Nc. Dhar et al., APPROACHES TO SHORT-ACTING NEUROMUSCULAR BLOCKING-AGENTS - NONSYMMETRICAL BIS-TETRAHYDROISOQUINOLINIUM MONOESTERS AND DIESTERS, Journal of medicinal chemistry, 39(2), 1996, pp. 556-561
Nonsymmetrical bisquaternary mono- and diesters combining the potency-
enhancing properties of the (1R)-laudanosinium group with a second unh
indered quaternary ammonium moiety have been studied as a means of pro
moting short action with high-potency neuromuscular block. Atracurium-
related nonsymmetrical diesters showed high potency, freedom from vaga
l blockade at neuromuscular blocking doses, and short action. Nonsymme
trical monoesters were short acting but showed varying degrees of vaga
l block.