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Chemical Compound Review

Raplon     [ (2S,3S,5S,8R,9S,10S,13S,14S,16 S,17S)-3...

Synonyms: Rapacuronium, AC1NSKJX, SureCN41132, Raplon (TN), Org-9487, ...
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  • RESULTS: Part I: Rapacuronium typically depressed ventilation in < or = 2 min with 10% twitch recovery in 20-60 min [20].
  • When the first twitch (T1) of a train-of-four stimulus (using the TOF Guard accelerometer) returned to 5%, an infusion of rapacuronium was started at 3 mg kg-1 h-1 and adjusted to maintain T1/T0 at 10% [21].
  • After three incremental doses of rapacuronium, there was a longer time to recovery of T1/T0 = 25% after neostigmine compared with edrophonium (5.1 (1.0) vs 3.3 (1.3) min; P < 0.05) but more rapid recovery to T1/T0 = 75% (10.1 (2.9) vs 16.8 (10.1) min; P < 0.05) and T4/T1 = 0.7 (19.8 (6.3) vs 35.1 (10.4) min; P < 0.05) [17].
  • IMPLICATIONS: Pulmonary function tests in the present study showed that rapacuronium consistently causes severe bronchoconstriction, confirming clinical case reports of bronchospasm [22].

Analytical, diagnostic and therapeutic context of


  1. Rapacuronium bromide: a review of its use in anaesthetic practice. Onrust, S.V., Foster, R.H. Drugs (1999) [Pubmed]
  2. Pharmacokinetics and pharmacodynamics of rapacuronium bromide. Wight, W.J., Wright, P.M. Clinical pharmacokinetics. (2002) [Pubmed]
  3. Newer neuromuscular blocking agents: how do they compare with established agents? Sparr, H.J., Beaufort, T.M., Fuchs-Buder, T. Drugs (2001) [Pubmed]
  4. Pharmacokinetics and pharmacodynamics of rapacuronium in patients with cirrhosis. Duvaldestin, P., Slavov, V., Rebufat, Y. Anesthesiology (1999) [Pubmed]
  5. A dose-ranging study of rapacuronium in pediatric patients. Meakin, G.H., Meretoja, O.A., Motsch, J., Taivainen, T., Wirtavuori, K., Schönstedt, R., Perkins, R., McCluskey, A. Anesthesiology (2000) [Pubmed]
  6. Rapacuronium preferentially antagonizes the function of M2 versus M3 muscarinic receptors in guinea pig airway smooth muscle. Jooste, E., Zhang, Y., Emala, C.W. Anesthesiology (2005) [Pubmed]
  7. Effects of rapacuronium on respiratory function during general anesthesia: a comparison with cis-atracurium. Tobias, J.D., Johnson, J.O., Sprague, K., Johnson, G. Anesthesiology (2001) [Pubmed]
  8. Influence of renal failure on the pharmacokinetics and neuromuscular effects of a single dose of rapacuronium bromide. Szenohradszky, J., Caldwell, J.E., Wright, P.M., Brown, R., Lau, M., Luks, A.M., Fisher, D.M. Anesthesiology (1999) [Pubmed]
  9. The effects of rapacuronium on histamine release and hemodynamics in adult patients undergoing general anesthesia. Levy, J.H., Pitts, M., Thanopoulos, A., Szlam, F., Bastian, R., Kim, J. Anesth. Analg. (1999) [Pubmed]
  10. Evaluation of neuromuscular and cardiovascular effects of two doses of rapacuronium (ORG 9487) versus mivacurium and succinylcholine. Miguel, R., Witkowski, T., Nagashima, H., Fragen, R., Bartkowski, R., Foldes, F.F., Shanks, C. Anesthesiology (1999) [Pubmed]
  11. Pharmacokinetics of rapacuronium in infants and children with intravenous and intramuscular administration. Reynolds, L.M., Infosino, A., Brown, R., Hsu, J., Fisher, D.M. Anesthesiology (2000) [Pubmed]
  12. The hemodynamic effects of rapacuronium in patients with coronary artery disease: succinylcholine and vecuronium compared. Delboy, N.J., Tomichek, R.C., Shields, J.A. Anesth. Analg. (2002) [Pubmed]
  13. Haemodynamic effects of rapacuronium in adults with coronary artery or valvular disease. McCourt, K.C., Elliott, P., Mirakhur, R.K., McMurray, T.J., Phillips, A.S., Cochrane, D. British journal of anaesthesia. (1999) [Pubmed]
  14. A pharmacodynamic explanation for the rapid onset/offset of rapacuronium bromide. Wright, P.M., Brown, R., Lau, M., Fisher, D.M. Anesthesiology (1999) [Pubmed]
  15. Pharmacokinetic analysis of rapacuronium and its metabolite during liver transplantation: an assessment of its potential as a pharmacodynamic probe. Black, R.E., Gertler, R., Wright, P.M., Cancemi, M.T., Hein, H.A., Ramsay, M.A. Proceedings (Baylor University. Medical Center) (2003) [Pubmed]
  16. Rapacuronium augments acetylcholine-induced bronchoconstriction via positive allosteric interactions at the M3 muscarinic receptor. Jooste, E.H., Sharma, A., Zhang, Y., Emala, C.W. Anesthesiology (2005) [Pubmed]
  17. Antagonism of rapacuronium using edrophonium or neostigmine: pharmacodynamics and pharmacokinetics. Mills, K.G., Wright, P.M., Pollard, B.J., Scott, J.M., Hing, J.P., Danjoux, G., Hunter, J.M. British journal of anaesthesia. (1999) [Pubmed]
  18. Prolonged duration of neuromuscular block with rapacuronium in the presence of sevoflurane. Cara, D.M., Armory, P., Mahajan, R.P. Anesth. Analg. (2000) [Pubmed]
  19. The new neuromuscular blocking agents: do they offer any advantages? Moore, E.W., Hunter, J.M. British journal of anaesthesia. (2001) [Pubmed]
  20. Intramuscular rapacuronium in infants and children: dose-ranging and tracheal intubating conditions. Reynolds, L.M., Infosino, A., Brown, R., Hsu, J., Fisher, D.M. Anesthesiology (1999) [Pubmed]
  21. Rapacuronium recovery characteristics and infusion requirements during inhalation versus propofol-based anaesthesia. Fu, W., Klein, K.W., White, P.F., Chiu, J.W., Lemmens, H.J., Whalley, D.G., Drover, D.R., Greenberg, C.P. British journal of anaesthesia. (2000) [Pubmed]
  22. The effect on lung mechanics in anesthetized children with rapacuronium: a comparative study with mivacurium. Fine, G.F., Motoyama, E.K., Brandom, B.W., Fertal, K.M., Mutich, R., Davis, P.J. Anesth. Analg. (2002) [Pubmed]
  23. Factors affecting the pharmacokinetic characteristics of rapacuronium. Fisher, D.M., Kahwaji, R., Bevan, D., Bikhazi, G., Fragen, R.J., Angst, M.S., Ornstein, E., Matteo, R.S. Anesthesiology (1999) [Pubmed]
  24. A mechanism for rapacuronium-induced bronchospasm: M2 muscarinic receptor antagonism. Jooste, E., Klafter, F., Hirshman, C.A., Emala, C.W. Anesthesiology (2003) [Pubmed]
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