Succinylcholine Flashcards
Class?
Ultra-short-acting depolarizing-type skeletal muscle relaxant
Mechanism of Action?
- Combines with cholinergic receptors of the motor end plate to produce depolarization.
- Hydrolyzed by acetylcholinesterase.
Indication and Field Use?
Endotrachael intubation requiring paralysis (RSI) by a qualified Paramedic with authorization from the Paramedic’s administrative medical director.
Contraindications?
- Muscle disorders
- Personal or family history of malignant hyperthermia.
- History of hyperkalemia
- Burn injured patients
- Ocular injuries
- Patients in whom successful endotracheal intubation in doubtful
Adverse Reactions?
- Vagal stimulation leading to bradycardia or asystole.
- Hyperkalemia
- Rhabdomyolysis
- Hypersalivation
- Elevated intraocular pressure
- Release of histamine
- Malignant hyperthermia
- Dysrhythmias
- Hypotension
Incompatibilities/Drug Interactions?
Beta-blockers, procainamide, lithium, and quinidine prolong the effects.
Adult Dosage?
0.6-2 mg/kg IV push
May repeat once in 2-3 minutes if inadequate response to initial dose to achieve paralysis.
If additional dosage is needed, contact medical direction.
Pediatric Dosage?
1-2 mg/kg IV push
May repeat once in 2-3 minutes if inadequate response to initial dose to achieve paralysis.
If additional dosage is needed, contact medical direction.
Onset of Action?
<1 minute
Route of Administration?
IV/IO
Duration of action?
Muscle paralysis lasting 4-6 minutes
AZ Drug Box Minimum Supply?
Optional: 400 mg
Special Notes?
Succinylcholine should not be given to patients for the period from 24 hours to 21 days after significant burns or crush injury due to elevated potassium levels and potential for cardiac dysrhythmias.
