Succinylcholine/ Anectine

Question 1

Succinylcholine Class

Answer 1

Depolarizing neuromuscular blocker.

Question 2

Succinylcholine Action

Answer 2

• Inhibits transmission of nerve impulses.
• Antagonizing action of acetylcholine.
causes muscle fasciculations & paralysis.
• Muscle relaxation begins in the eyelids and jaw, progresses to the limbs, the abdomen, and finally the diaphragm and intercostals.
• Succinylcholine has absolutely no effect on
consciousness

Question 3

Succinylcholine Indication

Answer 3

Facilitation of ETT Intubation

Question 4

Succinylcholine Contraindication

Answer 4

• Hypersensitivity
• History of malignant hyperthermia
• History of skeletal muscle myopathy (rhabdomyolysis)
• Penetrating eye injuries

Question 5

Succinylcholine Precaution

Answer 5

• Pregnancy (C)
• Cardiac disease
• Dehydration
• Respiratory disease
• Narrow-angle glaucoma
• Elderly
• Neuromuscular disease (prolonged effects, i.e. myasthenia gravis)
• Severe burns (potential for cardiac arrest and ventricular arrhythmias, usually not an acute concern)
• Crush Injuries (potential for cardiac arrest and ventricular arrhythmias, usually not an acute concern)
• Must be ready to intubate as soon given, use cricoid pressure to secure airway from gastric regurgitation

Question 6

Succinylcholine Dosage

Answer 6

Adults:
• IV, IM, IO: 1-2 mg/kg rapid push, repeat once if needed
Pediatrics:
• IV, IM, IO: 1-2 mg/kg rapid push, repeat once if needed
• INFANTS: IV, IM, IO 2 mg/kg

Question 7

Succinylcholine Onset/ Duration

Answer 7

• Onset: IV—30-60 seconds. IM—2-3 min

* Duration: IV—3-5 min. IM—10-30 min

Question 8

Succinylcholine Side Effects

Answer 8

• Sinus arrest
• Dysrhythmias
• Hypotension
• Increased intraocular pressure
• Prolonged apnea
• Bronchospasm
• Vomiting/Aspiration
• Malignant Hyperthermia
• Hyperkalemia (36 hours post crush trauma/ burns). Bradycardias (May eventually get tachycardia and HTN as an asphyxia response)

Question 9

Succinylcholine Interactions

Answer 9

• Theophylline users may end up with dysrhythmias
• Incompatible with barbiturates, chlorpromazine, nafcillin, alkaline solutions
• Effects enhanced by Lidocaine, Procainamide, beta blockers, magnesium sulfate, other neuromuscular blockers