Mivacurium

Structural formula
	Counterions (anions, e.g. chloride) not shown
General
Non-proprietary name	Mivacurium
other names	Bis {3 - [(1 R ) -6,7-dimethoxy-2-methyl-1 - [(3,4,5-trimethoxyphenyl) methyl] -3,4-dihydro-1 H -isoquinoline-2-ium- yl] propyl} - ( E ) -oct-4-endioate ( IUPAC )
Molecular formula	C 58 H 80 N 2 O 14 2+
External identifiers / databases
PubChem	5281042
ChemSpider	4444509
DrugBank	DB01226
Wikidata	Q413877
Drug information
ATC code	M03 AC10
Drug class	Muscle relaxant
properties
Molar mass	1029.26 g · mol -1
safety instructions
	Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed
GHS hazard labeling ; no classification available
	As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Mivacurium ( trade name Mivacron (EU, CH), manufacturer: GlaxoSmithKline ) is a drug that was introduced in 1992 as the first short-acting, non-depolarizing muscle relaxant from the group of benzylisoquinolines . There are three isomers (composition approx. 60% trans - trans , 35% cis - trans , 5% cis - cis ), the cis - cis form only having about a tenth of the effect.

After administration of a usual intubation dose (about 0.2 to 0.25 mg per kg of body weight), the onset time is about three to five minutes and the duration of action is 15 to 25 minutes. It can in the release of histamine come, thereby flushing, tachycardia , hypotension , bronchospasm and urticaria can be triggered. The use is contraindicated in infants under two months of age, people with pseudocholinesterase deficiency and (relatively) in asthmatics .

The breakdown takes place (as with succinylcholine ) in the plasma by the pseudocholinesterase . If there is a congenital or acquired deficiency in this enzyme, the duration of action (up to several hours) can be extended. Mivacurium is converted into three metabolites (quaternary amino alcohol, quaternary monoester, dicarboxylic acid).

literature

Heck, Fresenius: Revision course anesthesiology . Springer, Berlin; 5th edition 2007. ISBN 978-3-540-46575-1 .

Web links

C. Diefenbach, H. Mellinghoff: The clinical pharmacology of Mivacurium. In: The anesthesiologist. Volume 46, 1997, pp. 385-388.

Remarks

↑ This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.
↑ Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 38.
^ After administration of 2x ED ₉₅ , according to Heck / Fresenius 2007.
↑ DGAI / BDA : How to proceed with prolonged apnea after succinylcholine and mivacurium. Anesthetic intensive med. 39 (1998) 413-414.

[NV-1] This substance has either not yet been classified with regard to its hazardousness or a reliable and citable source has not yet been found.

[2] Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 38.

[3] After administration of 2x ED ₉₅ , according to Heck / Fresenius 2007.

[4] DGAI / BDA : How to proceed with prolonged apnea after succinylcholine and mivacurium. Anesthetic intensive med. 39 (1998) 413-414.