Succinylcholine

Question 1

Trade name

Answer 1

Anectine

Question 2

Class

Answer 2

Neuromuscular blocking agent (depolarizing)

Question 3

Actions

Answer 3

Ultra short acting depolarizing neuromuscular blocking agent witha high affinity for aCh receptor sites.
Binds with cholinergic receptors on the muscle motor end plates, which causes depolarizations (often leads to fasisculation and some muscular contractions) and antagonizes the action of acetylcholine to cause skeletal muscle and diaphragmatic paralyzation. Subsequent neuromuscular transmission is inhibited as long as an adequate concentration remains at receptor sites. It is then rapidly hydrolyzed by plasma cholinesterase.

Question 4

Indications

Answer 4

To facilitate endotracheal intubation…se PATI protocols

Question 5

Contraindications

Answer 5

Skeletal muscle myopathies.
Trauma or burns >48hrs ago.
Airway anatomy makes intubation unlikely. 
Acute rhabdomyolysis
Hx of malignant hyperthermia
Hypersensitivity
Hyperkalemia (suspect in dialysis pts)

Question 6

Side effects

Answer 6

Initial muscle fasiculations
Excessive salivation
Hypotension
Bradycardia / cardiac arrest
Malignant hyperthermia
May exacerbate hyperkalemia in post trauma crush injury, burn pts, and pts with paralyzed limbs

Question 7

Precautions

Answer 7

Succinylcholine has no effect on consciousness or pain.
Duration of action is 4 to 6 minutes and spontaneous respirations will usually resume in 5-10 minutes.
Have combitube and needlencricothyrotomy kit ready as airway adjuncts if unable to intubate.
Monitor EKG, SPO2, VS, and neurological response.
Pts suffering from electrolyte abnormalities and or massive digitalis toxicity may suffer serious cardiac arrhythmias or cpa 2nd to hyperK.