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Anaesthesia General 26ee7e45

Laudanosine is metabolite of aEUR'

A
>Cisatracurium
B
>Atracurium
C
>Pancuronium
D
>Gallamine
High-Yield Explanation
Atracurium > Cisatracurium Laudanosine (teiary amine) is a metabolite of both Atracurium and its isomer cisatracurium. Atracurium and its isomer cisatracurium posess a unique characteristic to undergo spontaneous non enzymatic chemical breakdown at physio- logical pH and temperature (Hoffman elimination). Most of the Atracurium and cisatracuriwn is metabolized in this way. - These drugs are so extensively metabolized in this way that their phurmacokinetics is independent of renal and hepatic function. Laudanosine is a breakdown product of the spontaneous non enzymatic organ independent degradation of the drug (Hoffman elimination). -Both Atracurium and cisatracurium undergo Hoffman elimination resulting in laudanosine. - "Because of its higher potency cisatracurium produces less laudanosine than Atracurium". Laudanosine may have some potentially toxic systemic effects - It crosses the blood brain barrier and may cause excitement and seizure activity. - In C. VS. high plasma concentration, produces hypotension and bradycardia. -These are probably irrelevant considerations/side effects unless a patient has received an extremely high total dose or has hepatic .failure. - Laudanosine concentration increases in hepatic failure as it is metabolized by the liver.

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