NIMBEX Injection

Cisatracurium
2mg/ml
GLAXOSMITHKLINE MANUFACTURING S.p.A.
Pack size 2.5ml Ampoule x 5
Dispensing mode POM
Source ITALY
AgentAHMED KHALIL AL BAKER MEDICAL SUPPLIES COMPANY
Retail Price 74.50 AED

Available as:

2mg/ml - Injection 2mg/ml - Injection

Indications

NIMBEX Injection is used for: Facilitate mechanical ventilation in intensive care, Facilitate endotracheal intubation, Muscle relaxant in general anaesthesia

Adult Dose

Intravenous Facilitate mechanical ventilation in intensive care, Facilitate endotracheal intubation, Muscle relaxant in general anaesthesia Adult: Initially, 150 mcg/kg by inj. Maintenance: 30 mcg/kg by inj (each dose provides 20 min of additional block), may also be given by infusion at an initial rate of 3 mcg/kg/min followed by a rate of 1-2 mcg/kg/min.

Child Dose

Intravenous Facilitate mechanical ventilation in intensive care, Facilitate endotracheal intubation, Muscle relaxant in general anaesthesia Child: 1-23 mth Initially, 150 mcg/kg by inj over 5-10 sec, during halothane or opiate anaesth; 2-12 yr Initially, 100-150 mcg/kg by inj over 5-10 sec, during halothane or opiate anaesth. Maintenance: 20 mcg/kg by inj (each dose provides 9 min of additional block), may also be given by infusion at an initial rate of 3 mcg/kg/min followed by a rate of 1-2 mcg/kg/min.

Renal Dose

Administration

IV Preparation Dilute in D5W, NS or D5/NS As low as 0.1 mg/mL can be stored at room temp or refrigerated for 24 hr

Contra Indications

Hypersensitivity to cisatracurium (or benzyl alcohol if 10 mL vial is used) Use of 10 mL vial in pediatric patients <1 month of age and low birth-weight infants (contains benzyl alcohol)

Precautions

Patient w/ burn injury, neuromuscular disease (e.g. myasthenia gravis, Eaton-Lambert syndrome), electrolyte abnormalities, hemiparesis or paraparesis, carcinomatosis. Childn. Pregnancy and lactation. Monitoring Parameters Monitor heart rate, BP, resp rate; peripheral nerve stimulator twitch response (when appropriate).

Pregnancy-Lactation

Pregnancy There are no adequate and well-controlled studies in pregnant women; animal studies conducted in rats administered cisatracurium besylate during organogenesis found no evidence of fetal harm at 0.8 times (ventilated rats) the exposure from a human starting IV bolus dose of 0.2 mg/kg Labor or delivery The action of neuromuscular blocking agents may be enhanced by magnesium salts administered for management of preeclampsia or eclampsia of pregnancy Lactation It is not known whether drug is present in human milk; developmental and health benefits of breastfeeding should be considered along with mother's clinical need for therapy and any potential adverse effects on breastfed child from treatment or from underlying maternal condition

Interactions

Increased effect w/ anaesth agents (e.g. enflurane, isoflurane, halothane, ketamine), other non-depolarising neuromuscular blocking agents, certain antibiotics (e.g. aminoglycosides, polymyxins, spectinomycin, tetracyclines, lincomycin, clindamycin), anti-arrhythmic drugs (e.g. propranolol, Ca channel blockers, lidocaine, procainamide, quinidine), diuretics (e.g. furosemide, and possibly thiazides, mannitol and acetazolamide), Mg and lithium salts, ganglion blocking drugs (e.g. trimetaphan, hexamethonium). Decreased effect w/ phenytoin, carbamazepine, anticholinesterases (e.g. donepezil).

Adverse Effects

Side effects of Cisatracurium : <1% Bronchospasm Bradycardia Flushing Pruritus Myositis ossificans Hypotension Rash

Mechanism of Action

Cisatracurium antagonises the action of acetylcholine by binding to cholinergic receptors on the motor end-plate, resulting in a competitive block of neuromuscular transmission.

Note

NIMBEX 2mg/ml Injection manufactured by GLAXOSMITHKLINE MANUFACTURING S.p.A.. Its generic name is Cisatracurium. NIMBEX is availble in United Arab Emirates. Farmaco UAE drug index information on NIMBEX Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.

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