Succinylcholine
A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for.
Neuromuscular Depolarizing Agents
Neuromuscular Blocking Agents
Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (NEUROMUSCULAR NONDEPOLARIZING AGENTS) or noncompetitive, depolarizing agents (NEUROMUSCULAR DEPOLARIZING AGENTS). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc.
Neuromuscular Nondepolarizing Agents
Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.
Vecuronium Bromide
Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.
Androstanols
Fasciculation
Involuntary contraction of the muscle fibers innervated by a motor unit. Fasciculations can often by visualized and take the form of a muscle twitch or dimpling under the skin, but usually do not generate sufficient force to move a limb. They may represent a benign condition or occur as a manifestation of MOTOR NEURON DISEASE or PERIPHERAL NERVOUS SYSTEM DISEASES. (Adams et al., Principles of Neurology, 6th ed, p1294)
Intubation, Intratracheal
Pancuronium
Neuromuscular Blockade
The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.
Malignant Hyperthermia
Thiopental
Anesthesia, Inhalation
Tubocurarine
Anesthesia, General
Ulnar Nerve
Muscle Rigidity
Continuous involuntary sustained muscle contraction which is often a manifestation of BASAL GANGLIA DISEASES. When an affected muscle is passively stretched, the degree of resistance remains constant regardless of the rate at which the muscle is stretched. This feature helps to distinguish rigidity from MUSCLE SPASTICITY. (From Adams et al., Principles of Neurology, 6th ed, p73)
Decamethonium Compounds
Atracurium
gamma-Cyclodextrins
Halothane
A nonflammable, halogenated, hydrocarbon anesthetic that provides relatively rapid induction with little or no excitement. Analgesia may not be adequate. NITROUS OXIDE is often given concomitantly. Because halothane may not produce sufficient muscle relaxation, supplemental neuromuscular blocking agents may be required. (From AMA Drug Evaluations Annual, 1994, p178)
Nitrous Oxide
Preanesthetic Medication
Butyrylthiocholine
Anesthetics, Intravenous
Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)
Tachyphylaxis
Propofol
An intravenous anesthetic agent which has the advantage of a very rapid onset after infusion or bolus injection plus a very short recovery period of a couple of minutes. (From Smith and Reynard, Textbook of Pharmacology, 1992, 1st ed, p206). Propofol has been used as ANTICONVULSANTS and ANTIEMETICS.
Laryngismus
Anesthesia
Masticatory Muscles
Anesthesia Recovery Period
Parabens
Laryngeal Muscles
Fentanyl
Preservatives, Pharmaceutical
Dibucaine
Diaphragm
Thiocholine
Laryngoscopy
Effects of an intubating dose of succinylcholine and rocuronium on the larynx and diaphragm: an electromyographic study in humans. (1/306)
BACKGROUND: Paralysis of the vocal cords is one objective of using relaxants to facilitate tracheal intubation. This study compares the neuromuscular blocking effect of succinylcholine and rocuronium on the larynx, the diaphragm, and the adductor pollicis muscle. METHODS: Electromyographic response was used to compare the neuromuscular blocking effect of succinylcholine and rocuronium on the laryngeal adductor muscles, the diaphragm, and the adductor pollicis muscle. Sixteen patients undergoing elective surgery were anesthetized with propofol and fentanyl, and their tracheas were intubated without neuromuscular blocking agents. The recurrent laryngeal and phrenic nerves were stimulated at the neck. The electromyographic response was recorded from electrodes placed on the endotracheal tube and intercostally before and after administration of 1 mg/kg succinylcholine or 0.6 mg/kg rocuronium. RESULTS: The maximum effect was greater at the adductor pollicis (100 and 99%) than at the larynx (96 and 97%) and the diaphragm (94 and 96%) after administration of succinylcholine and rocuronium, respectively (P < or = 0.05). Onset time was not different between the larynx (58+/-10 s), the diaphragm (57+/-8 s), and the adductor pollicis (54+/-13 s), after succinylcholine (all mean +/- SD). After rocuronium, onset time was 124+/-39 s at the larynx, 130+/-44 s at the diaphragm, and 115+/-21 