indication

Used in surgical procedures where a rapid onset and brief duration of muscle relaxation is needed (includes intubation, endoscopies, and ECT)

pharmacology

Succinylcholine is indicated as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Succinylcholine is a depolarizing skeletal muscle relaxant. As does acetylcholine, it combines with the cholinergic receptors of the motor end plate to produce depolarization. This depolarization may be observed as fasciculations. Subsequent neuromuscular transmission is inhibited so long as adequate concentration of succinylcholine remains at the receptor site. Succinylcholine has no direct action on the uterus or other smooth muscle structures.

mechanism of action

The mechanism of action of Succinylcholine involves what appears to be a "persistent" depolarization of the neuromuscular junction. This depolarization is caused by Succinylcholine mimicking the effect of acetylcholine but without being rapidly hydrolysed by acetylcholinesterase. This depolarization leads to desensitization.

biotransformation

By pseudocholinesterase, to succinylmonocholine and choline.

route of elimination

About 10% of the drug is excreted unchanged in the urine.

drug interactions

Amikacin: The agent increases the effect of muscle relaxant

Clindamycin: The agent increases the effect of muscle relaxant

Cyclophosphamide: Cyclophosphamide may increase the effect of succinylcholine.

Echothiophate: Echothiophate iodide may increase the effect of succinylcholine.

Gentamicin: The agent increases the effect of muscle relaxant

Lincomycin: The agent increases the effect of muscle relaxant

Netilmicin: The agent increases the effect of muscle relaxant

Piperacillin: The agent increases the effect of the muscle relaxant

Quinidine: The quinine derivative increases the effect of the muscle relaxant

Quinine: The quinine derivative increases the effect of the muscle relaxant

Tacrine: Tacrine may increase the effects of Succinylcholine. Monitor Succinylcholine therapy for increased effects.

Tobramycin: The agent increases the effect of the muscle relaxant