CIS COURN 5ML INJ

Cis-atracurium besylate is a neuromuscular blocking agent that competitively inhibits the binding of acetylcholine to nicotinic receptors at the neuromuscular junction. It acts by blocking the transmission of nerve impulses, leading to muscle paralysis. The cis isomer of atracurium, which is more potent and has a faster onset of action than the trans isomer, selectively binds to these receptors, causing reversible blockade. This mechanism results in muscle relaxation by preventing the activation of muscle fibers, without affecting the initial phases of neuromuscular transmission.

Cis-Atracurium Besylate

Neuromuscular blocking agent

Injection

The following are the uses of Cis-Atracurium Besylate Injection:

• Used for skeletal muscle relaxation during surgery or mechanical ventilation.
• Used for facilitating endotracheal intubation and for providing skeletal muscle relaxation during surgery or in the intensive care unit.
• Used for preventing and treating muscle spasms during surgery, allowing for better surgical access and improved patient comfort.
• Used for providing muscle relaxation in patients undergoing laparoscopic procedures, ensuring better visualization and surgical precision.
• Used for managing critical care patients on mechanical ventilation, aiding in synchronizing ventilation and preventing muscle-related complications.
• Used for reducing the risk of deep vein thrombosis and pulmonary embolism in surgical patients by inducing controlled muscle paralysis.
• Used for facilitating the placement of advanced airway devices, ensuring a secure airway during emergency situations.

In the case of an overdose of Cis-Atracurium Besylate Injection, immediate medical intervention is required. The severity of symptoms can vary, including prolonged muscle relaxation, respiratory distress, and potential paralysis. Treatment focuses on supportive care, ensuring adequate ventilation and monitoring vital signs. It is crucial to seek emergency medical assistance promptly, as timely intervention can significantly impact the patient's outcome.

In the case of a missed dose of Cis-Atracurium Besylate Injection, it is important to consult your healthcare provider for specific instructions. Generally, if a dose is missed, it should be administered as soon as possible, provided it is not too close to the time of the next scheduled dose. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of side effects.

To administer Cis-Atracurium Besylate Injection, prepare the medication by drawing the prescribed dose into a syringe, then inject it slowly into the intravenous line, ensuring the infusion is running at the recommended rate as directed by your healthcare professional.

Following are the conditions/situations when Cis-Atracurium Besylate Injection should not be administered:

• Must not be used in patients with known allergies or hypersensitivity to cisatracurium, benzyl alcohol, or any of the other components in the injection.
• Contraindicated in patients with a personal or family history of malignant hyperthermia (a severe reaction to certain anesthetics).
• Not suitable for patients with severe kidney disease or end-stage renal failure, as the drug is primarily eliminated by the kidneys.
• Should be avoided in patients with myasthenia gravis due to its muscle-relaxing effects.
• Not recommended for patients with known or suspected liver disease, as the liver plays a role in the metabolism of cisatracurium.
• Contraindicated in patients with a history of prolonged neuromuscular blockade or those who have experienced anaphylactic reactions to other neuromuscular blocking agents.
• Should not be used in patients with severe respiratory conditions or those with pre-existing respiratory muscle weakness.
• Not suitable for patients with a known or suspected esophageal, duodenal, or pyloric obstruction, as it may interfere with normal gastrointestinal function.
• Contraindicated in patients undergoing surgery where sustained muscle relaxation is not required, as the effects of the drug are not easily reversible.