s at the adductor pollicis. After succinylcholine administration, time to 90% recovery was 8.3+/-3.2, 7.2+/-3.5, and 9.1+/-3.0 min at the larynx, the diaphragm, and the adductor pollicis, respectively. Time to 90% recovery after rocuronium administration was 34.9+/-7.6, 30.4+/-4.2, and 49.1+/-11.4 min at the larynx, the diaphragm, and the adductor pollicis, respectively. CONCLUSION: Neuromuscular blocking effect of muscle relaxants on the larynx can be measured noninvasively by electromyography. Although the larynx appears to be resistant to muscle relaxants, we could not demonstrate that its onset time differed from that of peripheral muscles. (+info)Halothane induces calcium release from human skinned masseter muscle fibers. (2/306)
BACKGROUND: An increase in masseter muscle tone in response to halothane or succinylcholine anesthesia (or both) can be observed in healthy persons. Thus the authors compared the fiber-type halothane and succinylcholine sensitivities in human masseter and vastus lateralis muscles. METHODS: Masseter and vastus lateralis muscle segments were obtained from 13 and 9 healthy persons, respectively. After chemical skinning of a single fiber and loading the sarcoplasmic reticulum with Ca++ 0.16 microM solution, halothane (0.5-4 vol% bubbled in the incubating solution), succinylcholine (0.1 microM to 10 mM), or both sensitivities were defined as the concentration inducing more than 10% of the maximum tension obtained by application of 16 microM Ca++ solution. The myofilament response to Ca++ was studied with and without halothane by observing the isometric tension of skinned masseter fibers challenged with increasing concentrations of Ca++. Muscle fiber type was determined by the difference in strontium-induced tension measurements. RESULTS: A significant difference in halothane sensitivity was found between type 1 masseter fibers (0.6+/-0.2 vol%; mean +/- SD) versus type 1 (2.7+/-0.6 vol%) and type 2 vastus lateralis muscle (2.5+/-0.4 vol%). Succinylcholine did not induce Ca++ release by the sarcoplasmic reticulum. In the masseter muscle, 0.75 vol% halothane decreased the maximal activated tension by 40% but did not change the Ca++ concentration that yields 50% of the maximal tension. CONCLUSIONS: The very low halothane threshold for Ca++ release from the masseter muscle usually could be counteracted by a direct negative inotropic effect on contractile proteins. However, halothane may increase the sensitivity of the sarcoplasmic reticulum Ca++ release to succinylcholine-induced depolarization, leading to an increase in masseter muscle tone. (+info)Characteristics of recombinant human butyrylcholinesterase. (3/306)
AIM: To study the biochemical-pharmacological properties of the recombinant human butyrylcholinesterase (rhBChE) and thereby to size up the potential possibility of using it as a detoxifying agent in succinylcholine intoxication. METHODS: CHO-dhfr cells were transfected with plasmids by electroporation. BChE activity was determined colorimetrically by 5, 5'-dithiobis-(2-nitrobenzoic acid) (DTNB) method. Antigenicity was estimated by enzyme-linked immunosorbent assay and Western blot. RESULTS: The maximal expression amounted to 25.83 ng.h-1/10(6) cells. The rhBChE was highly similar to the native human BChE (nhBChE) in terms of its catalytic property, substrate affinity, inhibitor sensitivity, reactivation, stability, and immunoreactivity with anti-nhBChE antibodies. Mice challenged with 1.5 lethal dose of succinylcholine preincubated with rhBChE survived without any symptoms of intoxication. CONCLUSION: The rhBChE and nhBChE exhibit similar biochemical-pharmacological features. It is of potential value in practical use. (+info)Comparison of intubating conditions after rapacuronium (Org 9487) and succinylcholine following rapid sequence induction in adult patients. (4/306)
