The preparation alcuronium chloride is used to relax the muscles. Mainly, the drug is used to temporarily paralyze skeletal muscles before chest and abdominal surgeries so that the operating doctor has a better view of the surgical area. Because administration of the drug can cause severe anaphylactic reactions in rare cases, it should be administered only by experienced emergency physicians and anesthesiologists who can respond appropriately to an adverse reaction in the patient’s body.
What is alcuronium chloride?
Mainly, the drug is used to temporarily paralyze skeletal muscles before chest and abdominal surgeries to give the operating physician a better view of the surgical area. Alcuronium chloride is classified as a so-called muscle relaxant. These are preparations that cause the skeletal muscles to relax. The active ingredient alcuronium chloride belongs to the peripherally acting muscle relaxants. These block the transmission of stimuli to the motor end plates of the muscles and thus produce a reversible paralysis of the muscles. Alcuronium chloride is a semisynthetic derivative derived from the alcohol toxiferin. It is a crystalline powder that is both odorless and colorless. Alcuronium chloride can be dissolved in water, ethanol and methanol. It is administered before surgery to alleviate those postoperative symptoms that are reminiscent of sore muscles.
Pharmacological action
Like all muscle relaxants, alcuronium chloride causes skeletal muscle relaxation. This agent acts at the motor end plate of the muscle in question, i.e., where excitation impulses are transmitted from nerve cells to the corresponding muscle. This causes a reversible paralysis that can be overcome independently by the organism. How long the paralytic state lasts depends on the dosage of the active substance. The blocking of stimulus transmission proceeds as follows: As soon as the nerve cell is excited, it releases the messenger substance acetylcholine, which travels across the synaptic cleft to the receptors on the muscle cell. There, the messenger triggers a reaction of the muscle cell, which usually contracts. Preparations such as alcuronium chloride do not prevent the release of the messenger substance, but they do stop the reaction in the muscle cell. This paralyzes the muscle cell and prevents active movement. This effect occurs relatively quickly in the patient and has a comparatively short duration. The reason: the temporary paralysis of the muscles is overcome by the organism.
Medical application and use
The active ingredient alcuronium chloride is basically administered when the aim is to relax the muscles. Preferably, alcuronium chloride and similar preparations are administered during operations in the chest or abdomen. This attenuates the movement of the muscles to provide a better view of the surgical area. Muscle relaxants such as alcuronium chloride are also administered in various pathological spasms or in cases of poisoning. This prevents the muscles from straining and causing severe muscle soreness. If the patient is treated with electric shocks, the administration of muscle relaxants can prevent muscle and tendon tears from occurring. Because alcuronium chloride is difficult to break down from tissues and the gastrointestinal tract, the drug is administered exclusively intravenously. The active ingredient cannot be integrated into the human metabolism and is therefore largely broken down in the kidneys. Only a small portion of about five percent can be detected in bile after administration.
Risks and side effects
Frequently occurring side effects cannot be observed with the active substance alcuronium chloride, but they may still occur. Occasionally, the following side effects can be observed: Bronchospasm (this is the cramping of the muscles around the airways), cardiac arrhythmias, and allergic reactions. Various complaints in the digestive tract can also occasionally occur. These side effects can manifest themselves individually or in combination. In rare cases, a drop in blood pressure may occur in conjunction with an accelerated pulse.Various anaphylactic reactions are also observed in rare cases. These are reactions of the immune system that can affect the entire body. The spectrum of these reactions ranges from mild reactions of the skin to circulatory shock. For this reason, alcuronium chloride should be administered only by experienced emergency physicians or anesthesiologists.