1000:, a tertiary amino alkaloid reported to be a modest CNS stimulant with epileptogenic activity and cardiovascular effects such a hypotension and bradycardia. As part of the then fierce marketing battle between the competing pharmaceutical companies (Burroughs Wellcome Co. and Organon, Inc.) with their respective products, erroneous information was quickly and subtly disseminated very shortly after the clinical introduction of atracurium that the clinical use of atracurium was likely to result in a terrible tragedy because of the significant clinical hazard by way of frank seizures induced by the laudanosine by-product - the posited hypothesis being that the laudanosine produced from the chemodegradation of parent atracurium would cross the blood–brain barrier in sufficiently high enough concentrations that lead to epileptogenic foci. Fortunately, both for the public and for atracurium, rapid initial investigations irrefutably failed to find any overt or EEG evidence for a connection between atracurium administration and epileptogenic activity. Indeed, because laudanosine is cleared primarily via renal excretion, a cat study modelling anephric patients went so far as to corroborate that EEG changes, when observed, were evident only at plasma concentrations 8 to 10 times greater than those observed in humans during infusions of atracurium. Thus, the cat study predicted that, following atracurium administration in an anephric patient, laudanosine accumulation and related CNS or cardiovascular toxicity were unlikely - a prediction that correlated very well with a study in patients with
1070:
the elderly population. The pharmaceutical presentation is a mixture of all ten possible stereoisomers. Although there are four stereocentres, which could give 16 structures, there is a plane of symmetry running through the centre of the diester bridge, and so 6 meso structures (structures that can be superimposed by having the opposite configuration then 180° rotation) are formed. This reduces the number from sixteen to ten. There are three cis-cis isomers (an enantiomeric pair and a meso structure), four cis-trans isomers (two enantiomeric pairs), and three trans-trans isomers (an enantiomeric pair and a meso structure). The proportions of cis−cis, cis−trans, and trans−trans isomers are in the ratio of 10.5 :6.2 :1. . One of the three cis-cis structures is marketed as a single-isomer preparation,
1008:. confirmed that, in fact, it is the steroidal neuromuscular-blocking agents pancuronium and vecuronium that, when introduced directly into the CNS, were likely to cause acute excitement and seizures, owing to accumulation of cytosolic calcium caused by activation of acetylcholine receptor ion channels. Unlike the two steroidal agents, neither atracurium nor laudanosine caused such accumulation of intracellular calcium. Just over two decades later with availability of atracurium, there is little doubt that laudanosine accumulation and related toxicity will likely never be seen with the doses of atracurium that are generally used.
450:
427:
31:
851:
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969:(Raplon - a steroidal neuromuscular-blocking agent marketed by Organon) in 2001 after several serious events of bronchospasm, including five unexplained fatalities, following its administration. Bronchospasm was not an unknown phenomenon prior to rapacuronium: occasional reports of bronchospasm have been noted also with the prototypical agents,
529:
581:
InChI=1S/C53H72N2O12.2C6H6O3S/c1-54(22-18-38-32-48(62-7)50(64-9)34-40(38)42(54)28-36-14-16-44(58-3)46(30-36)60-5)24-20-52(56)66-26-12-11-13-27-67-53(57)21-25-55(2)23-19-39-33-49(63-8)51(65-10)35-41(39)43(55)29-37-15-17-45(59-4)47(31-37)61-6;2*7-10(8,9)6-4-2-1-3-5-6/h14-17,30-35,42-43H,11-13,18-29H2,1-10H3;2*1-5H,(H,7,8,9)/q+2;;/p-2
1255:
upon passage through a basic (as opposed to an acidic) ion-exchange resin. Stenlake's research group advanced this concept by systematically synthesizing numerous quaternary ammonium β-aminoesters and β-aminoketones and evaluated them for skeletal muscle relaxant activity: one of these compounds,
1069:
is unaffected by the level of plasma esterase activity, obesity, age, or by the status of renal or hepatic function. On the other hand, excretion of the metabolite, laudanosine, and, to a small extent, atracurium itself is dependent on hepatic and renal functions that tend to be less efficient in
927:
doses. The liberation of histamine is a dose-dependent phenomenon such that, with increasing doses administered at the same rate, there is a greater propensity for eliciting histamine release and its ensuing sequelae. Most commonly, the histamine release following administration of these agents is
1204:
provided precisely this basis: It is a chemical process in which a suitably activated quaternary ammonium compound can be degraded by the mildly alkaline conditions present at physiological pH and temperature. In effect, Hofmann elimination is a retro-Michael addition chemical process. It is
1217:
process: the latter is a chemical reaction in which a quaternary ammonium hydroxide solid salt is heated to 100 °C, or an aqueous solution of the salt is boiled. Regardless of which
Hofmann process is referenced, the end-products in both situations will be the same: an
953:
Bronchospasm has been reported on occasion with the use of atracurium. However, this particular undesirable effect does not appear to be observed nearly as often as that seen with rapacuronium, which led to the latter's withdrawal of approval for clinical use worldwide.
1057:
but, with accumulation of clinical data over time, the preponderance of evidence indicated that
Hofmann elimination at physiological pH is the major degradation pathway vindicating the premise for the design of atracurium to undergo an organ-independent metabolism.
1107:
Train-of-four (TOF) response: stimulated muscle twitch response in trains of four when stimuli are applied in a burst of four as opposed to a single stimulus, equal depression in depolarizing and fading response with non-depolarizing
940:
effects is no more than one to two minutes, while the facial flush may take around 3–4 minutes to dissipate. Because these effects are so transient, there is no reason to administer adjunctive therapy to ameliorate either the
1162:. Dewar first named this compound "33A74" before its eventual emergence in the clinic as atracurium. Atracurium was the culmination of a rational approach to drug design to produce the first non-depolarizing non-steroidal
4162:
1200:-quaternary structure via susceptibility to inactive breakdown products by enzymic-independent processes would prove to be invaluable in the clinical use of a drug with a predictable onset and duration of action.
3289:
Stenlake JB, Waigh RD, Dewar GH, Dhar NC, Hughes R, Chapple DJ, et al. (1984). "Biodegradable neuromuscular blocking agents. Part 6. Stereochemical studies on atracurium and related polyalkylene di-esters".
1763:
3071:
Vandenbrom RH, Wierda JM, Agoston S (1990). "Pharmacokinetics and neuromuscular blocking effects of atracurium besylate and two of its metabolites in patients with normal and impaired renal function".
2357:
Katz Y, Weizman A, Pick CG, Pasternak GW, Liu L, Fonia O, et al. (May 1994). "Interactions between laudanosine, GABA, and opioid subtype receptors: implication for laudanosine seizure activity".
1606:
5241:
4155:
2949:
Fahey MR, Rupp SM, Fisher DM, Miller RD, Sharma M, Canfell C, et al. (Dec 1984). "The pharmacokinetics and pharmacodynamics of atracurium in patients with and without renal failure".
3404:
Stenlake JB, Waigh RD, Dewar GH, Hughes R, Chapple DJ, Coker GG (1981). "Biodegradable neuromuscular blocking agents. Part 4. Atracurium besylate and related polyalkylene di-esters".
5309:
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109:
1065:
is highly influenced by body pH and temperature: An increase in body pH favors the elimination process, whereas a decrease in temperature slows down the process. Otherwise, the
597:
4148:
1181:
UK, which developed the drug (then known as BW 33A) and its introduction to first human trials in 1979, and then eventually to its first introduction (as a mixture of all ten
2862:
Varin F, Ducharme J, Théorêt Y, Besner JG, Bevan DR, Donati F (1990). "Influence of extreme obesity on the body disposition and neuromuscular blocking effect of atracurium".
3246:
Coker GG, Dewar GH, Hughes R, Hunt TM, Payne JP, Stenlake JB, et al. (1981). "A preliminary assessment of atracurium, a new competitive neuromuscular blocking agent".
1173:. The term chemodegradation was coined by Roger D. Waigh, Ph.D., also a pharmacist and a postdoctoral researcher in Stenlake's research group. Atracurium was licensed by
3423:
Stenlake JB, Waigh RD, Dewar GH, Hughes R, Chapple DJ (1983). "Biodegradable neuromuscular blocking agents. Part 5. α,ω-Bisquaternary polyalkylene phenolic esters".
61:
553:
3515:
3382:
Stenlake JB, Waigh RD, Urwin J, Dewar GH, Hughes R, Chapple DJ (1981). "Biodegradable neuromuscular blocking agents. Part 3. Bis-quaternary esters".
1593:
1755:
1115:
of skeletal muscle recovery - essentially, the difference in time between the time to recovery to 25% and time to recovery to 75% of baseline value
4945:
5294:
1146:
Atracurium besilate was first made in 1974 by George H. Dewar, a pharmacist and a medicinal chemistry doctoral candidate in John B. Stenlake's
561:
C1(CCc2cc(c(cc2C1Cc3ccc(c(c3)OC)OC)OC)OC)CCC(=O)OCCCCCOC(=O)CC4(CCc5cc(c(cc5C4Cc6ccc(c(c6)OC)OC)OC)OC)C.c1ccc(cc1)S(=O)(=O).c1ccc(cc1)S(=O)(=O)
688:
3598:
996:
Because atracurium undergoes
Hofmann elimination as a primary route of chemodegradation, one of the major metabolites from this process is
868:
3558:
1137:≥ 0.9: a 90% ratio of the fourth twitch to the first twitch in a TOF - provides a measure of the full recovery of neuromuscular function
1078:
has ten similar structures with 4 stereocentres and a plane of symmetry, but only two are presented in the pharmaceutical preparation.