We have assessed intubating conditions provided by rapacuronium (Org 9487) and succinylcholine after rapid sequence induction of anaesthesia in adult patients undergoing elective surgery. We studied 335 patients, ASA I and II, in five centres. Two hundred and thirty-four subjects with normal body weight and 101 obese subjects were allocated randomly to one of four treatment groups differing in the neuromuscular blocking drug administered (rapacuronium 1.5 mg kg-1 or succinylcholine 1 mg kg-1) and in the technique used for induction of anaesthesia (fentanyl 2-3 micrograms kg-1 with thiopental 3-6 mg kg-1 or alfentanil 20 micrograms kg-1 with propofol 1.5-2 mg kg-1). Intubation was started at 50 s by an anaesthetist blinded to the drugs used. Intubating conditions were clinically acceptable (excellent or good) in 89.4% of patients after rapacuronium and in 97.4% after succinylcholine (P = 0.004), the estimated difference being 8.1% (95% confidence interval (CI) 2.0-14.1%). Neither anaesthetic technique nor subject group had an influence on intubating conditions. After intubation, the maximum increase in heart rate averaged 23.1 (SD 25.4%) and 9.4 (26.1%) after rapacuronium and succinylcholine, respectively (P < 0.001). Pulmonary side effects (bronchospasm and increased airway pressure) were observed in 10.7% (95% CI 5.8-17%) and 4.1% (95% CI 1.3-8.8%) of patients given rapacuronium and succinylcholine, respectively (P = 0.021). We conclude that after rapid sequence induction of anaesthesia in adults, clinically acceptable intubating conditions were achieved less frequently after rapacuronium 1.5 mg kg-1 than after succinylcholine. (+info)Hemodynamic and metabolic manifestations of acute endotoxin infusion in pigs with and without the malignant hyperthermia mutation. (5/306)
BACKGROUND: The hypermetabolic state induced by acute endotoxemia and malignant hyperthermia (MH) may be indistinguishable. The aims of this study were (1) to investigate the differences between MH and sepsis, (2) to determine whether acute endotoxemia can trigger MH, and (3) to establish the effects of dantrolene in these two disorders. METHODS: Three groups of swine were studied. All pigs were invasively monitored and initially anesthetized with nontriggering agents. A placebo MH-susceptible group (n = 5) received normal saline whereas the endotoxin groups (MH-susceptible, n = 6; MH-negative, n = 4) received intravenous endotoxin (250 microg/kg total) during 2.5 h. Halothane (1.5%) and succinylcholine (2-4 mg/kg) were then administered, followed by two doses of dantrolene (4 mg/kg total). RESULTS: Endotoxin infusion resulted in pulmonary hypertension and systemic hypotension in pigs with and without the MH mutation, but did not trigger MH. Halothane and succinylcholine triggered MH, evidenced by a markedly higher oxygen consumption in the MH-susceptible pigs that received endotoxin (325+/-196 ml/min) and those that did not (374+/-110 ml/min) compared to the MH-negative pigs (69+/-15 ml/min, P<0.0009), as well as muscular rigidity in the susceptible animals. Dantrolene reversed these changes. Three of the six MH-susceptible pigs that received endotoxin died; two died soon after triggering and one after dantrolene administration. In contrast, none of the MH-negative pigs or the MH-susceptible pigs that did not receive endotoxin died (0 of 9 vs. 3 of 6, P = 0.044). CONCLUSION: Endotoxemia does not trigger MH, but may worsen outcome if it occurs. (+info)Effect of rocuronium compared with succinylcholine on intraocular pressure during rapid sequence induction of anaesthesia. (6/306)
We have compared the effect of rocuronium and succinylcholine on intraocular pressure (IOP) during rapid sequence induction of anaesthesia using propofol and fentanyl, in a randomized double-blind study. We studied 30 adult patients, allocated to one of two groups. Anaesthesia was induced with fentanyl 2 micrograms kg-1 and propofol until loss of verbal response. This was followed by succinylcholine 1.5 mg kg-1 (group S; n = 15) or rocuronium 0.9 mg kg-1 (group R; n = 15). Laryngoscopy was performed 60 s later. IOP, mean arterial pressure (MAP) and heart rate (HR) were measured before induction, immediately before intubation and every minute after intubation for 5 min. A Keeler Pulsair air impulse tonometer was used to measure IOP and the mean of two readings obtained in the right eye at each measurement time was recorded. Intubating conditions were evaluated according to a simple scoring system. IOP in the succinylcholine group was significantly greater than that in the rocuronium group (mean 21.6 (SEM 1.4) mm Hg vs 13.3 (1.4) mm Hg; P < 0.001). Intubating conditions were equally good in both groups. We conclude that with rapid sequence induction of anaesthesia using propofol and fentanyl, rocuronium did not cause as great an increase in IOP as succinylcholine and may be an alternative in open eye injury cases. (+info)Intramuscular rapacuronium in infants and children: dose-ranging and tracheal intubating conditions. (7/306)
