Compounds > rapacuronium
Page last updated: 2024-12-10

rapacuronium

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Description

rapacuronium: 16-N-allyl-17-beta-propionate analog of vecuronium; structure given in first source [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID5311399
CHEMBL ID1201352
CHEBI ID135845
SCHEMBL ID16977930
MeSH IDM0366636

Synonyms (15)

Synonym
rapacuronium
DB04834
CHEBI:135845
[(2s,3s,5s,8r,9s,10s,13s,14s,16s,17r)-3-acetyloxy-10,13-dimethyl-2-piperidin-1-yl-16-(1-prop-2-enylpiperidin-1-ium-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1h-cyclopenta[a]phenanthren-17-yl] propanoate
CHEMBL1201352
rapacuronium ion
rapacuronium [vandf]
1-allyl-1-(3.alpha.,17.beta.-dihydroxy-2.beta.-piperidino-5.alpha.-androstan-16.beta.-yl)piperidinium, 3-acetate 17-propionate
androstane-3,17-diol, 2-(1-piperidinyl)-16-(1-(2-propenyl)-1-piperidiniumyl)-, 3-acetate 17-propanoate, (2.beta.,3.alpha.,5.alpha.,16.beta.,17.beta.)-
rapacuronium cation
465499-11-0
gg1lbm463s ,
unii-gg1lbm463s
SCHEMBL16977930
DTXSID80861419

Research Excerpts

Overview

Rapacuronium is an aminosteroidal nondepolarising neuromuscular blocking agent. It is a rapid-onset and short- to intermediate-acting muscle relaxant.

ExcerptReferenceRelevance
"Rapacuronium is an aminosteroidal nondepolarising neuromuscular blocking agent (NMBA). "( Pharmacokinetics and pharmacodynamics of rapacuronium bromide.
Wight, WJ; Wright, PM, 2002)		2.02
"Rapacuronium (Org 9487) is a rapid-onset and short- to intermediate-acting muscle relaxant. "( Pharmacokinetics and pharmacokinetic-dynamic relationship between rapacuronium (Org 9487) and its 3-desacetyl metabolite (Org 9488).
Proost, JH; Schiere, S; Schuringa, M; Wierda, JM, 1999)		1.98
"Rapacuronium is a new nondepolarizing muscle relaxant with rapid onset and offset. "( Factors affecting the pharmacokinetic characteristics of rapacuronium.
Angst, MS; Bevan, D; Bikhazi, G; Fisher, DM; Fragen, RJ; Kahwaji, R; Matteo, RS; Ornstein, E, 1999)		1.99
"Rapacuronium is a rapid-onset, short-acting neuromuscular relaxant. "( Early reversal of rapacuronium with neostigmine.
Bevan, DR; Donati, F; Lichtor, JL; Purdy, R, 1999)		2.08
"Rapacuronium is an investigational intermediate-duration agent and is even less potent than rocuronium."( Recent advances in neuromuscular blocking agents.
Bartkowski, RR, 1999)		1.02
"Rapacuronium is a rapid-acting, steroidal-derived neuromuscular blocking drug whose hemodynamic effects have not been characterized."( The effects of rapacuronium on histamine release and hemodynamics in adult patients undergoing general anesthesia.
Bastian, R; Kim, J; Levy, JH; Pitts, M; Szlam, F; Thanopoulos, A, 1999)		1.38
"Rapacuronium is a new steroidal, nondepolarizing, neuromuscular blocking agent. "( Clinical pharmacology of rapacuronium bromide, a new short-acting neuromuscular blocking agent.
Goldberg, ME; Larijani, GE; Zafeiridis, A, 1999)		2.05
"Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation."( Comparison of the intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol.
Caldwell, JE; Chan, V; Chung, F; Cicutti, N; Fleming, NW; Gan, TJ; Glass, PS; Gronert, GA; Kirkegaard-Nielsen, H; Kitts, JB, 1999)		1.28
"Rapacuronium is a low-potency nondepolarizing muscle relaxant with a fast onset of relaxation and minimal cardiovascular effects."( The potency (ED50) and cardiovascular effects of rapacuronium (Org 9487) during narcotic-nitrous oxide-propofol anesthesia in neonates, infants, and children.
Bui, DT; Darrow, EJ; Fletcher, JE; Hannallah, RS; Kaplan, RF; Slaven, JS; Tsai, KT, 1999)		1.28
"Rapacuronium (RAP) is a new, rapid-onset, short-duration, nondepolarizing neuromuscular blocker. "( Duration of action of vecuronium after an intubating dose of rapacuronium, vecuronium, or succinylcholine.
Alexander, R; El-Moalem, H; Gan, TJ; Glass, PS; Jhaveri, R; Madan, R; Weatherwax, K, 2001)		1.99
"Rapacuronium, however, is a suitable alternative to mivacurium chloride (mivacurium) and succinylcholine for short procedures (e.g."( Newer neuromuscular blocking agents: how do they compare with established agents?
Beaufort, TM; Fuchs-Buder, T; Sparr, HJ, 2001)		1.03
"Rapacuronium is a new non-depolarizing relaxant with a fast onset and rapid recovery. "( Rapacuronium: first experience in clinical practice.
Bartkowski, RR; Witkowski, TA, 2001)		3.2
"Rapacuronium is a new, rapid-onset, short-duration, nondepolarizing neuromuscular blocking drug. "( A comparison of neuromuscular effects, tracheal intubating conditions, and reversibility of rapacuronium versus mivacurium in female patients.
Coppens, S; Geerts, E; van Iersel, M; Vanacker, BF, 2002)		1.98
"Rapacuronium is a nondepolarizing muscle relaxant similar in structure to pancuronium, rocuronium, and vecuronium. "( The hemodynamic effects of rapacuronium in patients with coronary artery disease: succinylcholine and vecuronium compared.
Delboy, NJ; Shields, JA; Tomichek, RC, 2002)		2.05

