Succinycholine (Anectine)

Question 1

Drug Classification

Answer 1

Depolarizing Neuromuscular Blocker

Question 2

Mechanism of Action

Answer 2

Nicotinic ACh R-agonist ->competes with ACh at neuromuscular junction; when bound, causes and initial wave of widespread neuromuscular depolarization and prevents ACh binding and secondary muscle stimulation

Question 3

Pharmacokinetics

Answer 3

• Onset of Action- 45-60 seconds IV, 2-3 minutes IM
• Peak Effects- 1-3 minutes
• Duration of Effects- 6-10 minutes IV, 10-30 minutes IM
• Half-Life- 5-10 minutes

Question 4

Indications/Field Use

Answer 4

Need for temporary paralysis to facilitate endotracheal intubation

Question 5

Contraindications

Answer 5

• Penetrating eye injuries, narrow angled glaucoma
• Known or suspected hyperkalemia
• History of malignant hyperthermia
• History of myasthenia gravis

Question 6

Side Effects/Adverse Reactions

Answer 6

Bradycardia/Hypotension/dysrhythmias, increased ocular pressure, increased ICP

Question 7

Dose

Answer 7

Adult:
1-2mg/kg IV/IO
Pedi:
1mg/kg IV/IO

Question 8

Precautions

Answer 8

May cause dysrhythmias and cardiac arrest, particularly in patients with hyperkalemia

Question 9

Drug-Drug Interactions

Answer 9

Potentiated by lidocaine, procainamide, beta blockers, magnesium sulfate, and other neuromuscular blockers