Rapid Sequence intubation Flashcards
Talk about the general pharmacology of Succinylcholine?
Succinylcholine is a depolarizing neuromuscular blocker with 2 phases. The depolarizing action can cause fasciculations (twitching), particularly in muscular patients. Phase 1 is the primary paralytic effect, and involves keeping the membrane potential above threshold so that it is constantly depolarized. Phase 2 involves a non-depolarizing blockage, where acetylcholine is competitively antagonized. Succinylcholine onset is rapid, biphasic, and has no refractory period. An important side effect is hyperkalemia due to increased cellular potassium efflux. Due to the risk of cardiac arrest from hyperkalemia, succinylcholine is contraindicated in burns, crush injuries, known hyperkalemia, and neuromuscular disease. Succinylcholine is also associated with malignant hyperthermia, which involves muscle rigidity and increased temperature after induction. Malignant hyperthermia is treated with dantrolene. Sugammadex is a reversal agent for non-depolarizing neuromuscular blockers, recently approved by the Food and Drug Administration (FDA), that may make succinylcholine obsolete in the future.
