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
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge