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Drug Guide

Suxamethonium / Succinylcholine

    IV / IM
    Suxamethonium / Succinylcholine

  • Mechanism of Action
  • Composed of two acetylcholine molecules joined at the acetate methyl group.
  • Bind to nicotinic receptors, resulting in depolarization with opening of voltage-gated channels and muscle contraction. Voltage-gated sodium channels then close and are inactivated, while the membrane remains depolarized.
  • Suxamethonium is not metabolized by acetylcholinesterase and therefore membrane depolarization is prolonged, resulting in prolonged inactivation of sodium channels and muscle relaxation.
  • As the membrane remains depolarized, no further acetylcholine molecules are able to produce further depolarization.
  • Pharmacology
  • Ultra short-acting
  • Onset 30-60 seconds
  • Duration 10 minutes

Clinical Use

  • Indications
  • Relaxation of skeletal muscle for periods of brief anaesthesia such as for:
  • Endotracheal intubation
  • Endoscopy
  • Orthopaedic manipulation
  • Short surgical procedures
  • Electroconvulsive therapy
  • Contraindications
  • Myopathies - including muscular dystrophy and rhabdomyolysis
  • Past history of malignant hyperthermia
  • Acute burns / multitrauma
  • Hyperkalaemia
  • Adverse Effects
  • Hypersensitivity reactions - rash, flushing, anaphylaxis
  • Bradycardia
  • Hyperkalaemia
  • Raised intracranial, intraabdominal and intraocular pressures
  • Muscle pain / weakness
  • Rhabdomyolysis
  • Malignant hyperthermia
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