Mivacurium - Revision history

Cornel.Chiu at 16:28, 5 January 2023

2023-01-05T16:28:11Z

← Older revision		Revision as of 09:28, 5 January 2023
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	}}		}}

	Mivacurium is a short acting non-depolarizing neuromuscular blocking agent used for optimizing tracheal intubation conditions, surgical relaxation, optimizing mechanical ventilation, and preventing fasciculation from succinylcholine when administered prior. This is medication is available in most of the world~~, however,~~ it is not sold in the United States of America<ref name=":0">{{Cite journal\|date=2015\|editor-last=Kaye\|editor-first=Alan David\|editor2-last=Kaye\|editor2-first=Adam M.\|editor3-last=Urman\|editor3-first=Richard D.\|title=Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care\|url=http://dx.doi.org/10.1007/978-1-4614-8948-1\|doi=10.1007/978-1-4614-8948-1}}</ref><ref name=":1">{{Citation\|last=Lien\|first=Cynthia A.\|title=Neuromuscular Blockers and Reversal Drugs\|date=2019\|url=http://dx.doi.org/10.1016/b978-0-323-48110-6.00022-3\|work=Pharmacology and Physiology for Anesthesia\|pages=428–454\|publisher=Elsevier\|access-date=2023-01-05\|last2=Eikermann\|first2=Matthias}}</ref>.		Mivacurium is a short acting non-depolarizing neuromuscular blocking agent used for optimizing tracheal intubation conditions, surgical relaxation, optimizing mechanical ventilation, and preventing fasciculation from succinylcholine when administered prior. This is medication is available in most of the world except it is not sold in the United States of America<ref name=":0">{{Cite journal\|date=2015\|editor-last=Kaye\|editor-first=Alan David\|editor2-last=Kaye\|editor2-first=Adam M.\|editor3-last=Urman\|editor3-first=Richard D.\|title=Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care\|url=http://dx.doi.org/10.1007/978-1-4614-8948-1\|doi=10.1007/978-1-4614-8948-1}}</ref><ref name=":1">{{Citation\|last=Lien\|first=Cynthia A.\|title=Neuromuscular Blockers and Reversal Drugs\|date=2019\|url=http://dx.doi.org/10.1016/b978-0-323-48110-6.00022-3\|work=Pharmacology and Physiology for Anesthesia\|pages=428–454\|publisher=Elsevier\|access-date=2023-01-05\|last2=Eikermann\|first2=Matthias}}</ref>.

	== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==		== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==

Cornel.Chiu at 16:27, 5 January 2023

2023-01-05T16:27:16Z

← Older revision		Revision as of 09:27, 5 January 2023
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	=== Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. --> ===		=== Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. --> ===
	Known hypersensitivity
			* Known hypersensitivity

	=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> ===		=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> ===
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	=== Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system --> ===		=== Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system --> ===
	Eliminated via pseudocholinesterase
			* Eliminated via pseudocholinesterase

	==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ====		==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ====
	Competitive antagonism of acetylcholine at the post junctional receptors preventing depolarization of the muscle preventing any movement. Only one molecule of the neuromuscular blocker is needed to prevent activation of the receptor as it competes with acetylcholine at the two binding sites.
			* Competitive antagonism of acetylcholine at the post junctional receptors preventing depolarization of the muscle preventing any movement. Only one molecule of the neuromuscular blocker is needed to prevent activation of the receptor as it competes with acetylcholine at the two binding sites.

