Doxacurium (Doxacurium)
Overview of Doxacurium
Doxacurium chloride is a long-acting, nondepolarizing skeletal muscle relaxant. The neuromuscular block produced by doxacurium chloride may be antagonized by anticholinesterase agents. As with other nondepolarizing neuromuscular blocking agents, the more profound the neuromuscular block at reversal, the longer the time and the greater the dose of anticholinesterase required for recovery of neuromuscular function. Doxacurium chloride is approximately 2.5 to 3 times more potent than pancuronium and 10 to 12 times more potent than metocurine. Doxacurium chloride binds competitively to cholinergic receptors on the motor end-plate to antagonize the action of acetylcholine, resulting in a block of neuromuscular transmission. This action is antagonized by acetylcholinesterase inhibitors, such as neostigmine.
Indication of Doxacurium
Doxacurium is primarily indicated in conditions like Adjunct to anesthesia, Painful musculoskeletal conditions.
Contraindication of Doxacurium
Doxacurium is contraindicated in conditions like Hypersensitivity to the drug.
Side Effects of Doxacurium
The severe or irreversible adverse effects of Doxacurium, which give rise to further complications include Fever, Wheezing, Muscular weakness, Dizziness, Hives.,The symptomatic adverse reactions produced by Doxacurium are more or less tolerable and if they become severe, they can be treated symptomatically, these include Pain, Redness, Flushing, Light headedness, Respiratory insufficiency, Apnea, Skeletal muscle paralysis.
Precautions of Doxacurium
Should be administered in carefully adjusted dosage by or under the supervision of experienced clinicians who are familiar with the drug's actions and the possible complications of its use. The drug should not be administered unless facilities for intubation, artificial respiration, oxygen therapy, and an antagonist are within immediate reach. It is recommended that clinicians administering long-acting neuromuscular blocking agents employ a peripheral nerve stimulator to monitor drug response, need for additional relaxants, and adequacy of spontaneous recovery or antagonism.