Succinylcholine

Question 1

Drug Class

Answer 1

Neuromuscular blocking agent (depolarizing)

Question 2

Description

Answer 2

Has the quickest onset and the shortest duration of action of all neuromuscular blocking agents. Binds to acetylcholine receptors. Because it cause causes depolarization of the muscle membrane, fasciculations and muscular contractions can occur.

Question 3

Onset and duration

Answer 3

Onset: less than 1 minute.
Duration: 5-10 minutes

Question 4

Indications

Answer 4

Facilitate Intubation, Terminating laryngospasm, Muscle relaxation.

Question 5

Contraindications

Answer 5

Burns or injuries within the last 12 hours. Hypersensitivity. Skeletal muscle myopathies. Inability to control airway and/or support ventilation with O2 on positive pressure. Personal or family history of malignant hyperthermia. Acute rhabdomyolysis. Intraocular (globe rupture) injuries.

Question 6

Adverse reactions

Answer 6

Hypotension, Respiratory depression, Bradycardia, Dysrhythmias, Initial muscle fasciculations, Excessive salvation, Malignant hyperthermia, Allergic reaction, Succinylcholine may exacerbate hyperkalemia in trauma patients.

Question 7

Drug Interations

Answer 7

Oxytocin, beta blockers, chronic contraceptive use, and oranophophates may potentiate effects.
Diazepam may reduce duration of action.
Cardiac glycosides may induce dysrhythmias (digoxin type drugs).

Question 8

Adult Dose

Answer 8

0. 3-1.1 mg/kg (24-75 mg) over 10-30 sec IV.

0. 04-0.07 mg/kg to maintain relaxation.

Question 9

Pediatric Dose

Answer 9

1-2 mg/kg rapid IV.

Question 10

Special Considerations

Answer 10

Pregnancy class C. Carefully monitor the patient and prepare to resuscitate. Administer with caution in patients with severe trauma, burns, or electrolyte imbalances (hyperkalima). Brain or spinal cord injuries may prolong effects. Patients must have a patient and adequate airway along with adequate sedation during paralysis. Children may require higher doses. Succs has no effect on consciousness or pain. Succs will not stop neuronal seizure activity. Succs rarely may cause ventricular dysrythmias or cardiac arrest in infants and children.

Question 11

Premedication considerations.

Answer 11

Atropine: control salivation’s (especially in pediatrics).
Lidocaine: May decrease increase ICP with intubation.
Use a sedative in a conscious patient prior to undergoing neuromuscular blockade.