metocurine; dimethyl tubocurarine (Metubine Iodide)

Tradename: Metubine Iodide. Indications: - skeletal muscle relaxation during surgery Contraindications: - hypersensitivity to iodide Caution: 1) myasthenia gravis 2) renal insufficiency 3) prolonged apnea 4) respiratory depression 5) muscle weakness Dosage: 1) adjunct to anesthesia: 0.2-0.4 mg/kg IV followed by 0.1-0.25 mg/kg every 25-90 min 2) neonates: a) start: 0.25-0.5 mg/kg b) repeat once if paralysis not achieved in 3 minutes c) maintenance: repeat previous dose as soon as movement is observed Injection: 2 mg/mL (20 mL) Adverse effects: 1) not common (1-10%) - cardiac arrhythmias, bradycardia, hypotension 2) uncommon (< 1%) - hypersensitivity reactions Drug interactions: 1) aminoglycosides 2) certain general anesthetics 3) quinidine 4) magnesium 5) other muscle relaxants Mechanism of action: (by analogy with tubocurarine) 1) non-depolarizing neuromuscular junction blocker 2) skeletal muscle relaxation produced by blocking response to acetylcholine at the myoneural junction 3) blocks access of acetylcholine to the motor end-plate

General

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

Properties

MISC-INFO: elimination route KIDNEY

References

Kaiser Permanente Northern California Regional Drug Formulary, 1998