The side effects of Cis-Atracurium Besylate Injection may include:

• Muscle weakness
• Bradycardia (slow heart rate)
• Hypotension (low blood pressure)
• Allergic reactions such as skin rash, itching, or hives
• Nausea and vomiting
• Increased salivation
• Respiratory distress or bronchospasm
• Injection site reactions

Following are the precautions and warnings for Cis-Atracurium Besylate Injection:

• Not recommended for patients with known hypersensitivity to cis-atracurium, atracurium, benzyl alcohol, or any other components of the injection.
• Must be administered by trained healthcare professionals in a medical setting equipped to manage potential adverse reactions.
• Should be used with caution in patients with myasthenia gravis, as it may exacerbate muscle weakness.
• Patients with renal impairment may require dosage adjustments, as the drug is primarily eliminated through the kidneys.
• Avoid using in patients with known or suspected pseudocholinesterase deficiency, as this may prolong the duration of neuromuscular blockade.
• Elderly patients may be more susceptible to the effects of the drug, and dosage adjustments might be necessary.
• Pregnant and breastfeeding women should only use this medication if the potential benefits outweigh the risks, as the safety in these populations is not well-established.
• Ensure proper ventilation and intubation equipment is readily available during administration to manage potential respiratory complications.

Following are the drug interactions for Cis-Atracurium Besylate Injection:

• Cis-Atracurium is known to interact with neuromuscular blocking agents, such as succinylcholine, enhancing their effects and potentially leading to prolonged paralysis.
• It may cause prolonged neuromuscular blockade when administered with other drugs that have similar effects, including aminoglycoside antibiotics and certain anesthetics.
• The use of Cis-Atracurium with calcium channel blockers can result in enhanced cardiovascular effects and hypotension.
• Concomitant administration with other medications that affect the respiratory system, like opioids, may increase the risk of respiratory depression.
• Cis-Atracurium may interact with certain antibiotics, such as aminoglycosides, and potentiate their neuromuscular blocking effects.
• Caution is advised when using Cis-Atracurium with drugs that affect renal function, as this may impact the elimination of the medication.
• Close monitoring is necessary when combining Cis-Atracurium with medications that prolong QT intervals, as it may increase the risk of cardiac arrhythmias.

Following are the food interactions for Cis-Atracurium Besylate Injection:

• Avoid grapefruit and grapefruit juice as they may interfere with the breakdown of Cis-Atracurium Besylate, potentially leading to increased side effects.
• Alcohol consumption should be minimized or avoided as it can enhance the sedative effects of the medication, causing excessive drowsiness and respiratory depression.
• Foods rich in vitamin K, like leafy green vegetables, should be consumed consistently as Cis-Atracurium Besylate can interfere with vitamin K metabolism, potentially affecting blood clotting.
• Limit caffeine intake from coffee, tea, or energy drinks as it can interact with the medication's effects on the central nervous system.
• Avoid eating large, heavy meals before or after the injection as it may affect the absorption and distribution of the medication.
• Maintain a balanced diet to support overall health and ensure the medication's effectiveness, focusing on foods rich in antioxidants and lean proteins.
• Always inform your healthcare provider about your dietary habits and any significant changes to ensure proper monitoring during the treatment.
• Stay hydrated by drinking adequate water, especially if experiencing gastrointestinal side effects like nausea or vomiting.

Cis-Atracurium Besylate Injection should be stored in a controlled environment, preferably in a cool and dry place, maintaining a temperature between 20°C and 25°C (68°F to 77°F). Protect the injection from direct sunlight, heat, and moisture, as these factors can impact its potency. Always keep the medication in its original packaging, ensuring the seal is intact, to maintain sterility. It is crucial to adhere to the expiration date indicated on the packaging and discard any unused or expired injections appropriately. When disposing of the medication, avoid flushing or pouring it down the drain; instead, consult your pharmacist or local waste management guidelines for safe disposal practices. Keep the injection out of the reach of children and pets to prevent accidental exposure or ingestion.

Following are the quick tips for Cis-Atracurium Besylate Injection:

• Store the injection as directed on the packaging, typically at room temperature away from light and moisture.
• Check the expiry date before use and do not use if expired.
• Ensure the injection is clear and free from particles before administration.
• Use a sterile syringe and needle for injection, and dispose of them safely after use.
• Do not reuse or share needles to prevent infections.
• Inform your healthcare provider if you experience any breathing difficulties or allergic reactions after the injection.
• Keep a record of your injection dates and dosage for accurate medical history.