| Indication |
Used to provide skeletal muscle relaxation as an adjunct to
general anesthesia, for endotracheal intubation or to facilitate
mechanical ventilation. |
| Pharmacodynamics |
Doxacurium chloride is a long-acting, nondepolarizing skeletal
muscle relaxant. The neuromuscular block produced by doxacurium chloride
may be antagonized by anticholinesterase agents. As with other
nondepolarizing neuromuscular blocking agents, the more profound the
neuromuscular block at reversal, the longer the time and the greater the
dose of anticholinesterase required for recovery of neuromuscular
function. Doxacurium chloride is approximately 2.5 to 3 times more
potent than pancuronium and 10 to 12 times more potent than metocurine. |
| Mechanism of action |
Doxacurium chloride binds competitively to cholinergic receptors
on the motor end-plate to antagonize the action of acetylcholine,
resulting in a block of neuromuscular transmission (non-depolarizing).
This action is antagonized by acetylcholinesterase inhibitors, such as
neostigmine. |
| Absorption |
Not Available |
| Volume of distribution |
- 0.11-0.43 L/kg [Healthy Young Adult Patients]
- 0.17-0.55 L/kg [Kidney Transplant Patients]
- 0.17-0.35 L/kg [Liver Transplant Patients]
|
| Protein binding |
Approximately 30%. |
| Metabolism |
In vivo data from humans suggest that doxacurium chloride is not
metabolized and that the major elimination pathway is excretion of
unchanged drug in urine and bile. |
| Route of elimination |
In vivo data from humans suggest that NUROMAX is not metabolized
and that the major elimination pathway is excretion of unchanged drug in
urine and bile. |
| Half life |
99 minutes in normal healthy adults. |
| Clearance |
- 2.66 mL/min/kg [Healthy Young Adult Patients]
- 1.23 mL/min/kg [Kidney Transplant Patients]
- 2.3 mL/min/kg [Liver Transplant Patients]
- 1.75 +/- 0.16 mL/min/kg [Elderly patients (70-83 yrs)]
- 2.54 +/- 0.24 mL/min/kg [younger patients (19-39 yrs)]
|
| Toxicity |
Overdosage with neuromuscular blocking agents may result in
neuromuscular block beyond the time needed for surgery and anesthesia. |
