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Cisatracurium besilate

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Cisatracurium besilate (INN; cisatracurium besylate (USAN); formerly recognized as 51W89; trade name Nimbex) is a bisbenzyltetrahydroisoquinolinium that has effect as a non-depolarizing neuromuscular-blocking drug, used adjunctively in anesthesia to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. It shows intermediate duration of action. Cisatracurium is one of the ten isomers of the parent molecule, atracurium.

Hofmann eliminationHofmann eliminationHofmann elimination is an elimination reaction of an amine to form alkenes. The least stable alkene (the one with the fewest substituents on the carbons of the double bond), called the Hofmann product, is formed. This tendency, known as the Hofmann alkene synthesis rule, is in contrast to usual elimination reactions, where Zaitsev's rule predicts the formation of the most stable alkene. It is named after its discoverer, August Wilhelm von Hofmann.LaudanosineLaudanosineLaudanosine or N-methyltetrahydropapaverine is a metabolite of the pharmaceutical drugs atracurium and cisatracurium. Laudanosine decreases the seizure threshold, and thus it can induce seizures if present at sufficient threshold concentrations; however, such concentrations are unlikely to be produced consequent to chemodegradable metabolism of clinically administered doses of cisatracurium or atracurium.University of StrathclydeThe University of Strathclyde (Scottish Gaelic: Oilthigh Shrath Chluaidh) is a public research university located in Glasgow, Scotland. Founded in 1796 as the Andersonian Institute, it is Glasgow's second-oldest university, having received its royal charter in 1964 as the first technological university in the United Kingdom.Neuromuscular-blocking drugNeuromuscular-blocking drugNeuromuscular-blocking drugs, or Neuromuscular blocking agents (NMBAs), block transmission at the neuromuscular junction, causing paralysis of the affected skeletal muscles. This is accomplished via their action on the post-synaptic acetylcholine (Nm) receptors.Atracurium besilateAtracurium besilateAtracurium besilate, also known as atracurium besylate, is a medication used in addition to other medications to provide skeletal muscle relaxation during surgery or mechanical ventilation. It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this needs to be done quickly. It is given by injection into a vein. Effects are greatest at about 4 minutes and last for up to an hour.Skeletal muscleSkeletal muscleSkeletal muscle (commonly referred to as muscle) is one of the three types of vertebrate muscle tissue, the others being cardiac muscle and smooth muscle. They are part of the musculoskeletal system, and typically are attached by tendons to the bones of a skeleton. The skeletal muscle cells (myocytes) are much longer than in the other types of muscle tissue, and are also known as muscle fibers.IntubationIntubationIntubation (sometimes entubation) is a medical procedure involving the insertion of a tube into the body. Most commonly, intubation refers to tracheal intubation, a procedure during which an endotracheal tube is inserted into the trachea to support patient ventilation. Other examples of intubation include balloon tamponade using a Sengstaken–Blakemore tube (a tube into the gastrointestinal tract), urinary catheterization, and nasogastric intubation using a feeding tube.AnesthesiaAnesthesiaState of medically-controlled temporary loss of sensation or awarenessMedical interventionAnesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), and unconsciousness.International nonproprietary nameAn international nonproprietary name (INN) is an official generic and nonproprietary name given to a pharmaceutical substance or an active ingredient, encompassing compounds, peptides and low-molecular-weight proteins (e.g., insulin, hormones, cytokines), as well as complex biological products, such as those used for gene therapy. INNs are intended to make communication more precise by providing a unique standard name for each active ingredient, to avoid prescribing errors.United States Adopted NameUnited States Adopted NameA United States Adopted Name (USAN) is a unique nonproprietary name assigned to a medication marketed in the United States. Each name is assigned by the USAN Council, which is co-sponsored by the American Medical Association (AMA), the United States Pharmacopeial Convention (USP), and the American Pharmacists Association (APhA).SurgerySurgerySurgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery such as gastric bypass), to reconstruct or alter aesthetics and appearance (cosmetic surgery), or to remove unwanted tissues, neoplasms and foreign bodies.Mechanical ventilationMechanical ventilationMechanical ventilation or assisted ventilation is the medical term for using a ventilator machine to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide.IsomerIsomerIn chemistry, isomers are molecules or polyatomic ions with an identical molecular formula – that is, the same number of atoms of each element – but distinct arrangements of atoms in space. Isomerism refers to the existence or possibility of isomers. Isomers do not necessarily share similar chemical or physical properties.

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