	==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ====		==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ====

Cornel.Chiu at 16:26, 5 January 2023

2023-01-05T16:26:38Z

← Older revision		Revision as of 09:26, 5 January 2023
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	{{Infobox drug reference		{{Infobox drug reference
	\| trade_names =		\| trade_names = Mivacron
	\| image_file = Mivacurium.svg		\| image_file = Mivacurium.svg
	\| drug_class = Neuromuscular blocker		\| drug_class = Neuromuscular blocker
	\| drug_class_color = neuromuscular_blocker		\| drug_class_color = neuromuscular_blocker
	\| uses =		\| uses = Tracheal intubation, surgical relaxation, optimizing mechanical ventilation condition
	\| contraindications =		\| contraindications = Known hypersensitivity
	\| routes = Intravenous		\| routes = Intravenous
	\| dosage =		\| dosage =
	\| mechanism = Nicotinic acetylcholine antagonism		\| mechanism = Nicotinic acetylcholine antagonism
	\| adverse_effects =		\| adverse_effects = Anaphylactic reaction, histamine release
	\| time_onset =		\| time_onset = 2 to 3.3 minutes
	\| duration =		\| duration = Less than 30 minutes
	\| metabolism =		\| metabolism = Pseudocholinesterase
	\| halflife_redistribution =		\| halflife_redistribution =
	\| halflife_elimination =		\| halflife_elimination =
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	=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> ===		=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> ===

	* Prolonged duration of action in patients who are homozygous for atypical pseudocholinesterase		* Prolonged duration of action in patients who are homozygous for atypical pseudocholinesterase<ref name=":2" />
	* Large doses of mivacurium can be divided into smaller doses to avoid hemodynamic side effects from the histamine release		* Large doses of mivacurium can be divided into smaller doses to avoid hemodynamic side effects from the histamine release<ref name=":1" />

	== Pharmacology ==		== Pharmacology ==
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	=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===		=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===

	* Duration of action after 2.5 x ED<sub>95</sub> is approximately less than 30 minutes <ref name=":1" /><ref>{{Cite journal\|last=Frampton\|first=James E.\|last2=McTavish\|first2=Donna\|date=1993-06\|title=Mivacurium: A Review of its Pharmacology and Therapeutic Potential in General Anaesthesia\|url=http://link.springer.com/10.2165/00003495-199345060-00009\|journal=Drugs\|language=en\|volume=45\|issue=6\|pages=1066–1089\|doi=10.2165/00003495-199345060-00009\|issn=0012-6667}}</ref>		* Duration of action after 2.5 x ED<sub>95</sub> is approximately less than 30 minutes <ref name=":1" /><ref name=":2">{{Cite journal\|last=Frampton\|first=James E.\|last2=McTavish\|first2=Donna\|date=1993-06\|title=Mivacurium: A Review of its Pharmacology and Therapeutic Potential in General Anaesthesia\|url=http://link.springer.com/10.2165/00003495-199345060-00009\|journal=Drugs\|language=en\|volume=45\|issue=6\|pages=1066–1089\|doi=10.2165/00003495-199345060-00009\|issn=0012-6667}}</ref>
	* Onset of action is about 2 to 3.3 minutes <ref name=":1" />		* Onset of action is about 2 to 3.3 minutes <ref name=":1" />

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	* Goodwin, G., Joseph, V. (2015). Neuromuscular Blockers. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. <nowiki>https://doi-org.laneproxy.stanford.edu/10.1007/978-1-4614-8948-1_12</nowiki><ref name=":0" />		* Goodwin, G., Joseph, V. (2015). Neuromuscular Blockers. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. <nowiki>https://doi-org.laneproxy.stanford.edu/10.1007/978-1-4614-8948-1_12</nowiki><ref name=":0" />
	*Lien, Cynthia A.; Eikermann, Matthias (2013), "Neuromuscular Blockers and Reversal Drugs", ''Pharmacology and Physiology for Anesthesia'', Elsevier, pp. 325–348, retrieved 2023-01-05<ref name=":1" />		*Lien, Cynthia A.; Eikermann, Matthias (2013), "Neuromuscular Blockers and Reversal Drugs", ''Pharmacology and Physiology for Anesthesia'', Elsevier, pp. 325–348, retrieved 2023-01-05<ref name=":1" />
	*Frampton JE, McTavish D. Mivacurium. A review of its pharmacology and therapeutic potential in general anaesthesia. Drugs. 1993 Jun;45(6):1066-1089. doi: 10.2165/00003495-199345060-00009. PMID: 7691494.		*Frampton JE, McTavish D. Mivacurium. A review of its pharmacology and therapeutic potential in general anaesthesia. Drugs. 1993 Jun;45(6):1066-1089. doi: 10.2165/00003495-199345060-00009. PMID: 7691494.<ref name=":2" />

