Cisatracurium Besylate and Tolterodine Tartrate

• Generic Name: cisatracurium
• Dosage Forms: n.a.
• Other Brand Names: Nimbex

Production of skeletal muscle relaxation during surgery after general anesthesia has been induced.

Facilitation of endotracheal intubation; however, a neuromuscular blocking agent with a rapid onset of action (e.g., succinylcholine, rocuronium) generally preferred in emergency situations when rapid intubation is required. Cisatracurium is not recommended for rapid sequence intubation because of its intermediate onset of action.

Also has been used to facilitate mechanical ventilation in the ICU. Has been given as a continuous IV infusion for up to 6 days in this setting. Whenever neuromuscular blocking agents are used in the ICU, consider benefits versus risks of such therapy and assess patients frequently to determine need for continued paralysis. (See Intensive Care Setting under Cautions.)

Compared with other neuromuscular blocking agents, cisatracurium has an intermediate onset and duration of action; exhibits minimal, if any, cardiovascular effects; and causes less histamine release than atracurium. Because elimination is not dependent on renal or hepatic pathways, may be particularly useful in patients with hepatic or renal dysfunction.

• Generic Name: tolterodine
• Dosage Forms: n.a.
• Other Brand Names: Detrol, Detrol LA

Treatment of overactive bladder for the relief of symptoms associated with voiding such as urge urinary incontinence, urgency, and frequency. Efficacy not established in pediatric patients.

Tolterodine (conventional tablets) appears to be as effective as conventional oxybutynin in reducing urinary symptoms in patients with overactive bladder and is associated with a lower incidence of dry mouth.

Tolterodine (2 mg twice daily as conventional tablets) appears to be less effective than extended-release oxybutynin (10 mg once daily as extended-release tablets) in reducing urinary symptoms in patients with overactive bladder. The incidence of adverse effects (e.g., dry mouth) is similar between conventional tolterodine tartrate and extended-release oxybutynin.

Single daily doses of extended-release capsules of tolterodine tartrate appear to be slightly more effective in relieving certain urinary symptoms (i.e., urge incontinence) than 2 daily doses of conventional tablets of the drug.