1304:
4182:
890:
573:
1126:≥ 0.7: a 70% ratio of the fourth twitch to the first twitch in a TOF - provides a measure of the recovery of neuromuscular function
4171:
3720:
2994:"Disposition of infusions of atracurium and its metabolite, laudanosine, in patients in renal and respiratory failure in an ITU"
3583:
1825:
Takki S, Tammisto T (Apr 1971). "Severe bronchospasm and circulatory collapse following the administration of d-tubocurarine".
1426:
Ortalli GL, Tiberio I, Mammana G (Mar 1993). "A case of severe bronchospasm and laryngospasm after atracurium administration".
727:
Neuromuscular-blocking agents can be classified in accordance to their duration of pharmacological action, defined as follows:
224:
139:
3336:
McCorkindale NJ, Magrill DS, Martin-Smith M, Smith SJ, Stenlake JB (1964). "Petaline: A 7,8-dioxygenated benzylisoquinoline".
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4605:
4201:
3508:
872:
1337:
5299:
5254:
5231:
3548:
3538:
3442:
Stenlake JB, Urwin J, Waigh RD, Hughes R (1979). "Biodegradable neuromuscular blocking agents. II. Quaternary ketones".
1601:
326:
4295:
3363:
Stenlake JB, Urwin J, Waigh RD, Hughes R (1979). "Biodegradable neuromuscular blocking agents. I. Quaternary esters".
2252:
Okazaki K, Saito T, Wakisaka K, Hirano T, Kozu K (Jun 1969). "Bronchospasm possible due to gallamine. A case report".
908:
406:
1091:: the dose of any given intramuscular-blocking agent required to produce 95% suppression of muscle twitch (e.g., the
2582:"Activation of brain acetylcholine receptors by neuromuscular blocking drugs. A possible mechanism of neurotoxicity"
4619:
4345:
4215:
2176:
Uratsuji Y, Konishi M, Ikegaki N, Kitada H (Jan 1991). "Possible bronchospasm after administration of vecuronium".
704:
622:
861:
5284:
4027:
3501:
1359:
1256:
initially labelled as 33A74, eventually led to further clinical development, and came to be known as atracurium.
1174:
1155:
1104:
Clinical duration: difference in time between time of injection and time to 25% recovery from neuromuscular block
1074:(trade name Nimbex); it has the configuration 1R, 2R, 1′R, 2′R at the four stereocentres. The beta-blocking drug
1811:
Bevan DR. (1992) "Curare". In: Maltby JR, Shephard DAE (Eds.), Harold
Griffith - His Life and Legacy; Suppl. to
1594:"Voluntary market withdrawal - Adverse Drug Reaction 27 March 2001. Raplon (rapacuronium bromide) for Injection"
5205:
4805:
3487:
2451:"Laudanosine (a metabolite of atracurium) increases the minimum alveolar concentration of halothane in rabbits"
1061:
Hofmann elimination is a temperature- and pH-dependent process, and therefore atracurium's rate of degradation
4335:
919:
release upon rapid administration of a bolus intravenous injection. There are some exceptions to this rule;
716:
634:
97:
1019:
that, because of its identical structure to atracurium, undergoes chemodegradation via
Hofmann elimination
445:
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395:
173:
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3952:
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The premise to the design of atracurium and several of its congeners stemmed from the knowledge that a
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4520:
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3675:
3630:
3620:
3609:
3543:
203:
4490:
1777:
Harrison GA (Aug 1966). "A case of cardiac arrest associated with bronchospasm and d-tubocurarine".
1625:"Rapacuronium: premarket drug evaluation can be very effective for the identification of drug risks"
1004:
and undergoing cadaveric renal transplantation. Furthermore, almost a decade later, work by
Cardone
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5070:
5005:
4600:
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3670:
3625:
3578:
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Stenlake JB, Waigh RD, Urwin J, Dewar GH, Coker GG (1983). "Atracurium: conception and inception".
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2382:
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2006:
1736:
1574:
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1408:
692:
653:
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79:
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Classification of neuromuscular-blocking agents by duration of pharmacological action (minutes)
4800:
4240:
4235:
3196:"Clinical pharmacology of atracurium besylate (BW 33A): a new non-depolarizing muscle relaxant"
2322:
Fodale V, Santamaria LB (Jul 2002). "Laudanosine, an atracurium and cisatracurium metabolite".
923:(Nimbex), for example, is one such agent that does not elicit histamine release even up to 5×ED
5210:
4930:
4810:
4709:
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1998:
1957:
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43:
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2958:
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2871:
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2782:
2733:
2689:
2645:
2593:
2552:
2511:
2500:"Cardiovascular and electroencephalographic effects of laudanosine in "nephrectomized" cats"
2462:
2413:
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2216:
2148:
2101:
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1988:
1947:
1906:
1865:
1786:
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1556:
1507:
1466:
1392:
1367:
681:
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155:
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71:
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974:
641:(succinylcholine) is generally preferred if this needs to be done quickly. It is given by
183:
163:
4637:
4629:
3036:
Hunter JM. (1993). "Atracurium and laudanosine pharmacokinetics in acute renal failure".
1185:) into clinical anesthetic practice in the UK, in 1983, under the tradename of Tracrium.
449:
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4641:
4565:
4360:
4305:
3840:
3259:
3194:
Basta SJ, Ali HH, Savarese JJ, Sunder N, Gionfriddo M, Cloutier G, et al. (1982).
2221:
2204:
2105:
1993:
1976:
1790:
1561:
1544:
1512:
1495:
1396:
1233:
1023:. Plasma concentrations of laudanosine generated are lower when cisatracurium is used.
1001:
937:
3349:
2539:
Fahey MR, Rupp SM, Canfell C, Fisher DM, Miller RD, Sharma M, et al. (Nov 1985).
1707:"A mechanism for rapacuronium-induced bronchospasm: M2 muscarinic receptor antagonism"
5278:
5195:
5025:
4995:
4935:
4885:
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4770:
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3084:
2962:
2694:
2677:
2598:
2581:
2467:
2450:
2418:
2401:
2370:
2295:
2053:"Severe bronchospasm in an asthmatic patient following alcuronium and D-tubocurarine"
1723:
1706:
1682:
1665:
1641:
1624:
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1454:
1206:
1193:
1182:
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1016:
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920:
677:
638:
540:
438:
3275:
3229:
3100:
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2804:
2755:
2435:
2386:
2238:
2121:
1740:
1529:
1412:
1387:
Savarese JJ, Wastila WB (1995). "The future of the benzylisoquinolinium relaxants".
22:
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4750:
4701:
4682:
4480:
4400:
4390:
4107:
3966:
3937:
3800:
3795:
3529:
3116:"Pharmacokinetics of atracurium and laudanosine in patients with hepatic cirrhosis"
2615:
2484:
2402:"The cerebral effects of pancuronium and atracurium in halothane-anesthetized dogs"
2092:
Heath ML (Jul 1973). "Bronchospasm in an asthmatic patient following pancuronium".
2010:
1578:
970:
966:
958:
687:
Atracurium was approved for medical use in the United States in 1983. It is on the
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30:
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4102:
4087:
4077:
4037:
4032:
4017:
4012:
3929:
3901:
3815:
3810:
2771:"The pharmacology of atracurium: a new competitive neuromuscular blocking agent"
1329:
997:
978:
933:
929:
928:
associated with observable cutaneous flushing (facial face and arms, commonly),
850:
642:
2069:
2052:
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Atracurium is a medication used in addition to other medications in to provide
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Ph.D. Thesis - the
Department of Pharmacy, University of Strathclyde, Scotland
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but takes up to 2.5 minutes to result in appropriate intubating conditions.
665:
65:
3132:
3115:
3010:
2993:
2926:
2909:
2449:
Shi WZ, Fahey MR, Fisher DM, Miller RD, Canfell C, Eger EI 2nd (Dec 1985).
2343:
1879:
1732:
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1650:
1364:
World Health
Organization model list of essential medicines: 21st list 2019
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2002:
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4325:
4320:
4225:
4072:
4062:
3987:
3919:
3853:
3830:
3570:
3160:
Dewar GH (1976). "Potential short-acting neuromuscular blocking agents".
2078:
2024:
Cardan E, Deacu E (Jan 1972). "Bronchospasm following succinyl choline".
1240:
1237:
1223:
1196:-blocking activity: ideally, therefore, a chemical entity devoid of this
1163:
1159:
1151:
286:
1372:
295:
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4725:
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4535:
4525:
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4250:
4245:
4082:
3729:
3049:
1911:
1894:
1756:"Anesthesia drug is removed from market after the deaths of 5 patients"
936:. These sequelae are very transient effects: the total duration of the
875: in this section. Unsourced material may be challenged and removed.
708:
626:
261:
1232:
The approach to utilizing
Hofmann elimination as a means to promoting
645:. Effects are greatest at about 4 minutes and last for up to an hour.
4755:
4575:
4385:
3567:
1219:
386:
621:, is a medication used in addition to other medications to provide
355:
5125:
2137:"Letter: Bronchospasm induced by althesin and pancuronium bromide"
1248:
1226:
1051:
1036:
528:
519:
366:
192:
2498:
Ingram MD, Sclabassi RJ, Cook DR, Stiller RL, Bennett MH (1986).
2282:
Standaert FG (Dec 1985). "Magic bullets, science, and medicine".