Effects

Rapacuronium has an active metabolite that is at least as potent as the parent compound. It has a mild to moderate effect on heart rate and arterial blood pressure in ASA physical status I and II patients.

Rapacuronium has a rapid onset, and a bolus dose has a short duration of action. It has a mild to moderate effect on heart rate and arterial blood pressure in ASA physical status I and II patients.

ExcerptReferenceRelevance
"Rapacuronium has an active metabolite that is at least as potent as the parent compound and is eliminated much less efficiently."( Pharmacokinetics and pharmacodynamics of rapacuronium bromide.
Wight, WJ; Wright, PM, 2002)		1.3
"Rapacuronium has a rapid onset, and a bolus dose has a short duration of action."( Clinical pharmacokinetics of the newer neuromuscular blocking drugs.
Atherton, DP; Hunter, JM, 1999)		1.02
"Rapacuronium has an onset profile that is not different from that previously reported for succinylcholine."( Dose-response and onset/offset characteristics of rapacuronium.
Flores, F; Ghori, K; Klewicka, MM; Kopman, AF; Neuman, GG, 2000)		1.28
"Rapacuronium has a mild to moderate effect on heart rate and arterial blood pressure in ASA physical status I and II patients."( The hemodynamic effects of rapacuronium in patients with coronary artery disease: succinylcholine and vecuronium compared.
Delboy, NJ; Shields, JA; Tomichek, RC, 2002)		1.33
"Rapacuronium has an active metabolite that is at least as potent as the parent compound and is eliminated much less efficiently."( Pharmacokinetics and pharmacodynamics of rapacuronium bromide.
Wight, WJ; Wright, PM, 2002)		1.3
"Rapacuronium has a rapid onset, and a bolus dose has a short duration of action."( Clinical pharmacokinetics of the newer neuromuscular blocking drugs.
Atherton, DP; Hunter, JM, 1999)		1.02
"Rapacuronium has an onset profile that is not different from that previously reported for succinylcholine."( Dose-response and onset/offset characteristics of rapacuronium.
Flores, F; Ghori, K; Klewicka, MM; Kopman, AF; Neuman, GG, 2000)		1.28
"Rapacuronium has been accepted wherever rapid onset and short duration of action are advantageous."( Rapacuronium: first experience in clinical practice.
Bartkowski, RR; Witkowski, TA, 2001)		2.47
"Rapacuronium has a mild to moderate effect on heart rate and arterial blood pressure in ASA physical status I and II patients."( The hemodynamic effects of rapacuronium in patients with coronary artery disease: succinylcholine and vecuronium compared.
Delboy, NJ; Shields, JA; Tomichek, RC, 2002)		1.33

Pharmacokinetics

Rapacuronium is a muscle relaxant with rapid onset and offset. The time course of a single bolus dose of 1.5 mg can be explained from its pharmacokinetic and pharmacodynamic characteristics.

