Neurology Book

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SuccinylcholineAka: Suxamethonium Chloride, Anectine

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  1. See Also
    1. Paralytic Agent
  2. Precautions
    1. Used only in anesthesia, emergency and intensive care
    2. Airway and respiratory control is critical after use
    3. Paralytic Agents do not alter Level of Consciousness
      1. Must be used with Sedation and analgesia
  3. Indication
    1. Paralysis in Rapid Sequence Intubation
  4. Contraindications
    1. Hyperkalemia
    2. Myopathy with elevated Creatine Phosphokinase
    3. Malignant hyperthermia history or Family History
    4. Penetrating Eye Injury
    5. Narrow Angle Glaucoma
    6. Increased Intracranial Pressure
    7. Congestive Heart Failure
  5. Mechanism
    1. Depolarizing Neuromuscular Blocking Agent (prototype)
  6. Dose (based on ideal body weight in obese patients)
    1. Initial dose
      1. IV Dose: 1-1.5 mg/kg up to 150 mg IV
      2. IM Dose: 2-4 mg/kg up to 150 mg IM
      3. Raise dose if used with non-depolarizing agent
    2. Maintenance dosing (if needed)
      1. Starts 5-10 minutes after initial dose
      2. Please see other references for maintenance dosing
      3. May be used as a continuous infusion
  7. Pharmacokinetics
    1. Onset: <1 minute
    2. Duration: 4-6 minute
  8. Adverse Effects
    1. Bradycardia
    2. Hyperkalemia
    3. Masseter muscle spasm
    4. Malignant hyperthermia
    5. Increased Intracranial Pressure
  9. References
    1. Miller in Katzung (1989) Pharmacology, p. 323-33
    2. Savarese in Miller (2000) Anesthesia, p. 412-90
    3. (2003) Lexicomp Drug database for Pocket PC

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