1496:"Severe bronchospasm following the use of atracurium in children"
965:-blocking agents arena after the withdrawal from clinical use of
346:
4144:
3497:
2910:"Pharmacokinetics of atracurium and laudanosine in the elderly"
1236:
had its roots in much earlier observations that the quaternary
660:. Prolonged paralysis may occur in people with conditions like
844:
2678:"Atracurium decay and the formation of laudanosine in humans"
1247:) readily underwent facile Hofmann elimination to a tertiary
411:
3461:
Stenlake JB. (2001). "Chance, coincidence and atracurium".
2580:
Cardone C, Szenohradszky J, Yost S, Bickler PE (May 1994).
4183:
2541:"Effect of renal failure on laudanosine excretion in man"
1376:. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
1705:
Jooste E, Klafter F, Hirshman CA, Emala CW (Apr 2003).
1455:"Atracurium: hypotension, tachycardia and bronchospasm"
689:
604:
4606:
4202:
1936:"Bronchospasm induced by suxamethonium. A case report"
5252:
1854:"Bronchospasm due to suxamethonium; report of a case"
1303:. The American Society of Health-System Pharmacists.
648:
Common side effects include flushing of the skin and
2722:"In vitro degradation of atracurium in human plasma"
2634:"In vitro degradation of atracurium in human plasma"
5138:
4599:
4195:
4181:
4120:
3975:
3946:
3928:
3910:
3892:
3839:
3785:
3776:
3754:
3719:
3597:
3566:
3557:
3537:
1895:"A case of bronchospasm induced by succinylcholine"
539:
517:
500:
461:
456:
437:
405:
385:
365:
345:
325:
305:
285:
260:
240:
215:
202:
182:
172:
162:
154:
138:
133:
108:
96:
78:
60:
52:
42:
37:
2203:O'Callaghan AC, Scadding G, Watkins J (Aug 1985).
2400:Lanier WL, Milde JH, Michenfelder JD (Dec 1985).
3399:
3397:
1852:Fellini AA, Bernstein RL, Zauder HL (Oct 1963).
1330:"Atracurium Besilate 10 mg/ml Injection - (eMC)"
274:
3241:
3239:
2823:"Evaluation of atracurium in anaesthetized man"
2671:
2669:
1453:Siler JN, Mager JG Jr, Wyche MQ Jr (May 1985).
249:
232:2,2'-{1,5-Pentanediylbis}bis dibenzenesulfonate
5101:Trimetaphan camsilate (trimethaphan camsylate)
2715:
2713:
2627:
2625:
2205:"Bronchospasm following the use of vecuronium"
1545:"Bronchospasm following the use of atracurium"
1050:studies appeared to indicate a major role for
5310:World Health Organization essential medicines
5242:Acetylcholine metabolism/transport modulators
4156:
3509:
3031:
3029:
1779:Australian and New Zealand Journal of Surgery
8:
5237:Muscarinic acetylcholine receptor modulators
3155:
3153:
3151:
2816:
2814:
2277:
2275:
1111:25%-75% recovery index: an indicator of the
1031:Atracurium is susceptible to degradation by
189:Hofmann elimination (retro-Michael addition)
21:
2903:
2901:
2632:Stiller RL, Cook DR, Chakravorti S (1985).
1295:
1293:
1291:
1289:
1213:differs from the non-physiological Hofmann
668:is safe for the baby. Atracurium is in the
656:; however, it has not been associated with
147:In general: ℞ (Prescription only)
4192:
4163:
4149:
4141:
3782:
3563:
3554:
3516:
3502:
3494:
2254:Tokushima Journal of Experimental Medicine
1287:
1285:
1283:
1281:
1279:
1277:
1275:
1273:
1271:
1269:
448:
425:
314:
29:
4188:Tooltip Nicotinic acetylcholine receptors
3486:at the U.S. National Library of Medicine
3211:
3131:
3009:
2925:
2838:
2786:
2737:
2720:Merrett RA, Thompson CW, Webb FW (1983).
2693:
2649:
2597:
2556:
2515:
2466:
2417:
2317:
2315:
2313:
2220:
2152:
2068:
1992:
1951:
1910:
1869:
1722:
1681:
1640:
1560:
1511:
1470:
1371:
891:Learn how and when to remove this message
676:type. It works by blocking the action of
334:
4731:Candocuronium iodide (chandonium iodide)
1494:Woods I, Morris P, Meakin G (Feb 1985).
1324:
1322:
729:
5259:
3444:European Journal of Medicinal Chemistry
3425:European Journal of Medicinal Chemistry
3406:European Journal of Medicinal Chemistry
3384:European Journal of Medicinal Chemistry
3365:European Journal of Medicinal Chemistry
3292:European Journal of Medicinal Chemistry
2992:Parker CJ, Jones JE, Hunter JM (1988).
1899:Canadian Anaesthetists' Society Journal
1265:
1192:-quaternary structure is essential for
578:
558:
421:
294:
229:
4611:Tooltip negative allosteric modulators
4207:Tooltip positive allosteric modulators
2908:Kent AP, Parker CJ, Hunter JM (1989).
2864:Clinical Pharmacology and Therapeutics
439:
20:
1366:. Geneva: World Health Organization.
1340:from the original on 20 December 2016
1307:from the original on 21 December 2016
545:85 to 90 °C (185 to 194 °F)
394:
374:
70:
7:
2051:Yeung ML, Ng LY, Koo AW (Feb 1979).
1977:"Suxamethonium induced bronchospasm"
1150:research group in the Department of
873:adding citations to reliable sources
672:family of medications and is of the
121:
3248:Acta Anaesthesiologica Scandinavica
2324:European Journal of Anaesthesiology
1893:Bele-Binda N, Valeri F (Jan 1971).
1813:Canadian Journal of Anaesthesiology
1389:Acta Anaesthesiologica Scandinavica
652:. Serious side effects may include
633:. It can also be used to help with
354:
265:
3260:10.1111/j.1399-6576.1981.tb01608.x
3120:British Journal of Anaesthesiology
2998:British Journal of Anaesthesiology
2914:British Journal of Anaesthesiology
2827:British Journal of Anaesthesiology
2775:British Journal of Anaesthesiology
2726:British Journal of Anaesthesiology
2638:British Journal of Anaesthesiology
2545:British Journal of Anaesthesiology
2504:British Journal of Anaesthesiology
2222:10.1111/j.1365-2044.1985.tb11010.x
2141:British Journal of Anaesthesiology
2106:10.1111/j.1365-2044.1973.tb00494.x
1994:10.1111/j.1365-2044.1967.tb10161.x
1940:British Journal of Anaesthesiology
1858:British Journal of Anaesthesiology
1791:10.1111/j.1445-2197.1966.tb04394.x
1612:from the original on 7 March 2010.
1562:10.1111/j.1365-2044.1983.tb14055.x
1513:10.1111/j.1365-2044.1985.tb10733.x
1397:10.1111/j.1399-6576.1995.tb04317.x
1243:(obtained from the Lebanese plant
14:
4816:Dimethyltubocurarine (metocurine)
3175:Waigh R.D. (1986). "Atracurium".
1934:Katz AM, Mulligan PG (Oct 1972).
1082:Intramuscular function parameters
1046:metabolic processes. The initial
5262:
4172:Nicotinic acetylcholine receptor
3213:10.1213/00000539-198209000-00002
3085:10.2165/00003088-199019030-00006
2963:10.1097/00000542-198412000-00011
2695:10.1097/00000542-199103000-00010
2599:10.1097/00000542-199405000-00025
2468:10.1097/00000542-198512000-00006
2419:10.1097/00000542-198512000-00007
2296:10.1097/00000542-198512000-00002
1766:from the original on 2016-03-03.
1724:10.1097/00000542-200304000-00017
1683:10.1097/00000542-200105000-00006
1642:10.1213/00000539-200302000-00070
1472:10.1097/00000542-198505000-00020
1205:important to note here that the
1169:that undergoes chemodegradation
849:
479:
473:
5196:Meclofenoxate (centrophenoxine)
4521:Suxethonium (succinyldicholine)
4516:Suxamethonium (succinylcholine)
1666:"Rapacuronium and bronchospasm"
945:or the cardiovascular effects.
860:needs additional citations for
691:. Atracurium is available as a
586:Key:XXZSQOVSEBAPGS-UHFFFAOYSA-L
2057:Anaesthesia and Intensive Care
715:. It can be used to help with
491:
485:
467:
1:
5295:Quaternary ammonium compounds
5232:Receptor/signaling modulators
4886:Hexamethonium (benzohexonium)
3484:Neuromuscular+blocking+agents
3350:10.1016/s0040-4039(01)93303-9
3114:Parker CJ, Hunter JM (1989).
2769:Hughes R, Chapple DJ (1981).
2371:10.1016/0006-8993(94)90084-1
1602:Food and Drug Administration
4966:Methorphan (racemethorphan)
4296:Bephenium hydroxynaphthoate
2821:Payne JP, Hughes R (1981).
2676:Nigrovic V, Fox JL (1991).
1827:Annals of Clinical Research
961:acquired prominence in the
5326:
4346:Dimethylphenylpiperazinium
2517:10.1093/bja/58.suppl_1.14s
2070:10.1177/0310057X7900700111
1629:Anesthesia & Analgesia
705:skeletal muscle relaxation
664:. It is unclear if use in
623:skeletal muscle relaxation
457:Chemical and physical data
5224:
3743:Polyalkylene derivatives:
3073:Clinical Pharmacokinetics
2336:10.1017/s0265021502000777
1360:World Health Organization
977:, as well as alcuronium,
784:(Time from injection to T
759:(Time from injection to T
594:
569:
549:
220:
28:
5206:Phosphatidylethanolamine
3488:Medical Subject Headings
3200:Anesthesia and Analgesia
1664:Goudsouzian NG. (2001).
