Have you ever had to undergo surgery? Or has someone you know been in the intensive care unit (ICU) on a ventilator? In such cases, it is very important to completely relax the muscles of the patient's body and keep them still. This helps the doctors work easily during surgery and also helps the patient's body not to collide with the machine while they are on the ventilator. So, today we are talking about a medicine that is used in such special cases. It is called Cisatracurium .
Simply put, what is Cisatracurium?
Cisatracurium is a skeletal muscle relaxant . It is a drug that temporarily relaxes or stops the muscles in our body that we control consciously (for example, the muscles in our limbs, the muscles in our neck). It is given to a patient either as an injection directly into a vein or as a continuous infusion like saline.
The two main uses of this are:
- During surgery: If a patient's muscles are tense during a major surgery, it can be difficult for the surgeon to do their job properly. This medicine relaxes the entire body, making the surgery safer and easier.
- When connected to a breathing machine/ventilator: In some severe cases, the patient is unable to breathe on their own. At that time, breathing is provided through a ventilator. However, sometimes the patient's body can fight the action of this machine. This medicine helps to stop it and allow the machine to supply air to the lungs more easily.
The most important thing is that this medicine is given to the patient after giving him anesthetics and making him completely unconscious. Because this only paralyzes the muscles, it does not cause loss of consciousness. Therefore, it is essential to make the patient unconscious so that he does not feel any discomfort.
Things you need to tell your doctor before giving this medicine
Before you are given Cisatracurium, the anaesthetist will ask you and your family about your health. It is very important to tell them about all your medical conditions without hiding anything . It is especially important to tell them about the following:
| Situation you need to report | Simply why? |
|---|---|
| Allergies to other medications, foods, or substances | If you have previously had an allergic reaction to cisplatin or any other anesthetic, it can be life-threatening. |
| Kidney or Liver Disease | This medicine is eliminated from the body by the kidneys and liver. If these organs are weak, the effects of the medicine may last longer. |
| Respiratory diseases such as asthma | This medication can sometimes affect the respiratory system, so it is important to be aware of this in advance. |
| Neuromuscular diseases such as myasthenia gravis | People with these conditions may experience a greater effect of this medication, so doctors should be especially careful about the dosage they prescribe. |
| Dehydration or imbalances in calcium, potassium, or magnesium levels in the blood | Changes in the body's salt and water levels directly affect how this medicine works. |
| Burns (Large Burns) | The way the body responds to these types of medications may vary in patients with extensive burns. |
| Pregnancy or breastfeeding | It is imperative to tell your doctor if you are pregnant, trying to get pregnant, or breastfeeding. |
How to use this medicine and other important things
This is not a medicine you can take home. Cisatracurium is given only in a hospital or clinic by a trained doctor or nurse. Therefore, there is no risk of missing a dose.
This medicine is given to small children and even infants in some special cases. But it is done under the strict supervision of a pediatrician, and with great caution.
What if the dosage of the medicine is increased? (Overdosage)
Since this is given in a hospital, the chance of overdose is very low. However, if something like this happens, it is an emergency. In such a case, the doctors at the hospital's Emergency Treatment Unit (ETU) will provide the necessary treatment. If you have any doubts about this, you can also call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other medications that may interact with this medicine
Tell your doctor about all the medicines you are taking, including prescription and over-the-counter medicines, herbal products, vitamins, and herbal products. Some medicines can interact with Cisplatin and increase or decrease its effects. For example:
- Some antibiotics - e.g. amikacin, gentamicin, tetracyclines
- Anticonvulsant medications (carbamazepine, phenytoin)
- Lithium
- Other drugs used for anesthesia (`isoflurane`, `halothane`)
- Numbing medication (lidocaine)
- Magnesium
What are the expected side effects?
Like any medicine, cisplatin can cause side effects. Doctors and nurses will monitor you closely while you are taking this medicine. If you have any problems, let them know right away.
| Classification of side effects | |
|---|---|
| Serious side effects that should be reported to your doctor or nurse immediately: | |
| Allergic Reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Breathing difficulties | Difficulty breathing. |
| Symptoms of low blood pressure | Dizziness , feeling light-headed, blue eyes. |
| Symptoms of muscle damage | Dark urine, difficulty urinating, extreme fatigue, muscle pain. |
| Other | Redness of the face, itching or burning of the eyes, seizures. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist: | |
| Muscle pain or weakness | After the anesthesia and medication wear off, you may feel some muscle pain or weakness. |
Take-Home Message
- Cisatracurium is a special injection that is given to relax muscles during surgery and intensive care treatments.
- This is only given in a hospital, under the supervision of doctors. This is not a medicine to take home.
- It is extremely important to tell your doctor about all your medical conditions, allergies, and medications you are taking before surgery.
- You will be constantly monitored while taking this medication, so if any side effects occur, you will receive immediate treatment.
- If you have any further questions about this medication, don't hesitate to ask your doctor.
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