ExcerptReferenceRelevance
" Terminal half-life and mean residence time were 71."( Pharmacodynamics and pharmacokinetics of an infusion of Org 9487, a new short-acting steroidal neuromuscular blocking agent.
Proost, JH; Smeulers, NJ; van den Broek, L; Wierda, JM, 1994)		0.29
" To determine whether similar differences exist for rapacuronium, a muscle relaxant with rapid onset and offset, the authors determined its pharmacodynamic characteristics."( A pharmacodynamic explanation for the rapid onset/offset of rapacuronium bromide.
Brown, R; Fisher, DM; Lau, M; Wright, PM, 1999)		0.8
" A semiparametric effect compartment pharmacodynamic model was fit to values for rapacuronium plasma concentrations and twitch tension of the adductor pollicis and laryngeal adductors."( A pharmacodynamic explanation for the rapid onset/offset of rapacuronium bromide.
Brown, R; Fisher, DM; Lau, M; Wright, PM, 1999)		0.77
" Pharmacokinetic parameters were determined using mixed-effects modeling."( Influence of renal failure on the pharmacokinetics and neuromuscular effects of a single dose of rapacuronium bromide.
Brown, R; Caldwell, JE; Fisher, DM; Lau, M; Luks, AM; Szenohradszky, J; Wright, PM, 1999)		0.52
" In this study, the pharmacokinetic behavior (n = 7) of this metabolite and the pharmacokinetic/pharmacodynamic (PK/PD) relationship of rapacuronium (n = 10) and Org 9488 (n = 7) were investigated in humans."( Pharmacokinetics and pharmacokinetic-dynamic relationship between rapacuronium (Org 9487) and its 3-desacetyl metabolite (Org 9488).
Proost, JH; Schiere, S; Schuringa, M; Wierda, JM, 1999)		0.74
" As part of a study to determine its neuromuscular effects, the authors sampled plasma sparsely to determine the influence of age, gender, and other covariates on its pharmacokinetic characteristics."( Factors affecting the pharmacokinetic characteristics of rapacuronium.
Angst, MS; Bevan, D; Bikhazi, G; Fisher, DM; Fragen, RJ; Kahwaji, R; Matteo, RS; Ornstein, E, 1999)		0.55
" Pharmacokinetic analysis was performed using a population approach (mixed-effects modeling) to determine the influence of demographic characteristics and preoperative laboratory values on the pharmacokinetic parameters."( Factors affecting the pharmacokinetic characteristics of rapacuronium.
Angst, MS; Bevan, D; Bikhazi, G; Fisher, DM; Fragen, RJ; Kahwaji, R; Matteo, RS; Ornstein, E, 1999)		0.55
" Rapacuronium's weight-normalized pharmacokinetic parameters were not influenced by age, gender, or other covariates examined."( Factors affecting the pharmacokinetic characteristics of rapacuronium.
Angst, MS; Bevan, D; Bikhazi, G; Fisher, DM; Fragen, RJ; Kahwaji, R; Matteo, RS; Ornstein, E, 1999)		1.46
" This finding contrasts to an age-related decrease in plasma clearance observed in a study of 10 healthy volunteers and in a pooled analysis of the pharmacokinetic data from 206 adults in multiple clinical studies."( Factors affecting the pharmacokinetic characteristics of rapacuronium.
Angst, MS; Bevan, D; Bikhazi, G; Fisher, DM; Fragen, RJ; Kahwaji, R; Matteo, RS; Ornstein, E, 1999)		0.55
" Pipecuronium resembles pancuronium in its pharmacokinetic and neuromuscular blocking profile, but is devoid of cardiovascular effects."( Clinical pharmacokinetics of the newer neuromuscular blocking drugs.
Atherton, DP; Hunter, JM, 1999)		0.3
" The elimination half-life was 88 (77-102) min in controls and 90 (76-117) min in patients with cirrhosis."( Pharmacokinetics and pharmacodynamics of rapacuronium in patients with cirrhosis.
Duvaldestin, P; Rebufat, Y; Slavov, V, 1999)		0.57
" A three-compartment pharmacokinetic model was justified."( Antagonism of rapacuronium using edrophonium or neostigmine: pharmacodynamics and pharmacokinetics.
Danjoux, G; Hing, JP; Hunter, JM; Mills, KG; Pollard, BJ; Scott, JM; Wright, PM, 1999)		0.66
" In the current study, the authors determined its pharmacokinetic characteristics in children."( Pharmacokinetics of rapacuronium in infants and children with intravenous and intramuscular administration.
Brown, R; Fisher, DM; Hsu, J; Infosino, A; Reynolds, LM, 2000)		0.63
" A mixed-effects population pharmacokinetic analysis was applied to these values to determine bioavailability, absorption rate constant, and time to peak plasma concentration with intramuscular administration."( Pharmacokinetics of rapacuronium in infants and children with intravenous and intramuscular administration.
Brown, R; Fisher, DM; Hsu, J; Infosino, A; Reynolds, LM, 2000)		0.63
" Rapacuronium's pharmacokinetic parameters were determined using mixed-effects modeling."( Effect of renal failure and cirrhosis on the pharmacokinetics and neuromuscular effects of rapacuronium administered by bolus followed by infusion.
Abengochea, A; Atherton, DP; Brown, R; Dempsey, GA; Fisher, DM; Hunter, JM, 2000)		1.44
"The rapid onset and offset of rapacuronium can be explained from its pharmacokinetic and pharmacodynamic characteristics."( A pharmacokinetic-dynamic explanation of the rapid onset-offset of rapacuronium.
Proost, JH; Wright, PM, 2001)		0.84
" Pharmacokinetic parameters do not appear to differ markedly in hepatic insufficiency, but clearance is reduced by approximately 30% in renal failure."( Pharmacokinetics and pharmacodynamics of rapacuronium bromide.
Wight, WJ; Wright, PM, 2002)		0.58
"To test the suitability of an Iterative Two-Stage Bayesian (ITSB) technique for population pharmacokinetic analysis of rich data sets, and to compare ITSB with Standard Two-Stage (STS) analysis and nonlinear Mixed Effect Modeling (MEM)."( Performance of an iterative two-stage bayesian technique for population pharmacokinetic analysis of rich data sets.
Eleveld, DJ; Proost, JH, 2006)		0.33
"ITSB is a suitable technique for population pharmacokinetic analysis of rich data sets, and in the presented data set it is superior to STS and MEM."( Performance of an iterative two-stage bayesian technique for population pharmacokinetic analysis of rich data sets.
Eleveld, DJ; Proost, JH, 2006)		0.33