932:and a consequent reflex
905:tetrahydroisoquinolinium
198:by nonspecific esterases
4986:Morphanol (racemorphan)
4926:Laudexium (laudolissin)
4336:Desformylflustrabromine
3038:Intensive Care Medicine
1975:Eustace BR (Oct 1967).
1754:Grady D. (2001-03-31).
1428:Minerva Anestesiologica
993:Seizures rarely occur.
717:endotracheal intubation
635:endotracheal intubation
3756:ACh release inhibitors
3638:intermediate duration:
3463:Pharmaceutical Journal
3177:Pharmaceutical Journal
2651:10.1093/bja/57.11.1085
2558:10.1093/bja/57.11.1049
2154:10.1093/bja/46.4.281-a
2135:Kounis NG (Apr 1974).
1953:10.1093/bja/44.10.1097
1245:Leontice leontopetalum
1175:Strathclyde University
1156:Strathclyde University
1011:Laudanosine is also a
909:neuromuscular blocking
749:Intermediate Duration
713:mechanical ventilation
658:malignant hyperthermia
631:mechanical ventilation
5290:Nicotinic antagonists
5191:Glycerophosphocholine
3607:ultra-short duration:
3044:(Suppl. 2): S91–S93.
2876:10.1038/clpt.1990.112
1871:10.1093/bja/35.10.657
1301:"Atracurium Besylate"
1042:as components of the
915:, is associated with
670:neuromuscular-blocker
643:injection into a vein
5300:Norsalsolinol ethers
5186:Dimethylethanolamine
5051:Rapacuronium bromide
5031:Pipecuronium bromide
4871:Gantacurium chloride
4831:Dizocilpine (MK-801)
4416:MEM-63,908 (RG-3487)
4366:Ethoxysebacylcholine
3983:Arbaclofen placarbil
3676:Dimethyltubocurarine
3584:Dimethyltubocurarine
3317:(Suppl. 1): 3S–10S.
3133:10.1093/bja/62.2.177
3011:10.1093/bja/61.5.531
2927:10.1093/bja/63.6.661
2510:(Suppl 1): 14S–18S.
1543:Sale JP (May 1983).
1391:. 106 Suppl: 91–93.
1334:www.medicines.org.uk
869:improve this article
740:Ultra-short Duration
5201:Phosphatidylcholine
5086:Threohydrobupropion
5071:Stercuronium iodide
5006:Pancuronium bromide
3730:Choline derivatives
3539:Peripherally acting
3338:Tetrahedron Letters
2840:10.1093/bja/53.1.45
2788:10.1093/bja/53.1.31
2739:10.1093/bja/55.1.61
1815:vol. 39 (1); 49-55.
1209:process of Hofmann
1202:Hofmann elimination
1179:Wellcome Foundation
1148:medicinal chemistry
1100:balanced anesthesia
1033:Hofmann elimination
732:
619:atracurium besylate
615:Atracurium besilate
56:Atracurium besylate
25:
23:Atracurium besilate
5121:Vecuronium bromide
5061:Rocuronium bromide
4971:Methyllycaconitine
4896:Hydroxynorketamine
4791:Dextropropoxyphene
4776:Dehydronorketamine
4766:Dacuronium bromide
3894:Nonbenzodiazepines
3599:4° ammonium agents
3050:10.1007/bf01708808
1912:10.1007/BF03025433
1760:The New York Times
1623:Lim R (Feb 2003).
757:Clinical Duration
730:
723:Duration of action
693:generic medication
654:allergic reactions
650:low blood pressure
5250:
5249:
5211:Phosphorylcholine
5149:
5134:
5133:
4931:Levacetylmethadol
4811:Dihydrochandonium
4691:sodium thiopental
4361:Ethanol (alcohol)
4138:
4137:
4116:
4115:
3772:
3771:
3737:(Succinylcholine)
3715:
3714:
3344:(51): 3841–3844.
2644:(11): 1085–1088.
2551:(11): 1049–1051.
1946:(10): 1097–1099.
1067:breakdown process
985:, and gallamine.
901:
900:
893:
833:
832:
807:Recovery Index (T
662:myasthenia gravis
612:
611:
530:Interactive image
407:CompTox Dashboard
48:Tracrium, Acurium
16:Chemical compound
5317:
5285:Muscle relaxants
5267:
5266:
5265:
5258:
5143:
5081:Thiocolchicoside
4891:Hydroxybupropion
4786:Dextromethorphan
4658:Allopregnanolone
4612:
4608:
4511:Suberyldicholine
4221:6-Chloronicotine
4208:
4204:
4193:
4189:
4185:
4165:
4158:
4151:
4142:
4093:Thiocolchicoside
3948:Anticholinergics
3912:Thienodiazepines
3783:
3778:Centrally acting
3708:(Hexafluorenium)
3564:
3559:Non-depolarizing
3555:
3526:muscle relaxants
3518:
3511:
3504:
3495:
3471:
3470:
3469:(7167): 430–441.
3458:
3452:
3451:
3439:
3433:
3432:
3420:
3414:
3413:
3401:
3392:
3391:
3379:
3373:
3372:
3360:
3354:
3353:
3333:
3327:
3326:
3306:
3300:
3299:
3286:
3280:
3279:
3243:
3234:
3233:
3215:
3191:
3185:
3184:
3172:
3166:
3165:
3157:
3146:
3145:
3135:
3111:
3105:
3104:
3068:
3062:
3061:
3033:
3024:
3023:
3013:
2989:
2983:
2982:
2946:
2940:
2939:
2929:
2905:
2896:
2895:
2859:
2853:
2852:
2842:
2818:
2809:
2808:
2790:
2766:
2760:
2759:
2741:
2717:
2708:
2707:
2697:
2673:
2664:
2663:
2653:
2629:
2620:
2619:
2601:
2592:(5): 1155–1161.
2577:
2571:
2570:
2560:
2536:
2530:
2529:
2519:
2495:
2489:
2488:
2470:
2446:
2440:
2439:
2421:
2397:
2391:
2390:
2354:
2348:
2347:
2319:
2308:
2307:
2279:
2270:
2269:
2249:
2243:
2242:
2224:
2200:
2194:
2193:
2173:
2167:
2166:
2156:
2132:
2126:
2125:
2089:
2083:
2082:
2072:
2048:
2042:
2041:
2026:Der Anaesthesist
2021:
2015:
2014:
1996:
1972:
1966:
1965:
1955:
1931:
1925:
1924:
1914:
1890:
1884:
1883:
1873:
1849:
1843:
1842:
1822:
1816:
1809:
1803:
1802:
1774:
1768:
1767:
1751:
1745:
1744:
1726:
1702:
1696:
1695:
1685:
1661:
1655:
1654:
1644:
1620:
1614:
1613:
1611:
1598:
1589:
1583:
1582:
1564:
1540:
1534:
1533:
1515:
1491:
1485:
1484:
1474:
1450:
1444:
1443:
1423:
1417:
1416:
1384:
1378:
1377:
1375:
1356:
1350:
1349:
1347:
1345:
1326:
1317:
1316:
1314:
1312:
1297:
1098:) response with
1027:Pharmacokinetics
896:
889:
885:
882:
876:
853:
845:
815:recovery slope)
733:
682:skeletal muscles
674:non-depolarizing
617:, also known as
608:
607:
600:
532:
512:
510:
493:
487:
481:
475:
469:
452:
441:
430:
429:
415:
413:
398:
378:
358:
338:
318:
298:
278:
268:
267:
253:
207:
125:
74:
33:
26:
24:
5325:
5324:
5320:
5319:
5318:
5316:
5315:
5314:
5275:
5274:
5273:
5263:
5261:
5253:
5251:
5246:
5220:
5142:
5130:
4736:Chlorisondamine
4610:
4603:
4595:
4206:
4199:
4187:
4177:
4169:
4139:
4134:
4122:Directly acting
4112:
3971:
3962:Cyclobenzaprine
3953:Antimuscarinics
3950:
3942:
3924:
3906:
3888:
3841:Benzodiazepines
3835:
3768:
3764:Botulinum toxin
3750:
3711:
3593:
3547:
3541:
3533:
3522:
3480:
3475:
3474:
3460:
3459:
3455:
3441:
3440:
3436:
3422:
3421:
3417:
3403:
3402:
3395:
3381:
3380:
3376:
3362:
3361:
3357:
3335:
3334:
3330:
3308:
3307:
3303:
3288:
3287:
3283:
3245:
3244:
3237:
3193:
3192:
3188:
3174:
3173:
3169:
3159:
3158:
3149:
3113:
3112:
3108:
3070:
3069:
3065:
3035:
3034:
3027:
2991:
2990:
2986:
2948:
2947:
2943:
2907:
2906:
2899:
2861:
2860:
2856:
2820:
2819:
2812:
2768:
2767:
2763:
2719:
2718:
2711:
2675:
2674:
2667:
2631:
2630:
2623:
2579:
2578:
2574:
2538:
2537:
2533:
2497:
2496:
2492:
2448:
2447:
2443:
2399:
2398:
2394:
2356:
2355:
2351:
2321:
2320:
2311:
2281:
2280:
2273:
2251:
2250:
2246:
2202:
2201:
2197:
2175:
2174:
2170:
2134:
2133:
2129:
2091:
2090:
2086:
2050:
2049:
2045:
2023:
2022:
2018:
1974:
1973:
1969:
1933:
1932:
1928:
1892:
1891:
1887:
1864:(10): 657–659.
