Succinylcholine (Anectine)

Question 1

Class

Answer 1

Neuromuscular blocker (depolarizing)

Question 2

Actions (2)

Answer 2

• Binds with cholinergic receptors on the muscle motor-end plate which causes depolarization (often lead to fasciculations and some muscular contractions) and antagonizes action of ACH to cause skeletal muscle and diaphragmatic paralyzation
• Causes release of histamine

Question 3

Indications (3)

Answer 3

• Facilitate endotracheal intubation
• Terminating laryngospasm
• Muscle relaxant

Question 4

Dosages/Routes

Answer 4

PATI SO: 1.5 mg/kg up to a max dose of 200 mg IV/IO, 3 mg/kg IM, repeat once if needed

• Onset: Less than 1 min (IV); 2-3 min (IM)
• Duration: 5-10 min

Question 5

Standard Prep

Answer 5

200 mg/10 cc

Question 6

Pediatric Dose

Answer 6

1-2 mg/kg IV usually

Question 7

Contraindications (5)

Answer 7

• Hx of malignant hyperthermia
• Skeletal muscle myopathies
• Airway anatomy makes intubation unlikely
• Hypersensitivity
• Acute rhabdomyolysis

Question 8

Side Effects (6)

Answer 8

• Initial muscle fasciculation
• Malignant hyperthermia
• May exacerbate hyperK in post-trauma crush injury, burn pts, pt with paralyzed limb
• Excessive salivation
• Hypotension
• Bradycardia

Question 9

Precautions (5)

Answer 9

• Sux has no effect on consciousness or pain
• Duration of action is ~4-6 min and spontaneous respirations will usually resume in 5-10 min
• Have Combitube, needle cricothyrotomy kit ready as airway adjuncts if unable to intubate
• Have Versed, Atropine and Lidocaine ready
• Monitor EKG, pulse ox, VS, neurological response