Succinylcholine Pharmacology


About Succinylcholine
Anticholinergic, Nicotinic agonist, Depolarizing Neuromuscular Blocker, Peripherally acting Skeletal Muscle Relaxant.
Mechanism of Action of Succinylcholine
This Depolarizing Neuromuscular Blocking Agent (prototype) produces a "persistent" depolarization of the neuromuscular junction at nicotinic receptors (mimicking the effect of acetylcholine but without being rapidly hydrolyzed by acetyl cholinesterase) by blocking the transmission through it. This depolarization leads to desensitization, thus decreasing skeletal muscle tone.
General anaesthesia: It is often administered during the induction of anaesthesia to relax muscles of the jaw, neck and airway and thereby facilitate laryngoscopy and endotracheal intubation. Following induction, continued muscle relaxation is required for many procedures to aid surgical exposure and to provide additional insurance of immobility.
Pharmacokinets of Succinylcholine
Absorption- Rapidly absorbed after intravenous administration.
Distribution- Distributed in the extra cellular fluid and rapidly reaches its site of action at the motor endplate of the myoneural junction.
Metabolism- Rapidly hydrolyzed by plasma pseudocholinesterase to succinylmonocholine (active metabolite) and choline. Succinylmonocholine is an active metabolite. It undergoes alkaline hydrolysis to the inactive metabolites succinate and choline.
Excretion- It is excreted through urine.
Onset of Action for Succinylcholine
< 1 min.
Duration of Action for Succinylcholine
1-5 minutes
Half Life of Succinylcholine
Side Effects of Succinylcholine
1. Eye pain
2. Fever
3. Increased heartbeat
4. Irregular heartbeat
5. Rapid breathing
6. Reduced amount of urine
7. Rigid muscles, especially the jaw muscles
8. Wheezing
9. Trembling
10. Flushing (reddening of skin)
11. Muscle pain
12. Increased saliva
13. Fainting or lightheadedness
Contra-indications of Succinylcholine
1. Hypersensitivity to the drug
2. Determined disorders of plasma pseudo cholinesterase
3. Personal or family history of malignant hyperthermia
4. Myopathies associated with elevated creatine phosphokinase values
5. Acute narrow-angle glaucoma
6. Penetrating eye injuries
7. Inability to control airway and/or support ventilations with oxygen and positive pressure
Special Precautions while taking Succinylcholine
1. Cardiovascular disorder
2. Hepatic impairment
3. Pulmonary dysfunction
4. Metabolic dysfunction
5. Renal dysfunction
6. Electrolyte imbalances
7. Hypokalemia or, hypocalcaemia
8. Neuromuscular disease
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Succinylcholine
1. To facilitate intubations
2. Terminating laryngospasm
3. Muscle relaxation
Interactions for Succinylcholine
Diazepam: Reduces duration of neuromuscular blockade produced by succinylcholine.
Phenelzine, Promazine, Oxytocin, certain Non-penicillin antibiotics, Quinidine, Beta-blokers, Procainamide, Lidocaine, Trimethaphan, Lithium carbonate, Frusemide, Magnesium sulphate, Quinine, Chloroquine, Acetylcholine, Anticholinesterases, Procaine type local anaesthetics & isoflurance: May enhance the efficacy of succinylcholine.
Amphotericin B and Thiazide diuretics: Electrolyte imbalances caused by these result in increased effects of succinylcholine.
Cyclophosphamide, I.V. Procaine: Prolong the effects of succinylcholine.
Digitalis glycosides: Toxicity of both drugs may be increased.
Inhalation anaesthetics (e.g. cyclopropane, diethylether, halothane and nitrous oxide): Increased incidence of bradycardia, arrhythmias, sinus arrest and apnoea. Malignant hyperthermia may occur in susceptible individuals.
Narcotic analgesics: Increased incidence of bradycardia and cardiac arrest.
Typical Dosage for Succinylcholine
Adults- 20mg (0.4ml) - 100mg (2ml).
Intubation- 50mg (1ml) - 80 mg (1.6 ml).
Electroconvulsive therapy- 40mg (0.8ml)-75mg (1.5ml).
Manipulation- 80mg (1.6ml).
For administration by continuous I.V. drip: 0.1% solution may be prepared by mixing 10ml injection of succinylcholine with 500ml of 5% glucose or isotonic sodium chloride. The adult dose ranges from 2 - 5mg per minute.
Schedule of Succinylcholine
Storage Requirements for Succinylcholine
Effects of Missed Dosage of Succinylcholine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Succinylcholine
Give symptomatic and supportive treatment. Provide controlled respiration and use a peripheral nerve stimulator to monitor the degree of blockade.

Home Delivery for Succinylcholine in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including succinylcholine.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for succinylcholine and other medicines and health products. Home delivery services for succinylcholine may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take succinylcholine only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for succinylcholine before they complete the sale. You can get this information while placing the order for succinylcholine with the pharmacy.

Succinylcholine is a generic medicine name and there are several brands available for it. Some of the brands for succinylcholine might be better known than succinylcholine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have succinylcholine in stock, you can ask for one of the branded alternatives for succinylcholine.