Bioavailability

ExcerptReferenceRelevance
" A mixed-effects population pharmacokinetic analysis was applied to these values to determine bioavailability, absorption rate constant, and time to peak plasma concentration with intramuscular administration."( Pharmacokinetics of rapacuronium in infants and children with intravenous and intramuscular administration.
Brown, R; Fisher, DM; Hsu, J; Infosino, A; Reynolds, LM, 2000)		0.63
" Intramuscular bioavailability averaged 56%."( Pharmacokinetics of rapacuronium in infants and children with intravenous and intramuscular administration.
Brown, R; Fisher, DM; Hsu, J; Infosino, A; Reynolds, LM, 2000)		0.63
" After intramuscular administration, bioavailability is 56%, and plasma rapacuronium concentrations peak within 4 or 5 min."( Pharmacokinetics of rapacuronium in infants and children with intravenous and intramuscular administration.
Brown, R; Fisher, DM; Hsu, J; Infosino, A; Reynolds, LM, 2000)		0.86

Dosage Studied

We analysed raw data for succinylcholine, rocuronium, rapacuronium, and cisatracurium from previously published studies using both LRA and NLR. We determined the ED(50) and ED(95) values and the respective slopes of the dose-response relationships.

ExcerptRelevanceReference
" However, the decreased clearance of rapacuronium and its potent metabolite in renal failure suggests that repeated dosing of rapacuronium may lead to prolonged effects in patients with renal failure."( Influence of renal failure on the pharmacokinetics and neuromuscular effects of a single dose of rapacuronium bromide.
Brown, R; Caldwell, JE; Fisher, DM; Lau, M; Luks, AM; Szenohradszky, J; Wright, PM, 1999)		0.79
"A rigorous study of the dose-response relation of rapacuronium has, to our knowledge, yet to be performed."( Dose-response and onset/offset characteristics of rapacuronium.
Flores, F; Ghori, K; Klewicka, MM; Kopman, AF; Neuman, GG, 2000)		0.81
" By dosing to maintain target twitch depression, recovery was not prolonged."( Effect of renal failure and cirrhosis on the pharmacokinetics and neuromuscular effects of rapacuronium administered by bolus followed by infusion.
Abengochea, A; Atherton, DP; Brown, R; Dempsey, GA; Fisher, DM; Hunter, JM, 2000)		0.53
" Some statisticians now consider this approach outmoded and assert that non-linear regression (NLR) is the preferred way to analyse sigmoidal dose-response relationships."( Determining the potency of neuromuscular blockers: are traditional methods flawed?
Kopman, AF; Lien, CA; Naguib, M, 2010)		0.36
"We analysed raw data for succinylcholine, rocuronium, rapacuronium, and cisatracurium from previously published studies using both LRA and NLR to determine the ED(50) and ED(95) values and the respective slopes of the dose-response relationships."( Determining the potency of neuromuscular blockers: are traditional methods flawed?
Kopman, AF; Lien, CA; Naguib, M, 2010)		0.61
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Drug Classes (1)

ClassDescription
steroid ester
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Research

Studies (110)

TimeframeStudies, This Drug (%)All Drugs %
pre-19900 (0.00)18.7374
1990's36 (32.73)18.2507
2000's70 (63.64)29.6817
2010's2 (1.82)24.3611
2020's2 (1.82)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 28.99