BACKGROUND: Intravenous rapacuronium's rapid onset and short duration suggest that intramuscular rapacuronium might facilitate tracheal intubation without prolonged paralysis. Accordingly, the authors injected rapacuronium into the deltoid muscle to determine the optimal dose and time for intubation in pediatric patients. METHODS: Unpremedicated patients (aged, 2 months to 3 yr) were studied. Part I: Spontaneous minute ventilation (V(E)) and twitch tension were measured during N2O/halothane anesthesia. Rapacuronium (2.2-5.5 mg/kg, given intramuscularly, n = 23), succinylcholine (4 mg/kg, given intramuscularly, n = 12), or vecuronium (0.1 mg/kg, given intravenously, n = 15) was given. Time to 50% depression of V(E) and 10% recovery of twitch were measured. Dose for each patient was changed 10-20% according to the previous patient's response. Part II: In 22 patients anesthetized with 0.82-1.0% halothane, the optimal rapacuronium dose determined in part I (infants, 2.8 mg/kg; children, 4.8 mg/kg) was given intramuscularly. Laryngoscopy was scored. Time to laryngoscopy was increased or decreased 0.5 min according to the previous patient's response. RESULTS: Part I: Rapacuronium typically depressed ventilation in < or = 2 min with 10% twitch recovery in 20-60 min. With succinylcholine, median time to ventilatory depression was 1.3 and 1.1 min for infants and children, respectively; for vecuronium, 0.7 and 0.6 min. Part I: Intubating conditions were good-excellent at 3.0 and 2.5 min in infants and children, respectively; time to 10% twitch recovery (mean +/- SD) was 31 +/- 14 and 36 +/- 14 min in the two groups. CONCLUSIONS: This pilot study indicates that deltoid injection of rapacuronium, 2.8 mg/kg in infants and 4.8 mg/kg in children, permits tracheal intubation within 2.5-3.0 min, despite a light plane of anesthesia. Duration of action is intermediate. (+info)Comparison of the intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol. (8/306)
BACKGROUND: Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with some undesirable effects. Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation. METHODS: This prospective, randomized clinical trial involved 336 patients. Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was to accomplish tracheal intubation by 60 s after administration of the neuromuscular blocking drug. Endotracheal intubation was performed, and conditions were graded by a blinded investigator. Recovery of neuromuscular function was assessed by electromyography. RESULTS: Intubation conditions were evaluated in 236 patients. Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P < 0.05). The time (median and range) to the first recovery of the train-of-four response was 8.0 (2.8-20.0) min with rapacuronium and 5.7 (1.8-17.7) min with succinylcholine (P < 0.05). The overall incidence of adverse effects was similar with both drugs. CONCLUSIONS: A 1.5-mg/kg dose of rapacuronium effectively facilitates rapid tracheal intubation. It can be considered a valid alternative to 1.0 mg/kg succinylcholine for this purpose. (+info)
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Suxamethonium chloride
"Succinylcholine, A Perfect Poison, Makes Appearance in the Dubai Killing , Medgadget". Compendium.ch: LYSTHENON 2% Inj Lös 100 ... "Succinylcholine Chloride". The American Society of Health-System Pharmacists. Archived from the original on 21 December 2016. ... Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ (October 2015). "Rocuronium versus succinylcholine for rapid sequence ... Instead in 1949 an Italian group led by Daniel Bovet was first to describe succinylcholine induced paralysis. The clinical ...
