Delving into the Latest Updates on Mivacurium Chloride with Synapse

Overview

Basic Info

Drug Type

Chemical drugs

Synonyms

Mivacurium chloride (USAN/INN), Mivacron

+ [1]

Target

nAChRs

Action

antagonists

Mechanism

Nicotinic receptors antagonists(Nicotinic receptors antagonists)

Therapeutic Areas

Urogenital Diseases

Active Indication

Hyperemesis Gravidarum

Inactive Indication

Anesthesia

Originator Organization

AbbVie, Inc.

Active Organization

Wellcome Foundation Ltd

Inactive Organization

AbbVie, Inc.

Drug Highest PhaseApproved

First Approval Date

United States (22 Jan 1992),

Anesthesia

Regulation-

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Structure/Sequence

Molecular FormulaC58H80ClN2O14

InChIKeyKFWHZSUNFAPZPW-FBIVYNMFSA-M

CAS Registry106861-44-3

The goal of this clinical trial is to evaluate whether mivacurium chloride and succinylcholine can provide effective and safe muscle relaxation in adult patients aged 18-60 years undergoing bronchoscopy who require muscle relaxants during anesthesia. The main questions it aims to answer are:
* Is the recovery of spontaneous breathing within 15 minutes after drug discontinuation with mivacurium chloride non-inferior to succinylcholine?
* How do mivacurium chloride and succinylcholine compare in terms of intraoperative hemodynamics and post-operative recovery and comfort? Researchers will compare the mivacurium chloride group and the succinylcholine group to observe if mivacurium chloride can provide similar or better recovery effects compared to succinylcholine.
Participants will:
* Receive either mivacurium chloride (0.14 mg/kg induction bolus + 0.5 mg/kg/h maintenance infusion) or succinylcholine (1 mg/kg induction bolus + 5 mg/kg/h maintenance infusion) as a muscle relaxant during bronchoscopy.
* Have their vital signs, including blood pressure, oxygen saturation, and heart rate, monitored at multiple time points during the procedure.
* Be assessed post-procedure for spontaneous breathing recovery, consciousness recovery, and time to laryngeal mask airway (LMA) removal, as well as overall comfort and satisfaction.

Start Date20 Nov 2024

Sponsor / Collaborator

West China Hospital

ChiCTR2300075970

/ SuspendedPhase 4IIT

Effect of mivacurium on tonsillar adenoidectomy in pediatric patients

Start Date01 Oct 2023

Sponsor / Collaborator-

NCT06072534

/ RecruitingNot ApplicableIIT

Evaluation of Effectiveness of Two Different Doses of Mivacurium in Modified Rapid Sequence Intubation for Emergency Surgery ,Prospective Randomized Double Blind Study

Mivacurium can be considered as an optimal choice for muscle relaxation in short duration surgeries, as butyrylcholinesterase can rapidly and reliably degrade this benzylisoquinoline muscle relaxant in vivo. However the histamine release related to a rapid high-dose injection, unsatisfactory intubation conditions and unexpected delay in recovery in patients may be encountered with butyrylcholinesterase deficiency

Start Date01 Sep 2023

Sponsor / Collaborator

Al-Azhar University

100 Clinical Results associated with Mivacurium Chloride

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100 Translational Medicine associated with Mivacurium Chloride

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100 Patents (Medical) associated with Mivacurium Chloride

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737

Literatures (Medical) associated with Mivacurium Chloride

04 Oct 2024·Medicine

A novel BCHE frameshift mutation in a Chinese woman with butyrylcholinesterase deficiency: A case report and literature review

Review

Author: Zeng, Jiantao ; Yang, Dan ; Xia, Jun ; Dai, Tao ; Zheng, Zhaobin

Rationale:Congenital butyrylcholinesterase deficiency (BCHED) is a rare autosomal recessive genetic disorder caused by a pathogenic mutation in the BCHE gene. Patients with BCHED may experience prolonged apnea or even death after the application of drugs such as succinylcholine. We aimed to identify the genetic basis of disease in a patient presenting with butyrylcholinesterase deficiency in order to confirm the diagnosis, expand BCHE gene mutation spectrum, and elucidate potential genotype-phenotype associations to inform management.Patient concerns:A 51-year-old woman presented with “vague pain in the upper and middle abdomen.” Her serum cholinesterase level was 211 U/L (reference value 4000–13,000 U/L). Other laboratory findings were normal. Genetic analysis revealed compound heterozygous mutations in BCHE gene, which was considered pathogenic in this case.Diagnoses:The patient presented with low serum cholinesterase levels, which excluded common causes such as liver disease, drug toxicity, and chronic illness. Whole exon examination revealed compound heterozygous mutations in the BCHE gene; thus, the patient was diagnosed with congenital BCHED.Interventions:Gastroscopy without succinylcholine or mivacurium chloride was recommended. The gastroscopy results were “gastric polyps,” and gastroscopic “polypectomy” was performed. The patient was advised to avoid succinylcholine use.Outcomes:The patient’s serum cholinesterase level was reviewed 3 months later, and the result was 215 U/L. Double heterozygous mutations are the cause of BChE deficiency of this woman in this study, including a novel mutation NM_000055.4: c.666_669del (p.Phe223Glufs*38). A review of the literature reveals considerable variation in the hotspot variants of the BCHE gene across different populations. The Chinese population displays a higher prevalence of the silent type, which is more sensitive to anesthetics such as succinylcholine.Lessons:Clinical manifestations of congenital BCHED were not significant. This study avoided a potential anesthetic accident, and the novel variant enriched the BCHE gene mutation spectrum.