1851:
1850:
1846:
1824:
1823:
1819:
1810:
1806:
1776:
1775:
1771:
1753:
1752:
1748:
1704:
1703:
1699:
1663:
1662:
1658:
1622:
1621:
1617:
1609:
1596:
1591:
1590:
1586:
1542:
1541:
1537:
1493:
1492:
1488:
1452:
1451:
1447:
1425:
1424:
1420:
1386:
1385:
1381:
1358:
1357:
1353:
1343:
1341:
1328:
1327:
1320:
1310:
1308:
1299:
1298:
1267:
1262:
1167:muscle relaxant
1144:
1136:
1132:
1125:
1121:
1090:
1084:
1029:
991:
975:succinylcholine
951:
926:
897:
886:
880:
877:
866:
854:
843:
838:
814:
810:
787:
783:
762:
758:
725:
701:
603:
601:
598:(what is this?)
595:
590:
587:
582:
577:
576:
565:
562:
557:
556:
535:
508:
506:
496:
490:
484:
478:
472:
433:
409:
401:
381:
361:
341:
321:
301:
281:
264:
256:
236:
233:
228:
227:
205:
174:Protein binding
164:Bioavailability
156:Pharmacokinetic
150:
129:
99:
92:
81:
17:
12:
11:
5:
5323:
5321:
5313:
5312:
5307:
5302:
5297:
5292:
5287:
5277:
5276:
5272:
5271:
5248:
5247:
5245:
5244:
5239:
5234:
5229:
5225:
5222:
5221:
5219:
5218:
5213:
5208:
5203:
5198:
5193:
5188:
5183:
5178:
5173:
5163:
5158:
5152:
5150:
5136:
5135:
5132:
5131:
5129:
5128:
5123:
5118:
5113:
5108:
5103:
5098:
5093:
5088:
5083:
5078:
5073:
5068:
5063:
5058:
5053:
5048:
5043:
5038:
5033:
5028:
5023:
5018:
5013:
5008:
5003:
4998:
4993:
4988:
4983:
4978:
4973:
4968:
4963:
4958:
4953:
4948:
4943:
4938:
4933:
4928:
4923:
4918:
4916:Kynurenic acid
4913:
4908:
4903:
4898:
4893:
4888:
4883:
4878:
4873:
4868:
4863:
4858:
4853:
4848:
4843:
4838:
4833:
4828:
4823:
4818:
4813:
4808:
4803:
4798:
4793:
4788:
4783:
4778:
4773:
4768:
4763:
4758:
4753:
4748:
4743:
4738:
4733:
4728:
4723:
4718:
4713:
4710:κ-bungarotoxin
4706:α-bungarotoxin
4699:
4694:
4680:
4675:
4670:
4665:
4660:
4655:
4650:
4645:
4644:, many others)
4634:α-bungarotoxin
4627:
4622:
4616:
4614:
4597:
4596:
4594:
4593:
4588:
4583:
4578:
4573:
4568:
4566:Tribendimidine
4563:
4558:
4553:
4548:
4543:
4538:
4533:
4528:
4523:
4518:
4513:
4508:
4503:
4498:
4493:
4491:Sebacylcholine
4488:
4483:
4478:
4473:
4468:
4463:
4458:
4453:
4448:
4443:
4438:
4433:
4423:
4418:
4413:
4408:
4403:
4398:
4393:
4388:
4383:
4378:
4373:
4368:
4363:
4358:
4353:
4348:
4343:
4338:
4333:
4328:
4323:
4318:
4313:
4308:
4306:Butyrylcholine
4303:
4298:
4293:
4288:
4283:
4278:
4273:
4268:
4263:
4258:
4253:
4248:
4243:
4238:
4233:
4228:
4223:
4218:
4212:
4210:
4190:
4179:
4178:
4170:
4168:
4167:
4160:
4153:
4145:
4136:
4135:
4133:
4132:
4126:
4124:
4118:
4117:
4114:
4113:
4111:
4110:
4105:
4100:
4095:
4090:
4085:
4080:
4075:
4070:
4065:
4060:
4055:
4050:
4045:
4040:
4035:
4030:
4025:
4020:
4015:
4010:
4005:
4000:
3995:
3990:
3985:
3979:
3977:
3973:
3972:
3970:
3969:
3964:
3958:
3956:
3944:
3943:
3941:
3940:
3934:
3932:
3926:
3925:
3923:
3922:
3916:
3914:
3908:
3907:
3905:
3904:
3898:
3896:
3890:
3889:
3887:
3886:
3881:
3876:
3871:
3866:
3861:
3856:
3851:
3845:
3843:
3837:
3836:
3834:
3833:
3828:
3823:
3818:
3813:
3808:
3803:
3798:
3792:
3790:
3780:
3774:
3773:
3770:
3769:
3767:
3766:
3760:
3758:
3752:
3751:
3749:
3748:
3739:
3738:
3725:
3723:
3717:
3716:
3713:
3712:
3710:
3709:
3699:
3698:
3693:
3688:
3683:
3678:
3673:
3668:long duration:
3664:
3663:
3658:
3653:
3648:
3643:
3634:
3633:
3628:
3623:
3617:short duration
3613:
3612:
3603:
3601:
3595:
3594:
3592:
3591:
3586:
3581:
3575:
3573:
3561:
3552:
3535:
3534:
3523:
3521:
3520:
3513:
3506:
3498:
3492:
3491:
3479:
3478:External links
3476:
3473:
3472:
3453:
3434:
3415:
3393:
3374:
3355:
3328:
3301:
3281:
3235:
3206:(9): 723–729.
3186:
3167:
3147:
3126:(2): 177–183.
3106:
3079:(3): 230–240.
3063:
3025:
3004:(5): 531–540.
2984:
2957:(6): 699–702.
2951:Anesthesiology
2941:
2920:(6): 661–666.
2897:
2854:
2810:
2761:
2709:
2688:(3): 446–454.
2682:Anesthesiology
2665:
2621:
2586:Anesthesiology
2572:
2531:
2490:
2461:(6): 584–589.
2455:Anesthesiology
2441:
2412:(6): 589–597.
2406:Anesthesiology
2392:
2365:(2): 235–241.
2359:Brain Research
2349:
2330:(7): 466–473.
2309:
2290:(6): 577–578.
2284:Anesthesiology
2271:
2244:
2215:(8): 801–805.
2195:
2184:(1): 109–112.
2168:
2127:
2100:(4): 437–440.
2084:
2043:
2016:
1987:(4): 638–641.
1967:
1926:
1905:(1): 116–119.
1885:
1844:
1833:(2): 112–115.
1817:
1804:
1769:
1746:
1717:(4): 906–911.
1711:Anesthesiology
1697:
1676:(5): 727–728.
1670:Anesthesiology
1656:
1635:(2): 631–632.
1615:
1584:
1555:(5): 511–512.
1535:
1506:(2): 207–208.
1486:
1465:(5): 645–646.
1459:Anesthesiology
1445:
1434:(3): 133–135.
1418:
1379:
1351:
1336:. March 2015.