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be moderate demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index28.99 (24.57)
Research Supply Index5.02 (2.92)
Research Growth Index4.34 (4.65)
Search Engine Demand Index39.34 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (28.99)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials40 (36.04%)5.53%
Reviews16 (14.41%)6.00%
Case Studies10 (9.01%)4.05%
Observational0 (0.00%)0.25%
Other45 (40.54%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]
SubstanceRelationship StrengthStudiesTrialsClassesRoles
histamine
[no description available]		8.3811aralkylamino compound;
imidazoles		human metabolite;
mouse metabolite;
neurotransmitter
nitrous oxide
Nitrous Oxide: Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream.. dinitrogen oxide : A nitrogen oxide consisting of linear unsymmetrical molecules with formula N2O. While it is the most used gaseous anaesthetic in the world, its major commercial use, due to its solubility under pressure in vegetable fats combined with its non-toxicity in low concentrations, is as an aerosol spray propellant and aerating agent for canisters of 'whipped' cream.		4.341gas molecular entity;
nitrogen oxide		analgesic;
bacterial metabolite;
food packaging gas;
food propellant;
general anaesthetic;
greenhouse gas;
inhalation anaesthetic;
NMDA receptor antagonist;
raising agent;
refrigerant;
vasodilator agent
4-diphenylacetoxy-1,1-dimethylpiperidinium
4-diphenylacetoxy-1,1-dimethylpiperidinium: muscarinic receptor antagonist; RN given refers to parent cpd; do not confuse abbreviation 4-DAMP with a similar cpd which does not contain dimethyl groups. 4-DAMP(1+) : A quaternary ammonium salt obtained by formal methylation of the tertiary amino function of 4-diphenylacetoxy-N-methylpiperidine.		2.0110quaternary ammonium ioncholinergic antagonist;
muscarinic antagonist
phenytoin
[no description available]		710imidazolidine-2,4-dioneanticonvulsant;
drug allergen;
sodium channel blocker;
teratogenic agent
carbamazepine
Carbamazepine: A dibenzazepine that acts as a sodium channel blocker. It is used as an anticonvulsant for the treatment of grand mal and psychomotor or focal SEIZURES. It may also be used in the management of BIPOLAR DISORDER, and has analgesic properties.. carbamazepine : A dibenzoazepine that is 5H-dibenzo[b,f]azepine carrying a carbamoyl substituent at the azepine nitrogen, used as an anticonvulsant.		710dibenzoazepine;
ureas		analgesic;
anticonvulsant;
antimanic drug;
drug allergen;
EC 3.5.1.98 (histone deacetylase) inhibitor;
environmental contaminant;
glutamate transporter activator;
mitogen;
non-narcotic analgesic;
sodium channel blocker;
xenobiotic
diazepam
Diazepam: A benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant, and amnesic properties and a long duration of action. Its actions are mediated by enhancement of GAMMA-AMINOBUTYRIC ACID activity.. diazepam : A 1,4-benzodiazepinone that is 1,3-dihydro-2H-1,4-benzodiazepin-2-one substituted by a chloro group at position 7, a methyl group at position 1 and a phenyl group at position 5.		2.01101,4-benzodiazepinone;
organochlorine compound		anticonvulsant;
anxiolytic drug;
environmental contaminant;
sedative;
xenobiotic
edrophonium
Edrophonium: A rapid-onset, short-acting cholinesterase inhibitor used in cardiac arrhythmias and in the diagnosis of myasthenia gravis. It has also been used as an antidote to curare principles.. edrophonium : A quaternary ammonium ion that is N-ethyl-N,N-dimethylanilinium in which one of the meta positions is substituted by a hydroxy group. It is a reversible inhibitor of cholinesterase, with a rapid onset (30-60 seconds after injection) but a short duration of action (5-15 minutes). The chloride salt is used in myasthenia gravis both diagnostically and to distinguish between under- or over-treatment with other anticholinesterases. It has also been used for the reversal of neuromuscular blockade in anaesthesia, and for the management of poisoning due to tetrodotoxin, a neuromuscular blocking toxin found in puffer fish and other marine animals.		4.3622phenols;
quaternary ammonium ion		antidote;
diagnostic agent;
EC 3.1.1.8 (cholinesterase) inhibitor
enflurane
Enflurane: An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate.. enflurane : An ether in which the oxygen atom is connected to 2-chloro-1,1,2-trifluoroethyl and difluoromethyl groups.		3.3911ether;
organochlorine compound;
organofluorine compound		anaesthetic
fentanyl
Fentanyl: A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078). fentanyl : A monocarboxylic acid amide resulting from the formal condensation of the aryl amino group of N-phenyl-1-(2-phenylethyl)piperidin-4-amine with propanoic acid.		9.3522anilide;
monocarboxylic acid amide;
piperidines		adjuvant;
anaesthesia adjuvant;
anaesthetic;
intravenous anaesthetic;
mu-opioid receptor agonist;
opioid analgesic
halothane
[no description available]		8.7921haloalkane;
organobromine compound;
organochlorine compound;
organofluorine compound		inhalation anaesthetic
lidocaine
Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of PROCAINE but its duration of action is shorter than that of BUPIVACAINE or PRILOCAINE.. lidocaine : The monocarboxylic acid amide resulting from the formal condensation of N,N-diethylglycine with 2,6-dimethylaniline.		210benzenes;
monocarboxylic acid amide;
tertiary amino compound		anti-arrhythmia drug;
drug allergen;
environmental contaminant;
local anaesthetic;
xenobiotic
isoflurane
Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.		5.8755organofluorine compoundinhalation anaesthetic
neostigmine
Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike PHYSOSTIGMINE, does not cross the blood-brain barrier.. neostigmine : A quaternary ammonium ion comprising an anilinium ion core having three methyl substituents on the aniline nitrogen, and a 3-[(dimethylcarbamoyl)oxy] substituent at position 3. It is a parasympathomimetic which acts as a reversible acetylcholinesterase inhibitor.		6.797quaternary ammonium ionantidote to curare poisoning;
EC 3.1.1.7 (acetylcholinesterase) inhibitor
oxyphenbutazone
Oxyphenbutazone: A non-steroidal anti-inflammatory drug. Oxyphenbutazone eyedrops have been used abroad in the management of postoperative ocular inflammation, superficial eye injuries, and episcleritis. (From AMA, Drug Evaluations Annual, 1994, p2000) It had been used by mouth in rheumatic disorders such as ankylosing spondylitis, osteoarthritis, and rheumatoid arthritis but such use is no longer considered justified owing to the risk of severe hematological adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p27). oxyphenbutazone : A metabolite of phenylbutazone obtained by hydroxylation at position 4 of one of the phenyl rings. Commonly used (as its hydrate) to treat pain, swelling and stiffness associated with arthritis and gout, it was withdrawn from the market 1984 following association with blood dyscrasis and Stevens-Johnson syndrome.		2.3110phenols;
pyrazolidines		antimicrobial agent;
antineoplastic agent;
antipyretic;
drug metabolite;
gout suppressant;
non-narcotic analgesic;
non-steroidal anti-inflammatory drug;
xenobiotic metabolite
propofol
Propofol: An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.. propofol : A phenol resulting from the formal substitution of the hydrogen at the 2 position of 1,3-diisopropylbenzene by a hydroxy group.		7.01118phenolsanticonvulsant;
antiemetic;
intravenous anaesthetic;
radical scavenger;
sedative
sevoflurane
Sevoflurane: A non-explosive inhalation anesthetic used in the induction and maintenance of general anesthesia. It does not cause respiratory irritation and may also prevent PLATELET AGGREGATION.. sevoflurane : An ether compound having fluoromethyl and 1,1,1,3,3,3-hexafluoroisopropyl as the two alkyl groups.		5.8755ether;
organofluorine compound		central nervous system depressant;
inhalation anaesthetic;
platelet aggregation inhibitor
succinylcholine
Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.. succinylcholine : A quaternary ammonium ion that is the bis-choline ester of succinic acid.		10.64229quaternary ammonium ion;
succinate ester		drug allergen;
muscle relaxant;
neuromuscular agent
tubocurarine
Tubocurarine: A neuromuscular blocker and active ingredient in CURARE; plant based alkaloid of Menispermaceae.. tubocurarine : A benzylisoquinoline alkaloid muscle relaxant which constitutes the active component of curare.. isoquinoline alkaloid : Any alkaloid that has a structure based on an isoquinoline nucleus. They are derived from the amino acids like tyrosine and phenylalanine.		2.730bisbenzylisoquinoline alkaloiddrug allergen;
muscle relaxant;
nicotinic antagonist
acepromazine
Acepromazine: A phenothiazine that is used in the treatment of PSYCHOSES.. acepromazine : A member of the class of phenothiazines that is 10H-phenothiazine substituted by an acetyl group at position 2 and a 3-(dimethylamino)propyl group at position 10.		2.3110aromatic ketone;
methyl ketone;
phenothiazines;
tertiary amino compound		phenothiazine antipsychotic drug
gallamine triethiodide
Gallamine Triethiodide: A synthetic nondepolarizing blocking drug. The actions of gallamine triethiodide are similar to those of TUBOCURARINE, but this agent blocks the cardiac vagus and may cause sinus tachycardia and, occasionally, hypertension and increased cardiac output. It should be used cautiously in patients at risk from increased heart rate but may be preferred for patients with bradycardia. (From AMA Drug Evaluations Annual, 1992, p198)		2.4620
pyridostigmine bromide
Pyridostigmine Bromide: A cholinesterase inhibitor with a slightly longer duration of action than NEOSTIGMINE. It is used in the treatment of myasthenia gravis and to reverse the actions of muscle relaxants.		1.9910pyridinium salt
vecuronium bromide
Vecuronium Bromide: Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.. vecuronium bromide : The organic bromide salt of a 5alpha-androstane compound having 3alpha-acetoxy-, 17beta-acetoxy-, 2beta-piperidinino- and 16beta-N-methylpiperidinium substituents.		16.0211040organic bromide salt;
quaternary ammonium salt		muscle relaxant;
neuromuscular agent;
nicotinic antagonist
desflurane
Desflurane: A fluorinated ether that is used as a volatile anesthetic for maintenance of general anesthesia.		10.4944organofluorine compoundinhalation anaesthetic