James Edward Cottrell
Cottrell, JE; Hartung, JE; Giffin, JP; Shwiry, B (1983). "Intracranial and Hemodynamic Changes after Succinylcholine ... Cottrell, James E. (2018). "Succinylcholine and Intracranial Pressure". Anesthesiology. 129 (6): 1159-1162. doi:10.1097/ALN. ...
Neuromuscular-blocking drug
Succinylcholine may also trigger malignant hyperthermia in rare cases in patients who may be susceptible. In depolarizing the ... An example is succinylcholine. Depolarizing blocking agents work by depolarizing the plasma membrane of the muscle fiber, ... Just like acetylcholine, succinylcholine, decamethonium and other polymethylene chains, of the appropriate length and with two ... Keeping the distance in mind the structure of the chain can vary (double bonded, cyclohexyl, benzyl, etc.) Succinylcholine has ...
Atracurium besilate
It can also be used to help with endotracheal intubation but suxamethonium (succinylcholine) is generally preferred if this ... Bele-Binda N, Valeri F (Jan 1971). "A case of bronchospasm induced by succinylcholine". Canadian Anaesthetists' Society Journal ... Cardan E, Deacu E (Jan 1972). "Bronchospasm following succinyl choline". Anaesthesist. 21 (1): 27-29. PMID 4111555. Yeung ML, ... tubocurarine and succinylcholine, as well as alcuronium, pancuronium, vecuronium, and gallamine. Seizures rarely occur. Because ...
Lambert-Eaton myasthenic syndrome
... prolonged apnoea after administration of succinylcholine". Lancet. 265 (6799): 1291-3. doi:10.1016/S0140-6736(53)91358-0. PMID ...
Fasciculation
The depolarizing neuromuscular blocker succinylcholine causes fasciculations. It is a normal side effect of the drug's ... can be prevented with a small dose of a nondepolarizing neuromuscular blocker prior to the administration of succinylcholine, ...
Postoperative residual curarization
Succinylcholine is the only depolarizing NMBA available for clinical use. It produces a neuromuscular blockade that is the ... When a continuous infusion, repeated doses, or a large dose of succinylcholine (>4 mg/kg) is used, the risk of a Phase II block ... TOF fade is indicative of phase II block that is likely to occur in patients who received succinylcholine and may resemble ... Tran DT, Newton EK, Mount VA, Lee JS, Wells GA, Perry JJ (29 October 2015). "Rocuronium versus succinylcholine for rapid ...
Rocuronium bromide
Tran, DT; Newton, EK; Mount, VA; Lee, JS; Wells, GA; Perry, JJ (29 October 2015). "Rocuronium versus succinylcholine for rapid ... like succinylcholine. It was designed to be a weaker antagonist at the neuromuscular junction than pancuronium; hence its ...
Nicotinic antagonist
Succinylcholine is a nicotinic agonist. See neuromuscular blocking agents page for details on the mechanism of action. ...
Wouter Basson
... succinylcholine, and tubocurarine. In 2021, the revelation that he was working at a Western Cape Mediclinic facility caused ...
Neuromuscular blocking agents
Succinylcholine interacts with nicotinic receptor to open the channel and cause depolarization of the end plate, which later ... Later, since succinylcholine is not able to be metabolised and removed effectively at the synapse, the depolarized membranes ... Use of succinylcholine infusion or repeated bolus administration increase the risk of Phase II block and prolonged paralysis. ... Options include succinylcholine, rocuronium or vecuronium if sugammadex is available for rapid reversal block. Any short or ...
