All are true about gantacurium-except
Gantacurium was the first compound of this new class of neuromuscular blocking drugs, the asymmetric mixed-onium chlorofumarates. Gantacurium is an asymmetric enantiomeric isoquinolinium diester of chlorofumaric acid . Gantacurium, like cisatracurium, is a single isomer as atracurium and mivacurium are consisting of a mixture of isomers . Gantacurium is an ultra-sho acting non-depolarizing neuromuscular blocking drug with a rapid onset and a wide safety margin . As cisatracurium and atracurium are inactivated by Hofmann elimination, gantacurium is metabolized by chemical degradation which involves cysteine adduction (fast process) and pH-sensitive hydrolysis (slow process) . Cysteine adduction results in replacement of chlorine by cysteine whereafter a heterocyclic ring is formed which cannot longer interact with the postjunctional acetylcholine receptor. Therefore, the metabolites of gantacurium showed no neuromuscular propeies . Moreover, there is no renal and hepatic involvement in the elimination of gantacurium . Reversal of a gantacurium-induced neuromuscular block is possible with administration of cysteine . This first drug in class showed promising results in animal and human studies which will be discussed.
Its onset and duration similar to succinylcholine
It is non depolarizing neuromuscular blocker
It is not metabolized by pseudocholinesterase
It is benzylisoquinoline nondepolarizing NMB
Neuromuscular Blocker