Cisatracurium Besylate and Valbenazine Tosylate

• 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: valbenazine
• Dosage Forms: n.a.
• Other Brand Names: Ingrezza

Treatment of tardive dyskinesia.

Tardive dyskinesia is a hyperkinetic movement disorder associated with prolonged use of antipsychotic agents or other antidopaminergic drugs (e.g., metoclopramide).

Prior to the availability of valbenazine, there was no standard treatment for tardive dyskinesia. Management generally included discontinuance or reducing the dosage of the precipitating drug when possible, switching from a conventional or first-generation antipsychotic to an atypical or second-generation antipsychotic, or switching to clozapine therapy.