Paralytics - Succinylcholine (Anectine) Flashcards
What is the recommended dose range of Succinylcholine for intravenous (IV) administration based on actual body weight?
A) 0.5-1 mg/kg
B) 1-1.5 mg/kg
C) 1.5-2 mg/kg
D) 2-3 mg/kg
B) 1-1.5 mg/kg
What is the recommended dose range of Succinylcholine for intravenous (IV) administration after a defasciculating dose?
A) 0.5-1 mg/kg
B) 1-1.5 mg/kg
C) 1.5-2 mg/kg
D) 2-3 mg/kg
C) 1.5-2 mg/kg
What is the concentration of Succinylcholine?
A) 10 mg/mL
B) 15 mg/mL
C) 20 mg/mL
D) 25 mg/mL
C) 20 mg/mL
Which of the following describe the effects of Succinylcholine at the neuromuscular junction (NMJ)? Select 3
A) Binds to N-AchR at the synaptic endplate
B) Opens monovalent cation channels
C) Causes muscle depolarization
D) Induces a Phase II block
A) Binds to N-AchR at the synaptic endplate,
B) Opens monovalent cation channels,
C) Causes muscle depolarization (pre-syn, post-syn, and extra-jxn receptors)
For Phase I Block, What is the typical onset time of action for Succinylcholine when administered intravenously?
A) 10-20 seconds
B) 30-60 seconds
C) 1-2 minutes
D) 3-5 minutes
B) 30-60 seconds
What is the approximate half-life of Succinylcholine?
A) 1-2 minutes
B) 3-5 minutes
C) 6-10 minutes
D) 10-15 minutes
B) 3-5 minutes
How is Succinylcholine primarily eliminated from the body?
A) Renal excretion
B) Hepatic metabolism
C) Hydrolysis by plasma cholinesterase
D) Biliary excretion
C) Hydrolysis by plasma cholinesterase
into succinylmonocholine (brady) and choline and diffused out of NMJ into plasma
What are the primary products of Succinylcholine hydrolysis?
A) Succinylmonocholine and acetylcholine
B) Succinylmonocholine and choline
C) Succinic acid and choline
D) Succinic acid and acetylcholine
B) Succinylmonocholine and choline
Succinylcholine is commonly used in which of the following clinical situations? (Select 2)
A) Rapid sequence intubation (RSI)
B) Pain management
C) Tracheal intubation
D) Prolonged muscle relaxation during surgery
A) Rapid sequence intubation (RSI)
C) Tracheal intubation
The dibucaine number can be used to test for atypical cholinesterase activity. Which of the following statements are true? (Select all that apply)
A) It measures the percentage inhibition of cholinesterase by dibucaine.
B) A normal dibucaine number is around 80.
C) A dibucaine number of 20 suggests atypical pseudocholinesterase activity.
D) It is used to determine the efficacy of succinylcholine metabolism.
Answer: A, B, C, D
Dibucaine
Amide local anesthetic
Inhibits activity of normal variant butyrylcholinesterase (pseudocholinesterase)
% inhibition = dibucaine number
Dibucaine number
Reflects quality not quantity of enzyme
20: SCh 1mg/kg lasts 3 hours
94m
If have concern of whter have functioning pseudocholinesterase
Qualitity not quantity
% of inhibition that they don’t have, how well are pseudocholinesterase not working
80 – gonna metabolize sux normally
20 - their pseudocholinesterase not gonna work at all and gonna take them long time to metabolize the sux
So wont give sux to ppl who are greatly prolonged
In what context might succinylcholine be administered during a local anesthetic (LA) seizure? (Select 2)
A) To relax skeletal muscles.
B) To reverse the seizure activity.
C) To increase cholinesterase levels.
D) To assist with mechanical ventilation.
A) To relax skeletal muscles.
D) To assist with mechanical ventilation.
Why is succinylcholine contraindicated for induction in pediatric patients? (Select 2)
A) Increased risk of bradycardia due to stronger vagal tone.
B) Risk of hypokalemia.
C) Black Box warning.
D) Risk of increased intraocular pressure (IOP).
A) Increased risk of bradycardia due to stronger vagal tone.
C) Black Box warning.
In which of the following conditions should succinylcholine be avoided? (Select all that apply)
A) Burn patients
B) History of malignant hyperthermia (MH)
C) Ocular trauma
D) Muscular dystrophy (e.g., Duchenne Muscular Dystrophy in children)
E) hyperkalemia
Answer: A, B, C, D, E
o C/I: Pediatric use for induction Black Box warning (if used still… give glyco to negate HR drop since children have stronger vagal tone); burn patients, hx of MH, **ocular trauma d/t 10 mmHg inc in IOP; **hyperK+, Severe muscle trauma, neuro injury, severe sepsis, muscle wasting/disorders, muscular dystrophy (Duchenne Muscular Dystrophy in children), allergy
Which of the following conditions increase the risk of succinylcholine-induced hyperkalemia? (Select all that apply)
A) Severe muscle trauma
B) Neuro injury
C) Severe sepsis
D) Muscle wasting disorders
E) Allergy
all of the above
Succinylcholine use can cause histamine release, which may lead to which of the following effects? (Select 3)
A) Bronchospasm
B) Hyperkalemia
C) Bradycardia
D) Urticaria (hives)
Answer: A, B, D
o Precautions: Histamine release; hyperkalemia especially with fetal/immature and neuronal nACh-Rs (5-10mOsm in short time); inc in plasma K+ by 0.5 mEq,
