Thursday June 7, 2007
Tachyphylaxis Associated With Continous Cisatracurium (Nimbex)

Tachyphylaxis is common among patients treated with neuromuscular blockers and varies with clinical situation like burn patients are more prone to have resistance with pancuronium. Cisatracurium is a very common neuromuscular blocker prescribed in ICUs, particularly it is a prefered agent in patients with major organ failures as it has a clearance mechanism independent of organ function. Other advantges of cisatracurium is no vagolytic effects ( minor histamine-releasing properties) and less association with prolonged muscle weakness. One disadvantage of continuous cisatracurium therapy is possible tachyphylaxis after 48-72 hours and may require escalating dose of the drug.

Reference:

Tachyphlaxis Associated With Continous Cisatracurium Versus Pancuronium Therapy - Pharmacotherapy, Pharmacotherapy 22(7):823-830, 2002