atracurium
Atracurium: A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents.. atracurium : A diester compound consisting of pentane-1,5-diol with both hydroxyls bearing 3-[1-(3,4-dimethoxybenzyl)-6,7-dimethoxy-2-methyl-3,4-dihydroisoquinolinium-2(1H)-yl]propanoyl groups.		8.46132diester;
quaternary ammonium ion		muscle relaxant;
nicotinic antagonist
pipecuronium
Pipecuronium: A piperazinyl androstane derivative which is a non-depolarizing neuromuscular blocking agent (NEUROMUSCULAR NONDEPOLARIZING AGENTS). It is used as a muscle relaxant during ANESTHESIA and surgical procedures.		4.2930steroid ester
alfentanil
Alfentanil: A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.. alfentanil : A member of the class of piperidines that is piperidine having a 2-(4-ethyl-5-oxo-4,5-dihydro-1H-tetrazol-1-yl)ethyl group at the 1-position as well as N-phenylpropanamido- and methoxymethyl groups at the 4-position.		210monocarboxylic acid amide;
piperidines		central nervous system depressant;
intravenous anaesthetic;
mu-opioid receptor agonist;
opioid analgesic;
peripheral nervous system drug
cisatracurium
cisatracurium: RN refers to (1R-(1alpha,2alpha(1'R*,2'R*)))-isomer. cisatracurium : A diester that is the (1R,1'R,2R,2'R)-diastereoisomer of atracurium, a quaternary ammonium ion consisting of pentane-1,5-diol with both hydroxy functions bearing 3-[1-(3,4-dimethoxybenzyl)-6,7-dimethoxy-2-methyl-3,4-dihydroisoquinolinium-2(1H)-yl]propanoyl groups. The active species in the skeletal muscle relaxant cisatracurium besylate.		12.181diester;
quaternary ammonium ion		muscle relaxant;
nicotinic antagonist
n-methylscopolamine
N-Methylscopolamine: A muscarinic antagonist used to study binding characteristics of muscarinic cholinergic receptors.		2.4420
methoctramine
methoctramine: structure given in first source. methoctramine : A tetramine that is N,N'-bis(6-aminohexyl)octane-1,8-diamine where the primary amino groups both carry 2-methoxybenzyl substituents.. methoctramine tetrahydrochloride : A hydrochloride obtained by combining methoctramine with four molar equivalents of hydrochloric acid.		2.4220hydrochloridemuscarinic antagonist
org 7617
Org 7617: structure given in first source		210
atropine
tropan-3alpha-yl 3-hydroxy-2-phenylpropanoate : A tropane alkaloid that is (1R,5)-8-methyl-8-azabicyclo[3.2.1]octane substituted by a (3-hydroxy-2-phenylpropanoyl)oxy group at position 3.		210
naringenin
(S)-naringenin : The (S)-enantiomer of naringenin.		2.3110(2S)-flavan-4-one;
naringenin		expectorant;
plant metabolite
pancuronium
Pancuronium: A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than CURARE but has less effect on the circulatory system and on histamine release.. pancuronium : A steroid ester in which a 5alpha-androstane skeleton is C-3alpha- and C-17beta-disubstituted with acetoxy groups and 2beta- and 16beta-disubstituted with 1-methylpiperidinium-1-yl groups. It is a non-depolarizing curare-mimetic muscle relaxant.		210acetate ester;
steroid ester		cholinergic antagonist;
muscle relaxant;
nicotinic antagonist
rocuronium
Rocuronium: An androstanol non-depolarizing neuromuscular blocking agent. It has a mono-quaternary structure and is a weaker nicotinic antagonist than PANCURONIUM.. rocuronium : A 5alpha-androstane compound having 3alpha-hydroxy-, 17beta-acetoxy-, 2beta-morpholino- and 16beta-N-allyllyrrolidinium substituents.		10.612053alpha-hydroxy steroid;
acetate ester;
androstane;
morpholines;
quaternary ammonium ion;
tertiary amino compound		drug allergen;
muscle relaxant;
neuromuscular agent
clindamycin
Clindamycin: An antibacterial agent that is a semisynthetic analog of LINCOMYCIN.. clindamycin : A carbohydrate-containing antibiotic that is the semisynthetic derivative of lincomycin, a natural antibiotic.		7.0110
etomidate
Etomidate: Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.. etomidate : The ethyl ester of 1-[(1R)-1-phenylethyl]-1H-imidazole-5-carboxylic acid. It is an intravenous general anaesthetic with no analgesic activity.		3.411ethyl ester;
imidazoles		intravenous anaesthetic;
sedative
thiopental
Thiopental: A barbiturate that is administered intravenously for the induction of general anesthesia or for the production of complete anesthesia of short duration.. thiopental : A barbiturate, the structure of which is that of 2-thiobarbituric acid substituted at C-5 by ethyl and sec-pentyl groups.		8.821barbituratesanticonvulsant;
drug allergen;
environmental contaminant;
intravenous anaesthetic;
sedative;
xenobiotic
mivacurium
Mivacurium: An isoquinoline derivative that is used as a short-acting non-depolarizing agent.		9.42156isoquinolines
win 51708
WIN 51708: neurokinin-1 receptor antagonist		2.3110
gantacurium
gantacurium: Neuromuscular Depolarizing Agents; structure in first source		2.0510
3-deacetylvecuronium
3-deacetylvecuronium: RN given refers to parent cpd (2beta,3alpha,5alpha,16beta,17beta)-isomer; structure given in first source		210steroid ester
piperidines
Piperidines: A family of hexahydropyridines.		2.0110
guanosine 5'-o-(3-thiotriphosphate)
