Imagine that you or someone close to you is about to undergo surgery. Or you may be in the intensive care unit (ICU) due to some medical condition. In such cases, you may have heard that doctors prescribe a "muscle relaxant" drug. Atracurium is a special drug that is used in such cases. This is not a drug that you can buy from a pharmacy. This is an injection that is given only in a hospital, under the supervision of specialist doctors. So, let's talk about this drug in a little more detail, very simply.
What kind of medicine is this Atracurium?
Simply put, Atracurium is a drug that temporarily relaxes or paralyzes the skeletal muscles of our body. Think of it like temporarily putting the muscles we control mentally, such as those in our arms, legs, neck, and stomach, to sleep.
Now you may be wondering, "Why do you relax your muscles like that?" There are two main reasons for that:
1. During Surgery: When performing a major surgery, the surgeon needs to work freely and without any hindrance. It is difficult to do this if the muscles of the body are tense. When Atracurium is given, the muscles relax completely. Also, during anesthesia, a tube needs to be inserted through the trachea (intubation). It is essential that the muscles of the throat and neck are relaxed at that time.
2. While on a Ventilator: In some severe cases, the patient may have difficulty breathing on their own. They may be put on a ventilator, a breathing machine. During this time, the patient's chest muscles may tighten, which can interfere with the machine's function. When atracurium is given, those muscles relax, allowing the ventilator to do the work of breathing for the patient.
The important thing is that this medicine does not make you unconscious. Therefore, whenever Atracurium is given, it is given with a medicine that makes you sleepy (sedative) or anaesthetic (anesthetic).
Things to tell your doctor before giving this medicine
Atracurium is a medicine that must be used with great caution. Therefore, it is extremely important that you tell the following information without hiding anything when the anaesthetist asks you questions before you have surgery.
| Situation you need to report | A simple explanation |
|---|---|
| Allergies to Atracurium or other medications | Be sure to tell your doctor if you have had an allergic reaction to this medicine before, or if you are allergic to any other medicine, food, or dye. |
| Myasthenia Gravis or other neuromuscular diseases | These are diseases that weaken the muscles. In such patients, the effects of Atracurium may be greatly increased. |
| Asthma or other lung diseases | Special care should be taken when administering this medicine to patients with breathing difficulties. |
| Heart Disease | If you have heart disease, inform your doctor about it. |
| Changes in body salt levels (Electrolyte Imbalance) | Low or high levels of salts such as calcium, magnesium, and potassium in the blood can affect the effectiveness of the medication. |
| Major burns or dehydration | The way the medicine works may be different for people with extensive burns or those who are dehydrated. |
| Pregnancy or breastfeeding | It is essential to inform your doctor if you are pregnant, trying to get pregnant, or breastfeeding. |
Other drugs that may interact with Atracurium
Some medications you are already taking can affect the way Atracurium works. This means that the effects of Atracurium may be increased or decreased too much. Therefore, tell your doctor about all medications you are taking, including vitamins, herbal products, and supplements .
Here are some of the main things that can be affected:
- Some antibiotics (e.g. amikacin, gentamicin)
- Some general anesthetics (e.g. isoflurane, halothane)
- Lithium
- Magnesium
- Medicines for heart disease such as Quinidine and Procainamide
- Other drugs used to relax muscles during surgery
Medication and Overdose
This medicine is given as an injection into a vein or through a saline infusion. This is done in a hospital, under the supervision of a medical team. So you don’t have to worry about missing a dose or getting an overdose. Everything happens in a very controlled manner. If there is any suspicion of an overdose, the medical team takes the necessary steps. If information is needed about such a poisoning situation, the National Poisons Information Centre at the Colombo National Hospital is the place to go. In an emergency, a patient is referred to the Emergency Treatment Unit (ETU) .
What are the possible side effects?
Like any medicine, Atracurium can cause some side effects. But remember, when you are given this medicine, you are surrounded by doctors and nurses. So if any problem arises, they will take care of it right away.
| Side effects of Atracurium | |
|---|---|
| Serious side effects that should be reported to the medical team immediately | |
| Allergic Reactions | Skin rash, severe itching, swelling of the face, lips or tongue. |
| Breathing Problems | Shortness of breath, abnormal changes in breathing rate. |
| Symptoms of Low Blood Pressure | Severe dizziness, feeling light-headed, and blue eyes. |
| Symptoms of Muscle Injury | Dark urine (cola-colored), severe muscle pain, difficulty urinating. |
| Other | Redness of the face, itchy or allergic eyes, seizures. |
| Things that are usually not serious, but should be reported if they persist | |
| Muscle pain/weakness | Feeling pain or weakness in the muscles even after the effects of the medicine wear off. |
| Pain at the injection site | Redness, pain, or swelling at the injection site. |
Take-Home Message
- Atracurium is a special drug used to temporarily relax muscles during surgery and intensive care treatments.
- This is only given in a hospital, under the strict supervision of specialist doctors. You do not have to use it at home.
- It is essential to tell your doctor about all of your medical conditions (especially allergies, asthma, heart disease, Myasthenia Gravis) and all other medications you are taking.
- There is no need to be afraid as the medical team will constantly monitor you while you are given this medicine.
- If any unusual symptoms or side effects arise, the medical team will take immediate action. Talk openly with your doctor about it.
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