Drug Information

Drug (ID: DG00593) and It's Reported Resistant Information

• Name: Rocuronium
• Synonyms: Rocuronium; 143558-00-3; UNII-WRE554RFEZ; CHEBI:8884; WRE554RFEZ; [(2S,3S,5S,8R,9S,10S,13S,14S,16S,17R)-3-hydroxy-10,13-dimethyl-2-morpholin-4-yl-16-(1-prop-2-enylpyrrolidin-1-ium-1-yl)-2,3,4,5,6,7,8,9,11,12,14,15,16,17-tetradecahydro-1H-cyclopenta[a]phenanthren-17-yl] acetate; Org-9426; 1-[(1S,2S,4S,5S,7S,10R,11S,13S,14R,15S)-14-(acetyloxy)-5-hydroxy-2,15-dimethyl-4-(morpholin-4-yl)tetracyclo[8.7.0.0^{2,7}.0^{11,15}]heptadecan-13-yl]-1-(prop-2-en-1-yl)pyrrolidin-1-ium; NCGC00167433-01; Rocuronium ion; Rocuronium cation; Epitope ID:174837; C07556; SCHEMBL29958; C32H53BrN2O4; BIDD:GT0360; GTPL4003; CHEMBL1201244; DTXSID6048339; TQP0579; C32H53N2O4; HMS2090E03; ZINC53229445; CS-0733; DB00728; NCGC00167433-05; (2beta,3alpha,5alpha,16beta,17beta)-17-acetoxy-16-(1-allylpyrrolidinium-1-yl)-3-hydroxy-2-(morpholin-4-yl)androstane; H896; HY-17033; X5020; AB01274786-01; AB01274786-02; AB01274786_03; Q185331; SR-05000001500; SR-05000001500-1; BRD-K43305603-004-02-8; 1-[(2; A,3; A,5; A,16; A,17; A)-17-(Acetyloxy)-3-hydroxy-2-(4-morpholinyl)androstan-16-yl]-1-(2-propenyl)pyrrolidinium
• Indication:
  In total 1 Indication(s)
  Muscle spasm [ICD-11: MB47]; Approved; [1]
• Drug Resistance Disease(s):
  Disease(s) with Clinically Reported Resistance for This Drug (1 diseases)
  Spastic cerebral palsy [ICD-11: 8D20]; [1]
• Target: Neuronal acetylcholine receptor alpha-2 (CHRNA2); ACHA2_HUMAN; [1]
• Formula: C32H53N2O4+
• IsoSMILES: CC(=O)O[C@H]1[C@H](C[C@@H]2[C@@]1(CC[C@H]3[C@H]2CC[C@@H]4[C@@]3(C[C@@H]([C@H](C4)O)N5CCOCC5)C)C)[N+]6(CCCC6)CC=C
• InChI: 1S/C32H53N2O4/c1-5-14-34(15-6-7-16-34)28-20-26-24-9-8-23-19-29(36)27(33-12-17-37-18-13-33)21-32(23,4)25(24)10-11-31(26,3)30(28)38-22(2)35/h5,23-30,36H,1,6-21H2,2-4H3/q+1/t23-,24+,25-,26-,27-,28-,29-,30-,31-,32-/m0/s1
• InChIKey: YXRDKMPIGHSVRX-OOJCLDBCSA-N
• PubChem CID: 441290
• ChEBI ID: CHEBI:8884
• TTD Drug ID: D0L5CZ
• VARIDT ID: DR00442
• DrugBank ID: DB00728

Type(s) of Resistant Mechanism of This Drug

  DISM: Drug Inactivation by Structure Modification

Drug Resistance Data Categorized by Their Corresponding Diseases

ICD-08: Nervous system diseases

Spastic cerebral palsy [ICD-11: 8D20]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Drug Inactivation by Structure Modification (DISM)

Key Molecule: Cytochrome P450 family 3 subfamily A member1 (CYP3A4) [1]

• Molecule Alteration: Expression; Up-regulation
• Resistant Disease: Spastic cerebral palsy [ICD-11: 8D20.1]
• Experimental Note: Identified from the Human Clinical Data
• Experiment for Molecule Alteration: Staining and imaging assay
• Mechanism Description: Resistance to neuromuscular blocking agents has been linked to the hepatoxicity of anticonvulsants and the upregulation of drug-metabolizing liver enzymes, especially CYP3A4, which is known to metabolize ROC, Although it was not possible to biopsy liver samples for the present study, elevated CYP3A4 generally correlates with increased circulating alanine transaminase (ALT) and total bilirubin.

References

• Ref 1: Resistance to Neuromuscular Blockade by Rocuronium in Surgical Patients with Spastic Cerebral Palsy .J Pers Med. 2021 Aug 3;11(8):765. doi: 10.3390/jpm11080765. 10.3390/jpm11080765