Succinylcholine (Ancetine)

Question 1

Classification

Answer 1

Neuromuscular blocker, depolarizing

Question 2

Mechanism of Action

Answer 2

• Competes with acetylcholine receptor of the motor end plate on the muscle cell, resulting in muscle paralysis

Question 3

Indications

Answer 3

• To induce neuromuscular blockade to facilitate intubation

Question 4

Contraindications

Answer 4

• Malignant hyperthermia,
• Severe burns
• Severe truma

Question 5

Adverse Effects

Answer 5

• Anaphylactoid reactions
• Respiratory depression, apnea, bronchospasm
• Cardiac arrythmias, malignant hyperthermia
• Hyper/hypotension
• Muscle fasciculation

Question 6

Administration

Answer 6

• Adult: 0.5 mg/kg IV/IO or 3-4 mg/kg IM (max 150 mg)

Question 7

Special Considerations

Answer 7

• IV results in neuromuscular blockade in 30-60 seconds, IM in 2-3 minutes
• IV in infants and children can potentially result in profound bradycardia, and, occasionally, asystyole. Bradycardia can be reduced by pretreating with atropine.
• Has significantly prolonged effect with nerve gas agents or organophosphate poisoning.