1318:
1264:
1263:
1261:
1258:
1234:biodegradation
1143:
1140:
1139:
1138:
1134:
1130:
1127:
1123:
1119:
1116:
1109:
1105:
1102:
1088:
1083:
1080:
1028:
1025:
1002:kidney failure
990:
987:
950:
947:
938:cardiovascular
924:
899:
898:
857:
855:
848:
842:
841:Cardiovascular
839:
837:
834:
831:
830:
827:
822:
819:
816:
812:
808:
804:
803:
800:
795:
792:
789:
785:
782:Recovery Time
779:
778:
775:
770:
767:
764:
760:
754:
753:
752:Long Duration
750:
747:
745:Short Duration
742:
737:
724:
721:
700:
697:
610:
609:
592:
591:
589:
588:
585:
583:
580:
572:
571:
570:
567:
566:
564:
563:
560:
552:
551:
550:
547:
546:
543:
537:
536:
534:
533:
525:
523:
515:
514:
504:
498:
497:
494:
488:
482:
476:
470:
465:
459:
458:
454:
453:
443:
435:
434:
432:
431:
418:
416:
403:
402:
400:
399:
391:
389:
383:
382:
380:
379:
371:
369:
363:
362:
360:
359:
351:
349:
343:
342:
340:
339:
331:
329:
323:
322:
320:
319:
311:
309:
303:
302:
300:
299:
291:
289:
283:
282:
280:
279:
271:
269:
258:
257:
255:
254:
246:
244:
238:
237:
235:
234:
231:
223:
222:
221:
218:
217:
213:
212:
209:
200:
199:
186:
180:
179:
176:
170:
169:
166:
160:
159:
152:
151:
149:
148:
144:
142:
136:
135:
131:
130:
128:
127:
114:
112:
106:
105:
102:
100:administration
94:
93:
91:
90:
86:
84:
76:
75:
68:
58:
57:
54:
50:
49:
46:
40:
39:
35:
34:
15:
13:
10:
9:
6:
4:
3:
2:
5322:
5311:
5308:
5306:
5303:
5301:
5298:
5296:
5293:
5291:
5288:
5286:
5283:
5282:
5280:
5270:
5260:
5256:
5243:
5240:
5238:
5235:
5233:
5230:
5227:
5226:
5223:
5217:
5214:
5212:
5209:
5207:
5204:
5202:
5199:
5197:
5194:
5192:
5189:
5187:
5184:
5182:
5179:
5177:
5174:
5171:
5167:
5164:
5162:
5159:
5157:
5154:
5153:
5151:
5147:
5141:
5137:
5127:
5124:
5122:
5119:
5117:
5114:
5112:
5109:
5107:
5104:
5102:
5099:
5097:
5094:
5092:
5089:
5087:
5084:
5082:
5079:
5077:
5074:
5072:
5069:
5067:
5064:
5062:
5059:
5057:
5054:
5052:
5049:
5047:
5044:
5042:
5039:
5037:
5034:
5032:
5029:
5027:
5026:Phencyclidine
5024:
5022:
5019:
5017:
5014:
5012:
5009:
5007:
5004:
5002:
4999:
4997:
4996:Nitrous oxide
4994:
4992:
4989:
4987:
4984:
4982:
4979:
4977:
4974:
4972:
4969:
4967:
4964:
4962:
4959:
4957:
4954:
4952:
4949:
4947:
4944:
4942:
4939:
4937:
4936:Levomethadone
4934:
4932:
4929:
4927:
4924:
4922:
4919:
4917:
4914:
4912:
4909:
4907:
4904:
4902:
4899:
4897:
4894:
4892:
4889:
4887:
4884:
4882:
4881:Hexafluronium
4879:
4877:
4874:
4872:
4869:
4867:
4864:
4862:
4859:
4857:
4854:
4852:
4849:
4847:
4844:
4842:
4839:
4837:
4834:
4832:
4829:
4827:
4824:
4822:
4819:
4817:
4814:
4812:
4809:
4807:
4804:
4802:
4799:
4797:
4794:
4792:
4789:
4787:
4784:
4782:
4779:
4777:
4774:
4772:
4771:Decamethonium
4769:
4767:
4764:
4762:
4759:
4757:
4754:
4752:
4749:
4747:
4744:
4742:
4741:Cisatracurium
4739:
4737:
4734:
4732:
4729:
4727:
4724:
4722:
4719:
4717:
4714:
4711:
4707:
4703:
4702:Bungarotoxins
4700:
4698:
4695:
4692:
4688:
4687:pentobarbital
4684:
4681:
4679:
4676:
4674:
4671:
4669:
4666:
4664:
4661:
4659:
4656:
4654:
4651:
4649:
4646:
4643:
4639:
4635:
4631:
4630:α-Neurotoxins
4628:
4626:
4623:
4621:
4618:
4617:
4615:
4609:
4602:
4598:
4592:
4589:
4587:
4584:
4582:
4579:
4577:
4574:
4572:
4569:
4567:
4564:
4562:
4559:
4557:
4554:
4552:
4549:
4547:
4544:
4542:
4539:
4537:
4534:
4532:
4529:
4527:
4524:
4522:
4519:
4517:
4514:
4512:
4509:
4507:
4504:
4502:
4499:
4497:
4494:
4492:
4489:
4487:
4484:
4482:
4479:
4477:
4474:
4472:
4469:
4467:
4464:
4462:
4459:
4457:
4454:
4452:
4449:
4447:
4444:
4442:
4439:
4437:
4434:
4431:
4427:
4424:
4422:
4419:
4417:
4414:
4412:
4409:
4407:
4404:
4402:
4399:
4397:
4394:
4392:
4389:
4387:
4384:
4382:
4379:
4377:
4374:
4372:
4369:
4367:
4364:
4362:
4359:
4357:
4354:
4352:
4349:
4347:
4344:
4342:
4339:
4337:
4334:
4332:
4331:Decamethonium
4329:
4327:
4324:
4322:
4319:
4317:
4314:
4312:
4309:
4307:
4304:
4302:
4299:
4297:
4294:
4292:
4289:
4287:
4284:
4282:
4279:
4277:
4274:
4272:
4269:
4267:
4266:Acetylcholine
4264:
4262:
4259:
4257:
4254:
4252:
4249:
4247:
4244:
4242:
4239:
4237:
4234:
4232:
4229:
4227:
4224:
4222:
4219:
4217:
4214:
4213:
4211:
4205:
4198:
4194:
4191:
4186:
4180:
4176:
4173:
4166:
4161:
4159:
4154:
4152:
4147:
4146:
4143:
4131:
4128:
4127:
4125:
4123:
4119:
4109:
4106:
4104:
4101:
4099:
4096:
4094:
4091:
4089:
4086:
4084:
4081:
4079:
4076:
4074:
4071:
4069:
4066:
4064:
4061:
4059:
4058:Methocarbamol
4056:
4054:
4051:
4049:
4048:Mephenoxalone
4046:
4044:
4041:
4039:
4036:
4034:
4031:
4029:
4026:
4024:
4021:
4019:
4016:
4014:
4011:
4009:
4006:
4004:
4003:Chlorzoxazone
4001:
3999:
3998:Chlorphenesin
3996:
3994:
3993:Chlormezanone
3991:
3989:
3986:
3984:
3981:
3980:
3978:
3974:
3968:
3965:
3963:
3960:
3959:
3957:
3954:
3949:
3945:
3939:
3936:
3935:
3933:
3931:
3927:
3921:
3918:
3917:
3915:
3913:
3909:
3903:
3900:
3899:
3897:
3895:
3891:
3885:
3882:
3880:
3877:
3875:
3872:
3870:
3867:
3865:
3864:Flunitrazepam
3862:
3860:
3857:
3855:
3852:
3850:
3847:
3846:
3844:
3842:
3838:
3832:
3829:
3827:
3824:
3822:
3821:Phenprobamate
3819:
3817:
3814:
3812:
3809:
3807:
3806:Difebarbamate
3804:
3802:
3799:
3797:
3794:
3793:
3791:
3788:
3787:Carbamic acid
3784:
3781:
3779:
3775:
3765:
3762:
3761:
3759:
3757:
3753:
3747:
3746:Hexamethonium
3744:
3741:
3740:
3736:
3735:Suxamethonium
3733:
3731:
3727:
3726:
3724:
3722:
3718:
3707:
3706:Hexafluronium
3704:
3701:
3700:
3697:
3694:
3692:
3689:
3687:
3684:
3682:
3679:
3677:
3674:
3672:
3669:
3666:
3665:
3662:
3659:
3657:
3654:
3652:
3649:
3647:
3646:Cisatracurium
3644:
3642:
3639:
3636:
3635:
3632:
3629:
3627:
3624:
3622:
3618:
3615:
3614:
3611:
3608:
3605:
3604:
3602:
3600:
3596:
3590:
3587:
3585:
3582:
3580:
3577:
3576:
3574:
3572:
3569:
3565:
3562:
3560:
3556:
3553:
3550:
3545:
3544:antinicotinic
3540:
3536:
3531:
3527:
3519:
3514:
3512:
3507:
3505:
3500:
3499:
3496:
3489:
3485:
3482:
3481:
3477:
3468:
3464:
3457:
3454:
3449:
3445:
3438:
3435:
3430:
3426:
3419:
3416:
3412:(6): 515–524.
3411:
3407:
3400:
3398:
3394:
3389:
3385:
3378:
3375:
3370:
3366:
3359:
3356:
3351:
3347:
3343:
3339:
3332:
3329:
3324:
3320:
3316:
3312:
3305:
3302:
3298:(5): 441–450.
