Succinylcholine (Anectine)

Question 1

Succinylcholine Classification

Answer 1

Depolarizing neuromuscular blocker

Question 2

Succinylcholine Mechanism of Action

Answer 2

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

Question 3

Succinylcholine Pharmacokinetics

Answer 3

Onset: 45-60s IV, 2-3m IM
Peak: 1-3m
Duration: 6-10m IV, 10-30m IM
Half Life: 5-10m

Question 4

Succinylcholine Indications/Field Use

Answer 4

Need for temporary paralysis to facilitate endotracheal intubation

Question 5

Succinylcholine Contraindications

Answer 5

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

Question 6

Succinylcholine Side Effects/Adverse Reactions

Answer 6

Dysrhythmia, bradycardia, hypotension, increased intraocular pressure, increased ICP

Question 7

Succinylcholine Dose

Answer 7

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

Question 8

Succinylcholine Precautions

Answer 8

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

Question 9

Succinylcholine Drug Interactions

Answer 9

Potentiated by lidocaine, procainamide, β-blockers, magnesium sulfate, and other neuromuscular blockers