藥碼
WIN01
藥名
Cisatracurium 10 mg/5 mL
英文商品名
Winbest 針 10 mg/5 mL/Amp
中文商品名
衛平適注射液 2毫克/毫升
螢幕名
Winbest 針 10 mg/5 mL/Amp
劑型
Inj
規格
成分
藥理分類
Autonomic-Neuromuscular Blocking Agents
健保碼
AC60359221
ATC碼
適應症
As an adjunct to general anesthesia or ICU sedation to provide skeletal muscle relaxation, facilitate endotracheal intubation, and facilitate mechanical ventilation. It is indicated for surgical procedures, including cardiac surgery, and for use in critically ill patients requiring mechanical ventilation.
藥理
Cisatracurium is an intermediate-acting, nondepolarizing neuromuscular blocking agent (NMBA) of the benzylisoquinolinium class. It competitively binds to cholinergic receptors at the motor end plate and antagonizes acetylcholine, resulting in blockade of neuromuscular transmission and skeletal muscle paralysis.
藥動學
Distribution :
Steady-state volume of distribution approximately 121–161 mL/kg.
Metabolism :
Primarily eliminated by Hofmann elimination, a temperature- and pH-dependent, organ-independent chemical degradation, producing laudanosine and monoquaternary acrylate; metabolites have no clinically relevant neuromuscular blocking activity.
Elimination :
Mean clearance approximately 4.7–5.7 mL/min/kg; elimination half-life 22–29 minutes. Approximately 80% of clearance is attributed to Hofmann elimination, with the remainder via renal/hepatic pathways.
Steady-state volume of distribution approximately 121–161 mL/kg.
Metabolism :
Primarily eliminated by Hofmann elimination, a temperature- and pH-dependent, organ-independent chemical degradation, producing laudanosine and monoquaternary acrylate; metabolites have no clinically relevant neuromuscular blocking activity.
Elimination :
Mean clearance approximately 4.7–5.7 mL/min/kg; elimination half-life 22–29 minutes. Approximately 80% of clearance is attributed to Hofmann elimination, with the remainder via renal/hepatic pathways.
禁忌症
Hypersensitivity to cisatracurium, atracurium, or benzenesulfonic acid.
懷孕分類
Use during pregnancy only if the potential benefit to the mother outweighs the potential risk to the fetus. Animal studies have not demonstrated adverse effects on fetal development.
哺乳分類
It is unknown whether cisatracurium or its metabolites are excreted into human milk. As a precaution, breastfeeding should be interrupted during treatment and for approximately 3 hours after the last dose or completion of infusion (approximately five elimination half-lives).
副作用
Common : bradycardia, hypotension.
Uncommon : flushing, bronchospasm, rash.
Rare/very rare : hypersensitivity reactions including anaphylaxis/anaphylactic shock; myopathy and muscle weakness, particularly with prolonged NMBA use in critically ill patients.
Uncommon : flushing, bronchospasm, rash.
Rare/very rare : hypersensitivity reactions including anaphylaxis/anaphylactic shock; myopathy and muscle weakness, particularly with prolonged NMBA use in critically ill patients.
劑量和給藥方法
IV administration only.
Dosage should be individualized and guided by neuromuscular monitoring.
Adults—
endotracheal intubation : 0.15 mg/kg IV administered over 5–10 seconds; satisfactory intubating conditions are generally achieved approximately 120 seconds after administration.
Maintenance dose : 0.03 mg/kg, providing approximately 20 minutes of additional neuromuscular blockade under typical opioid-based or propofol anesthesia.
Continuous infusion : initial rate 3 mcg/kg/min (0.18 mg/kg/hr) following spontaneous recovery, then typically 1–2 mcg/kg/min (0.06–0.12 mg/kg/hr) to maintain the desired degree of blockade.
Reduce infusion rate by approximately 40% with isoflurane or enflurane anesthesia.
Preparation and Administration
May be administered undiluted or diluted to 0.1–2.0 mg/mL with 0.9% Sodium Chloride Injection, 5% Dextrose Injection, 0.18% Sodium Chloride/4% Dextrose Injection, or 0.45% Sodium Chloride/2.5% Dextrose Injection.
For continuous infusion, the infusion rate should be adjusted according to body weight, solution concentration, and desired degree of neuromuscular blockade.
Do not use Lactated Ringer's solution for dilution.
Dosage should be individualized and guided by neuromuscular monitoring.
Adults—
endotracheal intubation : 0.15 mg/kg IV administered over 5–10 seconds; satisfactory intubating conditions are generally achieved approximately 120 seconds after administration.
Maintenance dose : 0.03 mg/kg, providing approximately 20 minutes of additional neuromuscular blockade under typical opioid-based or propofol anesthesia.
Continuous infusion : initial rate 3 mcg/kg/min (0.18 mg/kg/hr) following spontaneous recovery, then typically 1–2 mcg/kg/min (0.06–0.12 mg/kg/hr) to maintain the desired degree of blockade.
Reduce infusion rate by approximately 40% with isoflurane or enflurane anesthesia.
Preparation and Administration
May be administered undiluted or diluted to 0.1–2.0 mg/mL with 0.9% Sodium Chloride Injection, 5% Dextrose Injection, 0.18% Sodium Chloride/4% Dextrose Injection, or 0.45% Sodium Chloride/2.5% Dextrose Injection.
For continuous infusion, the infusion rate should be adjusted according to body weight, solution concentration, and desired degree of neuromuscular blockade.
Do not use Lactated Ringer's solution for dilution.
小兒調整劑量
>1 month to 12 years :
For endotracheal intubation, 0.15 mg/kg IV over 5–10 seconds. A dose of 0.1 mg/kg may be used when a shorter duration of action is desired.
Maintenance dose : 0.02 mg/kg may provide approximately 9 minutes of additional blockade under halothane anesthesia.
<1 month : Use is not recommended, as this population has not been adequately studied.
For endotracheal intubation, 0.15 mg/kg IV over 5–10 seconds. A dose of 0.1 mg/kg may be used when a shorter duration of action is desired.
Maintenance dose : 0.02 mg/kg may provide approximately 9 minutes of additional blockade under halothane anesthesia.
<1 month : Use is not recommended, as this population has not been adequately studied.
腎功能調整劑量
No dose adjustment required.
肝功能調整劑量
No dose adjustment required.
安定性
1. Store at 2–8°C, protect from light, and do not freeze.
2. The product contains no antimicrobial preservative; therefore, dilution should be performed immediately before use and the diluted solution should be used as soon as possible.
3. When diluted to 0.1–2.0 mg/mL with compatible infusion solutions, physical and chemical stability is maintained for at least 24 hours at 5°C or 25°C; however, because the product is preservative-free, prompt use is recommended.
2. The product contains no antimicrobial preservative; therefore, dilution should be performed immediately before use and the diluted solution should be used as soon as possible.
3. When diluted to 0.1–2.0 mg/mL with compatible infusion solutions, physical and chemical stability is maintained for at least 24 hours at 5°C or 25°C; however, because the product is preservative-free, prompt use is recommended.
藥袋資訊
臨床用途
非去極化神經肌肉阻斷劑麻醉劑與插管之輔助劑。
主要副作用
心搏徐緩、支氣管痙攣、低血壓、面潮紅、肌肉病變。
泡製方法
儲存方式
請置於 2-8℃ 冷藏儲存
注意事項
其他說明
藥局不備庫 | 藥庫 冰Y13 | 一盒5支
藥品外觀
顏色
形狀
剝痕
標記1
標記2
其他
健保藥價
73
自費價
97.09
仿單
資料庫
健保給付規定
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