	[[Category:Drug reference]]		[[Category:Drug reference]]
	[[Category:Neuromuscular blockers]]		[[Category:Neuromuscular blockers]]
	[[Category:Nondepolarizing neuromuscular blockers]]		[[Category:Nondepolarizing neuromuscular blockers]]

Cornel.Chiu at 15:55, 5 January 2023

2023-01-05T15:55:00Z

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 * Prolonged duration of action in patients who are homozygous for atypical pseudocholinesterase
 * Large doses of mivacurium can be divided into smaller doses to avoid hemodynamic side effects from the histamine release
 == Pharmacology ==

Cornel.Chiu: References and pharmacokinetics

2023-01-05T15:53:36Z

References and pharmacokinetics

← Older revision		Revision as of 08:53, 5 January 2023
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	}}		}}

	Mivacurium is a short acting non-depolarizing neuromuscular blocking agent used for optimizing tracheal intubation conditions, surgical relaxation, optimizing mechanical ventilation, and preventing fasciculation from succinylcholine when administered prior. This is medication is available in most of the world, however, it is not sold in the United States of America.		Mivacurium is a short acting non-depolarizing neuromuscular blocking agent used for optimizing tracheal intubation conditions, surgical relaxation, optimizing mechanical ventilation, and preventing fasciculation from succinylcholine when administered prior. This is medication is available in most of the world, however, it is not sold in the United States of America<ref name=":0">{{Cite journal\|date=2015\|editor-last=Kaye\|editor-first=Alan David\|editor2-last=Kaye\|editor2-first=Adam M.\|editor3-last=Urman\|editor3-first=Richard D.\|title=Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care\|url=http://dx.doi.org/10.1007/978-1-4614-8948-1\|doi=10.1007/978-1-4614-8948-1}}</ref><ref name=":1">{{Citation\|last=Lien\|first=Cynthia A.\|title=Neuromuscular Blockers and Reversal Drugs\|date=2019\|url=http://dx.doi.org/10.1016/b978-0-323-48110-6.00022-3\|work=Pharmacology and Physiology for Anesthesia\|pages=428–454\|publisher=Elsevier\|access-date=2023-01-05\|last2=Eikermann\|first2=Matthias}}</ref>.

	== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==		== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==
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	=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===		=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===
	Duration of action
			* Duration of action after 2.5 x ED<sub>95</sub> is approximately less than 30 minutes <ref name=":1" /><ref>{{Cite journal\|last=Frampton\|first=James E.\|last2=McTavish\|first2=Donna\|date=1993-06\|title=Mivacurium: A Review of its Pharmacology and Therapeutic Potential in General Anaesthesia\|url=http://link.springer.com/10.2165/00003495-199345060-00009\|journal=Drugs\|language=en\|volume=45\|issue=6\|pages=1066–1089\|doi=10.2165/00003495-199345060-00009\|issn=0012-6667}}</ref>
			* Onset of action is about 2 to 3.3 minutes <ref name=":1" />

	== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> ==		== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> ==
	Comprised of a mixture of 3 stereoisomers, one of which -the cis-cis isomer- is less than one-tenth as potent as the trans-trans and cis-trans isomers.
			* Comprised of a mixture of 3 stereoisomers, one of which -the cis-cis isomer- is less than one-tenth as potent as the trans-trans and cis-trans isomers<ref name=":1" />
			* Not available in the United States of America <ref name=":0" /><ref name=":1" />

	== History<!-- Describe the historical development of the drug. --> ==		== History<!-- Describe the historical development of the drug. --> ==
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	== References ==		== References ==

