Comparative clinical pharmacokinetics of tubocurarine, gallamine, alcuronium and pancuronium

Abstract

Data about plasma concentration, renal and biliary elimination of tubocurarine, gallamine, alcuronium and pancuronium are taken from the literature for synoptical pharmacokinetic analysis. All plasma concentration curves can be described by triexponential functions according to an open three-compartment pharmacokinetic model in line, the elements of which are an application and measuring compartment, a pharmacologically specific compartment and a non-specific one. The corresponding results for all drugs represent the same range and there is no substantial basis for a further differentiation of clinically significant drug specific characteristics, neither regarding the time course of neuromuscular blockade nor the excretory or metabolic disposition. Thus no particular advantage or disadvantage of any drug can be stated from the kinetic or metabolic point of view and especially none seems to have a striking advantage in patients with impaired renal function. Drug specific peculiarities are more likely to be found in the field of side effects.