3297:
3293:
3285:
3282:
3277:
3273:
3269:
3265:
3261:
3257:
3253:
3249:
3242:
3240:
3236:
3231:
3227:
3223:
3219:
3214:
3209:
3205:
3201:
3197:
3190:
3187:
3182:
3178:
3171:
3168:
3163:
3156:
3154:
3152:
3148:
3143:
3139:
3134:
3129:
3125:
3121:
3117:
3110:
3107:
3102:
3098:
3094:
3090:
3086:
3082:
3078:
3074:
3067:
3064:
3059:
3055:
3051:
3047:
3043:
3039:
3032:
3030:
3026:
3021:
3017:
3012:
3007:
3003:
2999:
2995:
2988:
2985:
2980:
2976:
2972:
2968:
2964:
2960:
2956:
2952:
2945:
2942:
2937:
2933:
2928:
2923:
2919:
2915:
2911:
2904:
2902:
2898:
2893:
2889:
2885:
2881:
2877:
2873:
2869:
2865:
2858:
2855:
2850:
2846:
2841:
2836:
2832:
2828:
2824:
2817:
2815:
2811:
2806:
2802:
2798:
2794:
2789:
2784:
2780:
2776:
2772:
2765:
2762:
2757:
2753:
2749:
2745:
2740:
2735:
2731:
2727:
2723:
2716:
2714:
2710:
2705:
2701:
2696:
2691:
2687:
2683:
2679:
2672:
2670:
2666:
2661:
2657:
2652:
2647:
2643:
2639:
2635:
2628:
2626:
2622:
2617:
2613:
2609:
2605:
2600:
2595:
2591:
2587:
2583:
2576:
2573:
2568:
2564:
2559:
2554:
2550:
2546:
2542:
2535:
2532:
2527:
2523:
2518:
2513:
2509:
2505:
2501:
2494:
2491:
2486:
2482:
2478:
2474:
2469:
2464:
2460:
2456:
2452:
2445:
2442:
2437:
2433:
2429:
2425:
2420:
2415:
2411:
2407:
2403:
2396:
2393:
2388:
2384:
2380:
2376:
2372:
2368:
2364:
2360:
2353:
2350:
2345:
2341:
2337:
2333:
2329:
2325:
2318:
2316:
2314:
2310:
2305:
2301:
2297:
2293:
2289:
2285:
2278:
2276:
2272:
2267:
2263:
2259:
2255:
2248:
2245:
2240:
2236:
2232:
2228:
2223:
2218:
2214:
2210:
2206:
2199:
2196:
2191:
2187:
2183:
2179:
2172:
2169:
2164:
2160:
2155:
2150:
2146:
2142:
2138:
2131:
2128:
2123:
2119:
2115:
2111:
2107:
2103:
2099:
2095:
2088:
2085:
2080:
2076:
2071:
2066:
2062:
2058:
2054:
2047:
2044:
2039:
2035:
2031:
2027:
2020:
2017:
2012:
2008:
2004:
2000:
1995:
1990:
1986:
1982:
1978:
1971:
1968:
1963:
1959:
1954:
1949:
1945:
1941:
1937:
1930:
1927:
1922:
1918:
1913:
1908:
1904:
1900:
1896:
1889:
1886:
1881:
1877:
1872:
1867:
1863:
1859:
1855:
1848:
1845:
1840:
1836:
1832:
1828:
1821:
1818:
1814:
1808:
1805:
1800:
1796:
1792:
1788:
1784:
1780:
1773:
1770:
1765:
1761:
1757:
1750:
1747:
1742:
1738:
1734:
1730:
1725:
1720:
1716:
1712:
1708:
1701:
1698:
1693:
1689:
1684:
1679:
1675:
1671:
1667:
1660:
1657:
1652:
1648:
1643:
1638:
1634:
1630:
1626:
1619:
1616:
1608:
1604:
1603:
1595:
1588:
1585:
1580:
1576:
1572:
1568:
1563:
1558:
1554:
1550:
1546:
1539:
1536:
1531:
1527:
1523:
1519:
1514:
1509:
1505:
1501:
1497:
1490:
1487:
1482:
1478:
1473:
1468:
1464:
1460:
1456:
1449:
1446:
1441:
1437:
1433:
1429:
1422:
1419:
1414:
1410:
1406:
1402:
1398:
1394:
1390:
1383:
1380:
1374:
1369:
1365:
1361:
1355:
1352:
1339:
1335:
1331:
1325:
1323:
1319:
1306:
1302:
1296:
1294:
1292:
1290:
1288:
1286:
1284:
1282:
1280:
1278:
1276:
1274:
1272:
1270:
1266:
1259:
1257:
1254:
1250:
1246:
1242:
1239:
1235:
1230:
1228:
1225:
1221:
1216:
1212:
1208:
1207:physiological
1203:
1199:
1195:
1194:neuromuscular
1191:
1186:
1184:
1183:stereoisomers
1180:
1176:
1172:
1168:
1165:
1161:
1157:
1153:
1149:
1141:
1128:
1117:
1114:
1110:
1106:
1103:
1101:
1097:
1094:
1086:
1085:
1081:
1079:
1077:
1073:
1072:cisatracurium
1068:
1064:
1059:
1056:
1053:
1049:
1045:
1041:
1038:
1034:
1026:
1024:
1022:
1018:
1017:cisatracurium
1014:
1009:
1007:
1003:
999:
994:
988:
986:
984:
980:
976:
972:
968:
964:
963:neuromuscular
960:
957:The issue of
955:
948:
946:
944:
939:
935:
931:
922:
921:cisatracurium
918:
914:
910:
906:
895:
892:
884:
881:December 2022
874:
870:
864:
863:
858:This section
856:
852:
847:
846:
840:
835:
828:
826:
823:
820:
817:
806:
805:
801:
799:
796:
793:
790:
781:
780:
776:
774:
771:
768:
765:
756:
755:
751:
748:
746:
743:
741:
738:
735:
734:
728:
722:
720:
718:
714:
710:
706:
698:
696:
694:
690:
685:
683:
679:
678:acetylcholine
675:
671:
667:
663:
659:
655:
651:
646:
644:
640:
639:suxamethonium
636:
632:
628:
624:
620:
616:
606:
599:
593:
584:
579:
575:
568:
559:
555:
548:
544:
542:
541:Melting point
538:
531:
527:
526:
524:
521:
516:
505:
503:
499:
466:
464:
460:
455:
451:
447:
444:
442:
440:ECHA InfoCard
436:
428:
424:
423:DTXSID6022630
420:
419:
417:
408:
404:
397:
396:ChEMBL1200527
393:
392:
390:
388:
384:
377:
373:
372:
370:
368:
364:
357:
353:
352:
350:
348:
344:
337:
333:
332:
330:
328:
324:
317:
313:
312:
310:
308:
304:
297:
293:
292:
290:
288:
284:
277:
273:
272:
270:
263:
259:
252:
248:
247:
245:
243:
239:
230:
226:
219:
214:
211:17–21 minutes
210:
208:
201:
197:
194:
190:
187:
185:
181:
177:
175:
171:
167:
165:
161:
157:
153:
146:
145:
143:
141:
137:
132:
124:
119:
116:
115:
113:
111:
107:
103:
101:
95:
88:
87:
85:
83:
77:
73:
69:
67:
63:
59:
55:
51:
47:
45:
41:
38:Clinical data
36:
32:
27:
19:
5111:Tubocurarine
5041:Promegestone
5036:Progesterone
4951:Mecamylamine
4761:Cyclopropane
4751:Coronaridine
4683:Barbiturates
4668:Anatruxonium
4638:α-cobratoxin
4481:Sazetidine A
4401:JNJ-39393406
4391:Ispronicline
4108:Zoxazolamine
3967:Orphenadrine
3938:Methaqualone
3930:Quinazolines
3801:Cyclarbamate
3796:Carisoprodol
3742:
3728:
3721:Depolarizing
3702:
3686:Pipecuronium
3667:
3640:
3637:
3621:Rapacuronium
3616:
3606:
3589:Tubocurarine
3466:
3462:
3456:
3447:
3443:
3437:
3428:
3424:
3418:
3409:
3405:
3387:
3383:
3377:
3368:
3364:
3358:
3341:
3337:
3331:
3314:
3311:Br J Anaesth
3310:
3304:
3295:
3291:
3284:
3254:(1): 67–69.
3251:
3247:
3203:
3199:
3189:
3180:
3176:
3170:
3161:
3123:
3119:
3109:
3076:
3072:
3066:
3041:
3037:
3001:
2997:
2987:
2954:
2950:
2944:
2917:
2913:
2870:(1): 18–25.
2867:
2863:
2857:
2833:(1): 45–54.
2830:
2826:
2781:(1): 31–44.
2778:
2774:
2764:
2732:(1): 61–66.
2729:
2725:
2685:
2681:
2641:
2637:
2589:
2585:
2575:
2548:
2544:
2534:
2507:
2503:
2493:
2458:
2454:
2444:
2409:
2405:
2395:
2362:
2358:
2352:
2327:
2323:
2287:
2283:
2257:
2253:
2247:
2212:
2208:
2198:
2181:
2177:
2171:
2144:
2140:
2130:
2097:
2093:
2087:
2063:(1): 62–64.
2060:
2056:
2046:
2032:(1): 27–29.
2029:
2025:
2019:
1984:
1980:
1970:
1943:
1939:
1929:
1902:
1898:
1888:
1861:
1857:
1847:
1830:
1826:
1820:
1812:
1807:
1785:(1): 40–42.
1782:
1778:
1772:
1759:
1749:
1714:
1710:
1700:
1673:
1669:
1659:
1632:
1628:
1618:
1600:
1587:
1552:
1548:
1538:
1503:
1499:
1489:
1462:
1458:
1448:
1431:
1427:
1421:
1388:
1382:
1373:10665/325771
1363:
1354:
1342:. Retrieved
1333:
1309:. Retrieved
1244:
1231:
1214:
1210:
1197:
1189:
1187:
1170:
1145:
1112:
1095:
1092:
1066:
1062:
1060:
1047:
1043:
1030:
1020:
1010:
1005:
995:
992:
971:tubocurarine
967:rapacuronium
959:bronchospasm
956:
952:
949:Bronchospasm
912:
902:
887:
878:
867:Please help
862:verification
859:
836:Side effects
824:
797:
772:
744:
739:
726:
702:
699:Medical uses
686:
647:
618:
614:
613:
602:
596:
204:Elimination
140:Legal status
134:Legal status
18:
5216:Pirisudanol
5181:Cyprodenate
5161:Adafenoxate
5076:Surugatoxin
5066:Sevoflurane
5021:Pentolinium
5001:Norketamine
4921:Laudanosine
4851:Erythravine
4841:Encenicline
4826:Dipyrandium
4796:Dextrorphan
4642:α-conotoxin
4601:Antagonists
4586:WAY-317,538
4581:Varenicline
4571:Tropisetron
4561:Tebanicline
4506:SSR-180,711
4471:Rivanicline
4461:Pozanicline
4456:PNU-282,987
4451:PNU-120,596
4446:PHA-709,829
4441:PHA-543,613
4381:Galantamine
4356:Epiboxidine
4351:Epibatidine
4271:Altinicline
4103:Tolperisone
4088:Silperisone
4078:Promoxolane
4038:Lanperisone
4033:Inaperisone
4018:Flopropione
4013:Fenyramidol
3902:Eszopiclone
3816:Meprobamate
3811:Febarbamate
3681:Pancuronium
3610:Gantacurium
3542:(primarily
3450:(1): 85–88.