01 Aug 2024·Acta Anaesthesiologica Scandinavica

Onset time, duration of action, and intubating conditions after mivacurium in elderly and younger patients

Article

Author: Creutzburg, Andreas ; Vested, Matias ; Kempff‐Andersen, Sebastian ; Wadland, Sarah Sofie ; Rosager, Christine L. ; Dalsten, Helene ; Rasmussen, Lars S. ; Rosenkrantz, Oscar

AbstractBackgroundThe neuromuscular blocking agent mivacurium can be used during anesthesia to facilitate tracheal intubation. Data on onset time, duration of action, and effect on intubating conditions in patients 80 years and older are however limited. We hypothesized that onset time and duration of action of mivacurium would be longer in elderly patients than in younger adults.MethodsThis prospective observational study included 35 elderly (≥80 years) and 35 younger (18–40 years) patients. Induction of anesthesia comprised fentanyl 1–3 μg kg−1 and propofol 1.5–2.5 mg kg−1 and propofol and remifentanil for maintenance. Acceleromyography was used for monitoring neuromuscular blockade. The primary outcome was onset time defined as time from injection of mivacurium 0.2 mg kg−1 to a train‐of‐four (TOF) count of zero. Other outcomes included duration of action (time to TOF ratio ≥0.9), intubating conditions using the Fuchs‐Buder scale and the intubating difficulty scale (IDS), and occurrence of hoarseness and sore throat postoperatively.ResultsNo difference was found in onset time comparing elderly with younger patients; 219 s (SD 45) versus 203 s (SD 74) (difference: 16 s (95% CI: −45 to 14), p = .30). Duration of action was significantly longer in elderly patients compared with younger patients; 52 min (SD 17) versus 30 min (SD 8) (difference: 22 min [95% CI: 15 to 28], p < .001). No difference was found in the proportion of excellent intubating conditions (Fuchs‐Buder); 31/35 (89%) versus 26/35 (74%) (p = .12) or IDS score (p = .13). A larger proportion of younger patients reported sore throat 24 h postoperatively; 34% versus 0%, p = .0002. No difference was found in hoarseness.ConclusionNo difference in onset time of mivacurium 0.2 mg kg−1 was found comparing elderly and younger patients. However, elderly patients had significantly longer duration of action. No difference was found in intubating conditions.

01 Aug 2024·Bioorganic & Medicinal Chemistry Letters

Design, synthesis, and biological evaluation of new bis-benzylisoquinoline-based analogues as potential neuromuscular blocking agents

Article

Author: Chen, Gang ; Gan, Yu ; Fu, Lin ; Song, Hao ; Qin, Yong ; Liu, Xiaofeng ; Ke, Bowen ; Chen, Chen ; Zhao, Yi

Neuromuscular blocking agents (NMBAs) are widely used in anesthesia for intubation and surgical muscle relaxation. Novel atracurium and mivacurium derivatives were developed, with compounds 18c, 18d, and 29a showing mivacurium-like relaxation at 27.27 nmol/kg, and 15b, 15c, 15e, and 15h having a shorter duration at 272.7 nmol/kg. The structure-activity and configuration-activity relationships of these derivatives and 29a's binding to nicotinic acetylcholine receptors were analyzed through molecular docking. Rabbit trials showed 29a has a shorter duration compared to mivacurium. This suggests that linker properties, ammonium group substituents, and configuration are crucial for NMBA activity and duration, with compound 29a emerging as a potential ultra-short-acting NMBA.

100 Deals associated with Mivacurium Chloride

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External Link

KEGG	Wiki	ATC	Drug Bank
D00763	Mivacurium Chloride	M03AC10	DBSALT001359

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Hyperemesis Gravidarum	China	Wellcome Foundation Ltd	11 Aug 2005

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT01631149 (BLISS, CTgov)	Phase 4	Kidney Diseases \| Prostatic Hyperplasia	24	atracurium/mivacurium+rocuronium (Moderate/Normal Surgical Block)	pxaohgdawz(uwkopdzcil) = owhrfbulkh pvchzdiygt (pebduaokzk, lslwepdojc - kmdahtnpxs) View more	-	17 Oct 2016
				atracurium/mivacurium+rocuronium (Deep Surgical Block)	pxaohgdawz(uwkopdzcil) = obswmzcljl pvchzdiygt (pebduaokzk, jfqlhxavjj - yuzsvtyvde) View more