Classes
DEA Class; Rx
Common Brand Names; Anectine, suxamethonium, Quelicin
- Neuromuscular Blockers, Depolarizing
Description
Parenteral, short-acting, depolarizing neuromuscular blocking agent (NMBA)
Used for an adjunct to general anesthesia to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation
Associated with histamine release and vagal stimulation
Indications
Indicated For muscular relaxation during non-emergent endotracheal intubation.
For muscular relaxation during rapid-sequence intubation.
For neuromuscular blockade during surgery.
For muscular relaxation during electroconvulsive therapy (ECT)
Contraindications
Hypersensitivity to drug or component; known or suspected genetic susceptibility to malignant hyperthermia, lack of ventilatory support, history of malignant hyperthermia, myopathies associated with elevated serum creatine kinase, acute phase of injury following major burns (hyperkalemia may occur), multiple trauma, extensive denervation of skeletal muscle or upper motor neuron injury
Adverse Effects
- Muscle fasciculation which may result in postoperative pain
- Jaw rigidity
- Apnea
- Respiratory depression
- Bradycardia
- Hypotension
- Cardiac arrhythmias
- Sinus tachycardia
- Increased IOP
- Salivary gland enlargement
- Excessive salivation
- Rash
- Hypersensitivity reactions
- Malignant hyperthermia
- Myoglobinuria/myoglobinemia (rare)
Warnings
Severe anaphylactic reactions to neuromuscular blocking agents have been reported; these reactions have, in some cases, been life threatening and fatal; because of the potential severity of these reactions, the necessary precautions, such as the immediate availability of appropriate emergency treatment, should be taken
Use caution in chronic abdominal infection, subarachnoid hemorrhage, degenerative or dystrophic neuromuscular disease, conditions that may cause degeneration of central & peripheral nervous systems, upper motor neuron injury, multiple trauma, extensive denervation of skeletal muscle, electrolyte imbalance
Additive/synergistic effects if administered with or following an opioid, sedative or anesthetic agent
Death due to errors reported; administration of drug results in paralysis, which may lead to respiratory arrest and death; this progression may be more likely to occur in a patient for whom it is not intended; confirm proper selection of intended product and avoid confusion with other injectable solutions that are present in critical care and other clinical settings; if another healthcare provider is administering the product, ensure that the intended dose is clearly labeled and communicated
Succinylcholine causes an increase in intraocular pressure; avoid this drug in instances in which an increase in intraocular pressure is undesirable (eg, narrow angle glaucoma, penetrating eye injury) unless potential benefit of its use outweighs potential risk
Pregnancy and Lactation
Not known whether succinylcholine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity; animal reproduction studies not conducted with succinylcholine chloride; therapy should be administered to a pregnant woman only if clearly needed
Not known whether drug excreted in human milk; because many drugs are excreted in human milk, use caution following succinylcholine administration to a nursing woman
Maximum Dosage
1.5 mg/kg/dose IV; 150 mg/dose IM.
1.5 mg/kg/dose IV; 150 mg/dose IM.
1.5 mg/kg/dose IV; 4 mg/kg/dose (Max: 150 mg/dose) IM.
2 to 12 years: 1.5 mg/kg/dose IV; 4 mg/kg/dose (Max: 150 mg/dose) IM.
1 year: 2 mg/kg/dose IV; 4 mg/kg/dose IM.
6 to 11 months: 2 mg/kg/dose IV; 4 mg/kg/dose IM.
1 to 5 months: 3 mg/kg/dose IV (Max: 4 mg/kg IV per intubation attempt); 5 mg/kg/dose IM.
3 mg/kg/dose IV (Max: 4 mg/kg IV per intubation attempt); 4 mg/kg/dose IM.
How supplied
Succinylcholine chloride
injectable solution
- 20mg/mL
- 100mg/mL