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Suxamethonium Chloride information from DrugsUpdate  

See Available Brands of Suxamethonium Chloride in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Suxamethonium, also known as succinylcholine, is a drug used to induce muscle relaxation, usually to make endotracheal intubation possible. Suxamethonium is sold under the trade names Anectine and Scoline.

Suxamethonium acts as a depolarizing neuromuscular blocker. It imitates the action of acetylcholine at the neuromuscular junction, acting on muscle type nicotinic receptors, but it is degraded not by acetylcholinesterase but by butyrylcholinesterase, a plasma cholinesterase. This hydrolysis by butyrylcholinesterase is much slower than that of acetylcholine by acetylcholinesterase.

Pharmacodynamics

Pharmacokinetics

Suxamethonium chloride is an ultrashort-acting depolarising type skeletal muscle relaxant. It blocks the neuromuscular junction by binding to the cholinergic receptors and depolarising it.

Onset

IV: 30-60 seconds; IM: 2-3 minutes.

Duration
IV: 2-6 minutes; IM: 10-30 minutes.

Distribution
Small amounts of suxamethonium cross the placenta

Metabolism
Rapidly hydrolysed by plasma cholinesterase.

Excretion
10% excreted unchanged in urine.

Suxamethonium Chloride Indications / Suxamethonium Chloride Uses

Information Not Available

Suxamethonium Chloride Adverse Reactions / Suxamethonium Chloride Side Effects

Bradycardia, tachycardia, hypotension, hyperpertension, raised intraocular pressure, hyperkalaemia, excessive salivation.

Potentially Fatal: Respiratory depression, dysrhythmias, rhabdomyolsis, malignant hyperthermia.

Precautions

Information Not Available

Special Precautions

Bone fracture, raised intraocular pressure, neuromuscular disease, infants, childn, adolescents, pregnancy and lactation.

Other Drug Interactions

Concurrent use with anticholinesterases, cyclophosphamide, antiarrhythmics, aminoglycosides, lincosamides (clindamycin and lincomycin), anticonvulsants, phenelzine, magnesium, metoclopramide, inhalation anaesthetics, exposure to organophosphate insecticides may enhance neuromuscular block of suxamethonium. Increased risk of arrhythmias with cardiac glycosides.

Other Interactions

Information Not Available

Dosage

Intravenous
Muscle Relaxant in General Anaesthesia
Adult: As chloride: single dose of 0.3-1.1 mg/kg injected; supplementary doses of 50-100% of the initial dose may be given at 5-10 min intervals. Max dose (repeated IV injection or continuous infusion): 500 mg/hour.
Child: As chloride: <1 year: 2 mg/kg; 1-12 years: 1 mg/kg.

Intramuscular
Muscle Relaxant in General Anaesthesia
Adult: As chloride: 3-4 mg/kg. Max total dose: 150 mg
Child: As chloride: <1 year: Up to 4-5 mg/kg; ≥1 year: Up to 4 mg/kg. Max dose: 150 mg.

Reconstitution
IV infusion: dilute to a concentration of 1–2 mg/ml (0.1–0.2%) with 5% dextrose, 5% dextrose and 0.9% sodium chloride, 0.9% sodium chloride, (1/6) M sodium lactate; given at a rate 0.5–10 mg/minutes depending on the response and requirements of patient.

Incompatibility
Alkaline solutions with pH>8.5 .

Food(before/after)

Information Not Available

List of Contraindications

Suxamethonium Chloride and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Suxamethonium Chloride and Lactation

Caution when used during lactation

Suxamethonium Chloride and Children

Information Not Available

Suxamethonium Chloride and Geriatic

Information Not Available

Suxamethonium Chloride and Other Contraindications

Genetic disorders of plasma pseudocholinesterase, personal/family history of malignant hyperthermia, hypersensitivity from previous neuromuscular drug, severe burns, massive trauma, extensive denervation of skeletal muscle, patients with risk of hyperkalaemia, renal impairment, angle closure glaucoma.

Storage

Intramuscular
Refrigerate at 2-8°C.

Intravenous
Refrigerate at 2-8°C.

Lab interference

Intramuscular
Refrigerate at 2-8°C.

Intravenous
Refrigerate at 2-8°C.

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