3371:(1): 77–84.
2260:(1): 9–14.
2209:Anaesthesia
2094:Anaesthesia
1981:Anaesthesia
1549:Anaesthesia
1500:Anaesthesia
1344:16 December
1215:degradation
1211:elimination
998:laudanosine
979:pancuronium
934:tachycardia
930:hypotension
513: g·mol
446:100.058.840
216:Identifiers
53:Other names
44:Trade names
5305:Anesthesia
5279:Categories
5176:Citicoline
5156:Acetyl-coA
5140:Precursors
5116:Vanoxerine
5106:Tropeinium
5091:Toxiferine
5056:Reboxetine
5046:Radafaxine
4991:Neramexane
4981:Mivacurium
4976:Metocurine
4941:Malouetine
4906:Isoflurane
4861:Fazadinium
4856:Esketamine
4836:Doxacurium
4821:Dioscorine
4781:Desflurane
4746:Coclaurine
4678:Atracurium
4663:Amantadine
4653:Alcuronium
4406:Levamisole
4396:Ivermectin
4341:Dianicline
4301:Butinoline
4286:Anatoxin-a
4175:modulators
4130:Dantrolene
4098:Tizanidine
4068:Pregabalin
4053:Metaxalone
4043:Mephenesin
4023:Gabapentin
3884:Tetrazepam
3874:Nitrazepam
3859:Clonazepam
3849:Bromazepam
3671:Doxacurium
3661:Vecuronium
3656:Rocuronium
3651:Fazadinium
3641:Atracurium
3631:Chandonium
3626:Mivacurium
3579:Alcuronium
3431:: 273–276.
3390:: 508–514.
3183:: 577–578.
2147:(4): 281.
1592:Shapse D.
1311:8 December
1260:References
1253:leonticine
1055:hydrolysis
1040:hydrolysis
1013:metabolite
983:vecuronium
913:in general
788:recovery)
763:recovery)
736:Parameter
518:3D model (
502:Molar mass
376:CHEBI:2915
336:40AX66P76P
307:ChemSpider
251:64228-81-5
242:CAS Number
225:IUPAC name
196:hydrolysis
184:Metabolism
5016:Pentamine
5011:Pempidine
4961:Methadone
4956:Memantine
4876:Halothane
4866:Gallamine
4846:Enflurane
4801:Diadonium
4716:Bupropion
4501:SIB-1553A
4496:SIB-1508Y
4486:SB-206553
4311:Carbachol
4291:AR-R17779
4281:Anatabine
4276:Anabasine
4241:A-867,744
4236:A-582,941
4231:A-366,833
4008:Eperisone
3879:Temazepam
3869:Lorazepam
3826:Styramate
3703:unsorted:
3696:Gallamine
3691:Laudexium
3571:alkaloids
3549:NMJ block
3524:Skeletal
1076:nebivolol
943:cutaneous
917:histamine
907:class of
666:pregnancy
206:half-life
168:100% (IV)
98:Routes of
80:Pregnancy
72:Monograph
66:Drugs.com
5269:Medicine
5228:See also
5170:lecithin
5146:prodrugs
5096:Tramadol
4946:ME-18-MC
4911:Ketamine
4901:Ibogaine
4721:BW284C51
4476:RJR-2429
4466:Pyrantel
4426:Nicotine
4421:Morantel
4411:Lobeline
4376:EVP-6124
4371:EVP-4473
4326:Cytisine
4321:Cotinine
4226:A-84,543
4197:Agonists
4073:Pridinol
4063:Phenibut
3988:Baclofen
3920:Etizolam
3854:Diazepam
3831:Tybamate
3276:37109119
3230:32126218
3101:37966268
2979:39573578
2892:31131670
2805:12663014
2756:10006364
2436:26776273
2387:35031924
2344:12113608
2239:22700697
2122:21429279
1880:14073484
1764:Archived
1741:13063601
1733:12657852
1692:11388519
1651:12538231
1607:Archived
1530:43519278
1413:39461057
1362:(2019).
1338:Archived
1305:Archived
1241:petaline
1238:alkaloid
1224:tertiary
1164:skeletal
1160:Scotland
1152:Pharmacy
1108:blocker.
1096:pollicis
1093:abductor
1048:in vitro
989:Seizures
911:agents,
605:(verify)
287:DrugBank
110:ATC code
82:category
5166:Choline
4726:BW-A444
4704:(e.g.,
4697:BNC-210
4685:(e.g.,
4648:ABT-126
4632:(e.g.,
4591:XY-4083
4556:TC-6683
4551:TC-5619
4546:TC-5214
4541:TC-2216
4536:TC-1827
4531:TC-1734
4526:TC-1698
4436:NS-1738
4430:tobacco
4316:Choline
4261:ABT-894
4256:ABT-560
4251:ABT-418
4246:ABT-202
4083:Quinine
3323:6688014
3268:7293706
3222:6213181
3142:2923767
3093:2394062
3058:8106685
3020:3207525
2971:6239574
2936:2611066
2884:2369806
2849:7459185
2797:6161627
2748:6687375
2704:2001023
2660:3840382
2616:9064617
2608:7912481
2567:3840380
2526:3707810
2485:2814293
2477:2932981
2428:2932982
2379:8069669
2304:2932980
2266:5348343
2231:3839980
2190:1675699
2163:4451602
2114:4268667
2038:4111555
2011:1501797
2003:4168012
1962:4639831
1921:5545731
1839:4104054
1799:5225576
1579:5484390
1571:6687984
1522:3838421
1481:2581480
1440:8515854
1405:8533554
1251:called
1177:to the
1171:in vivo
1142:History
1063:in vivo
1044:in vivo
1021:in vivo
829:>30
802:90-180
791:<15
777:>60
709:surgery
707:during
627:surgery
625:during
463:Formula
296:DB00732
262:PubChem
126:)
120: (
118:M03AC04
5255:Portal
4756:Curare
4673:AQW051
4620:18-MAC
4576:UB-165
4386:GTS-21
4216:5-HIAA
4184:nAChRs
3789:esters
3568:Curare
3490:(MeSH)
3321:
3274:
3266:
3228:
3220:
3140:
3099:
3091:
3056:
3018:
2977:
2969:
2934:
2890:
2882:
2847:
2803:
2795:
2754:
2746:
2702:
2658:
2614:
2606:
2565:
2524:
2483:
2475:
2434:
2426:
2385:
2377:
2342:
2302:
2264:
2237:
2229:
2188:
2161:
2120:
2112:
2079:434447
2077:
2036:
2009:
2001:
1960:
1919:
1878:
1837:
1797:
1739:
1731:
1690:
1649:
1577:
1569:
1528:
1520:
1479:
1438:
1411:
1403:
1222:and a
1220:alkene
1006:et al.
825:10-15
798:50-70
794:25-30
773:30-45
769:12-20
554:SMILES
387:ChEMBL
356:D00758
5144:(and
5126:Xenon
4625:18-MC
4604:(and
4200:(and
3976:Other
3272:S2CID
3226:S2CID
3097:S2CID
2975:S2CID
2888:S2CID
2801:S2CID
2752:S2CID
2612:S2CID
2481:S2CID
2432:S2CID
2383:S2CID
2235:S2CID
2178:Masui
2118:S2CID
2007:S2CID
1737:S2CID
1610:(PDF)
1597:(PDF)
1575:S2CID
1526:S2CID
1409:S2CID
1249:amine
1227:amine
1052:ester
1037:ester
574:InChI
520:JSmol
367:ChEBI
316:43068
276:47320
193:ester
4806:DHβE
4607:NAMs
4203:PAMs
3319:PMID
3264:PMID
3218:PMID
3138:PMID
3089:PMID
3054:PMID
3016:PMID
2967:PMID
2932:PMID
2880:PMID
2845:PMID
2793:PMID
2744:PMID
2700:PMID
2656:PMID
2604:PMID
2563:PMID
2522:PMID
2473:PMID
2424:PMID
2375:PMID
2340:PMID
2300:PMID
2262:PMID
2227:PMID
2186:PMID
2159:PMID
2110:PMID
2075:PMID
2034:PMID
1999:PMID
1958:PMID
1917:PMID
1876:PMID
1835:PMID
1795:PMID
1729:PMID
1688:PMID
1647:PMID
1567:PMID
1518:PMID
1477:PMID
1436:PMID
1401:PMID
1346:2016
1313:2016
1113:rate
1035:and
973:and
903:The
818:2-3
766:6-8
637:but
347:KEGG
327:UNII
191:and
158:data
62:AHFS
4028:GHB
3530:M03
3467:267
3346:doi
3256:doi
3208:doi
3181:236
3128:doi
3081:doi
3046:doi
3006:doi
2959:doi
2922:doi
2872:doi
2835:doi
2783:doi
2734:doi
2690:doi
2646:doi
2594:doi
2553:doi
2512:doi
2463:doi
2414:doi
2367:doi
2363:646
2332:doi
2292:doi
2217:doi
2149:doi
2102:doi
2065:doi
1989:doi
1948:doi
1907:doi
1866:doi
1787:doi
1719:doi
1678:doi
1637:doi
1557:doi
1508:doi
1467:doi
1393:doi
1368:hdl
1198:bis
1190:bis
1154:at
1015:of
871:by
813:75%
809:25%
786:95%
761:25%
711:or
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