Guanosine 5'-O-(3-Thiotriphosphate): Guanosine 5'-(trihydrogen diphosphate), monoanhydride with phosphorothioic acid. A stable GTP analog which enjoys a variety of physiological actions such as stimulation of guanine nucleotide-binding proteins, phosphoinositide hydrolysis, cyclic AMP accumulation, and activation of specific proto-oncogenes.		2.0510nucleoside triphosphate analogue
ConditionIndicatedRelationship StrengthStudiesTrials
Rhabdomyolysis
Necrosis or disintegration of skeletal muscle often followed by myoglobinuria.		02.3110
Anesthesia
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.		09.5124
Muscle Contraction
A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.		06.27104
Bronchospasm
[description not available]		05.27121
Bronchial Spasm
Spasmodic contraction of the smooth muscle of the bronchi.		05.27121
Drug Withdrawal Symptoms
[description not available]		02.0110
Substance Withdrawal Syndrome
Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.		02.0110
Chronic Kidney Failure
[description not available]		0531
Cirrhosis, Liver
[description not available]		0531
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.		0531
Liver Cirrhosis
Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules.		0531
Tachyarrhythmia
[description not available]		03.411
Tachycardia
Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia.		03.411
Neuromuscular Blockade
The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.		010.081811
Muscle Relaxation
That phase of a muscle twitch during which a muscle returns to a resting position.		04.6332
Aging
The gradual irreversible changes in structure and function of an organism that occur as a result of the passage of time.		04.721
Pregnancy
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.		03.3220
Cardiac Diseases
[description not available]		0210
Heart Diseases
Pathological conditions involving the HEART including its structural and functional abnormalities.		0210
Becker Muscular Dystrophy
[description not available]		0210
Muscular Dystrophy, Duchenne
An X-linked recessive muscle disease caused by an inability to synthesize DYSTROPHIN, which is involved with maintaining the integrity of the sarcolemma. Muscle fibers undergo a process that features degeneration and regeneration. Clinical manifestations include proximal weakness in the first few years of life, pseudohypertrophy, cardiomyopathy (see MYOCARDIAL DISEASES), and an increased incidence of impaired mentation. Becker muscular dystrophy is a closely related condition featuring a later onset of disease (usually adolescence) and a slowly progressive course. (Adams et al., Principles of Neurology, 6th ed, p1415)		0210
Diathesis
[description not available]		0210
Depression, Endogenous
[description not available]		0210
Anesthesia Related Hyperthermia
[description not available]		0210
Depressive Disorder
An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.		0210
Elevated ICP (Intracranial Pressure)
[description not available]		0210
Acute Brain Injuries
[description not available]		0210
Benign Neoplasms, Brain
[description not available]		0210
Brain Injuries
Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.		0210
Brain Neoplasms
Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain.		0210
Intracranial Hypertension
Increased pressure within the cranial vault. This may result from several conditions, including HYDROCEPHALUS; BRAIN EDEMA; intracranial masses; severe systemic HYPERTENSION; PSEUDOTUMOR CEREBRI; and other disorders.		0210
Anti-MuSK Myasthenia Gravis
[description not available]		0210
Myasthenia Gravis
A disorder of neuromuscular transmission characterized by fatigable weakness of cranial and skeletal muscles with elevated titers of ACETYLCHOLINE RECEPTORS or muscle-specific receptor tyrosine kinase (MuSK) autoantibodies. Clinical manifestations may include ocular muscle weakness (fluctuating, asymmetric, external ophthalmoplegia; diplopia; ptosis; and weakness of eye closure) and extraocular fatigable weakness of facial, bulbar, respiratory, and proximal limb muscles. The disease may remain limited to the ocular muscles (ocular myasthenia). THYMOMA is commonly associated with this condition.		0210
Laryngeal Spasm
[description not available]		0210
Adult Spinal Muscular Atrophy
[description not available]		0210
Laryngismus
A disorder in which the adductor muscles of the VOCAL CORDS exhibit increased activity leading to laryngeal spasm. Laryngismus causes closure of the VOCAL FOLDS and airflow obstruction during inspiration.		0210
Muscular Atrophy, Spinal
A group of disorders marked by progressive degeneration of motor neurons in the spinal cord resulting in weakness and muscular atrophy, usually without evidence of injury to the corticospinal tracts. Diseases in this category include Werdnig-Hoffmann disease and later onset SPINAL MUSCULAR ATROPHIES OF CHILDHOOD, most of which are hereditary. (Adams et al., Principles of Neurology, 6th ed, p1089)		0210
Emergencies
Situations or conditions requiring immediate intervention to avoid serious adverse results.		02.0110
Coronary Heart Disease
[description not available]		02.0110
Coronary Disease
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.		02.0110
Airway Obstruction
Any hindrance to the passage of air into and out of the lungs.		03.3911