	* Frampton JE, McTavish D. Mivacurium. A review of its pharmacology and therapeutic potential in general anaesthesia. Drugs. 1993 Jun;45(6):1066-1089. doi: 10.2165/00003495-199345060-00009. PMID: 7691494.		* Goodwin, G., Joseph, V. (2015). Neuromuscular Blockers. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. <nowiki>https://doi-org.laneproxy.stanford.edu/10.1007/978-1-4614-8948-1_12</nowiki><ref name=":0" />
	* Goodwin, G., Joseph, V. (2015). Neuromuscular Blockers. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. <nowiki>https://doi-org.laneproxy.stanford.edu/10.1007/978-1-4614-8948-1_12</nowiki>		*Lien, Cynthia A.; Eikermann, Matthias (2013), "Neuromuscular Blockers and Reversal Drugs", ''Pharmacology and Physiology for Anesthesia'', Elsevier, pp. 325–348, retrieved 2023-01-05<ref name=":1" />
			*Frampton JE, McTavish D. Mivacurium. A review of its pharmacology and therapeutic potential in general anaesthesia. Drugs. 1993 Jun;45(6):1066-1089. doi: 10.2165/00003495-199345060-00009. PMID: 7691494.

	[[Category:Drug reference]]		[[Category:Drug reference]]
	[[Category:Neuromuscular blockers]]		[[Category:Neuromuscular blockers]]
	[[Category:Nondepolarizing neuromuscular blockers]]		[[Category:Nondepolarizing neuromuscular blockers]]

Cornel.Chiu: References

2023-01-05T15:06:15Z

References

← Older revision		Revision as of 08:06, 5 January 2023
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	=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===		=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===
			Duration of action

	== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> ==		== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> ==
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	== References ==		== References ==

			* Frampton JE, McTavish D. Mivacurium. A review of its pharmacology and therapeutic potential in general anaesthesia. Drugs. 1993 Jun;45(6):1066-1089. doi: 10.2165/00003495-199345060-00009. PMID: 7691494.
			* Goodwin, G., Joseph, V. (2015). Neuromuscular Blockers. In: Kaye, A., Kaye, A., Urman, R. (eds) Essentials of Pharmacology for Anesthesia, Pain Medicine, and Critical Care. Springer, New York, NY. <nowiki>https://doi-org.laneproxy.stanford.edu/10.1007/978-1-4614-8948-1_12</nowiki>

	[[Category:Drug reference]]		[[Category:Drug reference]]
	[[Category:Neuromuscular blockers]]		[[Category:Neuromuscular blockers]]
	[[Category:Nondepolarizing neuromuscular blockers]]		[[Category:Nondepolarizing neuromuscular blockers]]

Cornel.Chiu: Brief summary, Uses, contraindication, precautions, pharmacodynamics, adverse effects, chemistry and formulation

2023-01-03T14:50:41Z

Brief summary, Uses, contraindication, precautions, pharmacodynamics, adverse effects, chemistry and formulation

← Older revision		Revision as of 07:50, 3 January 2023
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	}}		}}

	~~Provide~~ a ~~brief summary~~ of ~~this drug here~~.		Mivacurium is a short acting non-depolarizing neuromuscular blocking agent used for optimizing tracheal intubation conditions, surgical relaxation, optimizing mechanical ventilation, and preventing fasciculation from succinylcholine when administered prior. This is medication is available in most of the world, however, it is not sold in the United States of America.

	== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==		== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> ==

			* Optimizing tracheal intubation condition among patients with renal or hepatic dysfunction
			** Abduction of vocal cords
			** Opening of mouth
			** Reduction in coughing and gagging
			* Provide surgical relaxation among patients with renal or hepatic dysfunction
			* Optimizing mechanical ventilation conditions among patients with renal or hepatic dysfunction
			** Reduction in bucking/coughing
			** Reduction in breath stacking

	== Contraindications<!-- List contraindications and precautions for use of the drug. --> ==		== Contraindications<!-- List contraindications and precautions for use of the drug. --> ==

	=== Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. --> ===		=== Absolute contraindications<!-- List absolute contraindications for use of the drug. If none, this section may be removed. --> ===
			Known hypersensitivity

	=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> ===		=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> ===

			* Prolonged duration of action in patients who are homozygous for atypical pseudocholinesterase
			* Large doses of mivacurium can be divided into smaller doses to avoid hemodynamic side effects from the histamine release
			** Myasthenia gravis/myathenic syndrome
			** Amyotrophic lateral sclerosis
			** Autoimmune disorders including polymyositis, dermatomyositis and systemic lupus erythematous
			** Familial periodic paralysis hyperkalemia
			** Guillain-Barré syndrome
			** Muscular dystrophy (Duchenne type)
			** Myotonia including dystrophic, congenital,, and paramyotonia
			** Patient may have resistance include:
			*** Burn injury
			*** Cerebral palsy
			*** Hemiplegia (on the affected side)
			*** Muscular denervation
			*** Severe chronic infection such as tetanus and botulism

	== Pharmacology ==		== Pharmacology ==

	=== Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system --> ===		=== Pharmacodynamics<!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system --> ===
			Eliminated via pseudocholinesterase

	==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ====		==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ====
			Competitive antagonism of acetylcholine at the post junctional receptors preventing depolarization of the muscle preventing any movement. Only one molecule of the neuromuscular blocker is needed to prevent activation of the receptor as it competes with acetylcholine at the two binding sites.

	==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ====		==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ====

			* Anaphylactic reaction due to the ammonium ion in the NMB
			* Histamine release
			* Muscle weakness or myopathy due to persistent failure of neuromuscular transmission and immobilization-induced atrophy of diaphragm when used for a prolonged duration
			* Posttraummatic stress syndrome from awareness during paralysis if sedation is not used adequately.
			* Impairment of ventilation-perfusion distribution and decreased right ventricular end-diastolic volume due to abolishment of spontaneous breathing.

	=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===		=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> ===

	== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> ==		== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> ==
			Comprised of a mixture of 3 stereoisomers, one of which -the cis-cis isomer- is less than one-tenth as potent as the trans-trans and cis-trans isomers.

	== History<!-- Describe the historical development of the drug. --> ==		== History<!-- Describe the historical development of the drug. --> ==

Chris.Rishel at 11:26, 12 November 2021

2021-11-12T11:26:20Z

← Older revision		Revision as of 04:26, 12 November 2021
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	[[Category:Drug reference]]		[[Category:Drug reference]]
			[[Category:Neuromuscular blockers]]
			[[Category:Nondepolarizing neuromuscular blockers]]

Chris.Rishel: Created page with "{{Infobox drug reference | trade_names = | image_file = Mivacurium.svg | drug_class = Neuromuscular blocker | drug_class_color = neuromuscular_blocker | uses = | contraindic..."

2021-11-12T11:09:57Z

Created page with "{{Infobox drug reference | trade_names = | image_file = Mivacurium.svg | drug_class = Neuromuscular blocker | drug_class_color = neuromuscular_blocker | uses = | contraindic..."

New page

{{Infobox drug reference
| trade_names =
| image_file = Mivacurium.svg
| drug_class = Neuromuscular blocker
| drug_class_color = neuromuscular_blocker
| uses =
| contraindications =
| routes = Intravenous
| dosage =
| mechanism = Nicotinic acetylcholine antagonism
| adverse_effects =
| time_onset =
| duration =
| metabolism =
| halflife_redistribution =
| halflife_elimination =
| clearance =
| protein_binding =
}}

Provide a brief summary of this drug here.

== Uses ==

== Contraindications ==

=== Absolute contraindications ===

=== Precautions ===

== Pharmacology ==

=== Pharmacodynamics ===

==== Mechanism of action ====

==== Adverse effects ====

=== Pharmacokinetics ===

== Chemistry and formulation ==

== History ==

== References ==

[[Category:Drug reference]]