval, e.g., certain antiarrhythmics, should be used cautiously due to potential cardiac effects.
• Calcium channel blockers and beta-blockers may enhance the cardiovascular effects of Atracurium.
• Atracurium may interact with anticholinesterase agents, potentially affecting neuromuscular transmission.
• Caution is advised when combining Atracurium with other muscle relaxants, as this may lead to additive effects and prolonged paralysis.

Following are the food interactions with Atracurium 25mg injection:

• Avoid consuming grapefruit or grapefruit juice as it may affect the way Atracurium is metabolized, potentially altering its effectiveness.
• Alcohol consumption should be avoided as it can enhance the sedative effects of Atracurium, leading to increased drowsiness and potential respiratory depression.
• Caffeine-rich beverages like coffee and energy drinks may counteract the muscle relaxant effects of Atracurium, reducing its efficacy during surgical procedures.
• Spicy foods and acidic beverages should be consumed with caution as they may irritate the injection site and cause discomfort or local inflammation.
• Avoid high-fat meals as they can slow down the absorption of Atracurium, delaying its onset of action.
• Consuming foods rich in antioxidants, such as berries and leafy greens, may help reduce the oxidative stress associated with anesthesia and surgery.
• Stay well-hydrated with water to maintain blood volume and facilitate the excretion of Atracurium and its metabolites post-surgery.
• It is advisable to follow a balanced diet and adhere to any pre-surgery fasting guidelines provided by your healthcare team for optimal surgical outcomes.

Atracurium 25mg injection should be stored in a controlled environment, specifically at room temperature, typically between 20-25°C (68-77°F). It is crucial to keep the injection away from direct sunlight, heat, and moisture, as these factors can degrade the medication. Store it in its original packaging, ensuring it remains intact and sealed to maintain sterility. Always check the expiration date before use, and never use the injection if it has expired. When disposing of unused or expired Atracurium injections, do not flush or pour them down the drain. Contact a pharmacist or healthcare professional for guidance on proper disposal methods to ensure environmental safety. Keep the medication securely locked away from children and pets to prevent accidental exposure or ingestion.

Following are the quick tips for Atracurium 25mg Injection:

• Administer under medical supervision; do not self-inject.
• Ensure accurate dosage calculation based on body weight and clinical condition.
• Use only clear and colourless solutions; discard if particles are present.
• Inject slowly to avoid rapid plasma concentration changes.
• Monitor vital signs and respiratory function during and after administration.
• Store at controlled room temperature, away from light and moisture.
• Keep a record of injection sites and rotate injection areas to prevent tissue damage.