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Death"; killed six people with succinylcholine in the town of Dhom. Raman Raghav: known as "Psycho Raman"; Mumbai man who ...
Gerhard Werner
He was instrumental in introducing the neuropharmacological use of Succinylcholine. Werner became Chairman of the Pharmacology ...
Lethal injection
Other drugs in use are succinylcholine chloride and tubocurarine chloride. Pancuronium bromide is a derivative of the alkaloid ...
Rapid sequence induction
Succinylcholine - This drug has rapid onset of action and fast duration. Its dosages are between 1 and 2 mg/kg body weight with ... Repetitive dosages of succinylcholine are discouraged to prevent vagal stimulation which leads to bradycardia. There are many ... Vecuronium is only used when there is a shortage of drugs such as succinylcholine and rocuronium. Sugammadex - It is used as a ... The patient is given a sedative and paralytic agent, usually midazolam / succinylcholine / Propofol and intubation is quickly ...
Meriter Hospital
"Succinylcholine in the Critically Ill Patient: When Is It Not OK+?" (Chapter 5). In: Canaday, Bruce Robert. ASHP's Clinical ...
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The succinylcholine is delivered through a hypodermic needle disguised as a pen. Twisting the nib switches the tip from a ... To carry out the assassinations, the brothers are issued a weapon utilizing succinylcholine, developed by a Columbia University ...
Trismus
Succinyl choline, phenothiazines and tricyclic antidepressants causes trismus as a secondary effect. Trismus can be seen as an ...
Vecuronium bromide
It is also used to help with endotracheal intubation; however, suxamethonium (succinylcholine) is generally preferred if this ...
Acetylcholinesterase inhibitor
Anaesthesia: Cholinesterase inhibitors are likely to exaggerate succinylcholine-type muscle relaxation during anaesthesia. 5. ...
Clindamycin
... may prolong the effects of neuromuscular-blocking drugs, such as succinylcholine and vecuronium. Its similarity to ...
Flurothyl
Premedication with pentothal and succinylcholine chloride, as is customary in ECT, was tested and found safe. Four random ...
Paromomycin
... may have dangerous reactions when used with the paralytic succinylcholine by increasing its neuromuscular effects. ...
Cholinesterase
The decrease must be greater than 75% before significant prolongation of neuromuscular blockade occurs with succinylcholine. In ... a silent condition that manifests itself only when people that have the deficiency receive the muscle relaxants succinylcholine ...
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He was Ng Yui-kwong's friend and was later injected with succinylcholine by him, causing him to die from suffocation. Lam King- ... He was Louis' friend and injected succinylcholine in his body to kill him due to financial disputes. Mak ling-ling as Principal ...
Cyclophosphamide
... activity and may result in prolonged neuromuscular blockade when administered concurrently with succinylcholine. Tricyclic ...
Pseudocholinesterase deficiency
Drugs to avoid: Succinylcholine, also known as suxamethonium, which is commonly given to paralyse skeletal muscles as part of a ... In case of an atypical PCE or complete absence of PCE, the effect of the injected succinylcholine can last for up to 10 hours. ... Mivacurium, like succinylcholine, is a muscle relaxant and will have prolonged action in those with butyrylcholinesterase ... When succinylcholine is used for anesthesia, its high plasma concentration immediately after intravenous injection decreases ...
Pralidoxime
... succinylcholine, reserpine, and phenothiazine-type tranquilizers should be avoided in patients with organophosphate poisoning. ...
Hyperthermia
... or the paralytic agent succinylcholine. Those who have this reaction, which is potentially fatal, have a genetic predisposition ...
Optimal Dose of Succinylcholine for Rapid Sequence Induction
Succinylcholine remains one of the most commonly used neuromuscular blocking agents for rapid sequence induction, but its ... 7 with succinylcholine 0.3 mg kg− 1;. 2 with succinylcholine 0.4 mg kg− 1 ... Succinylcholine 1.5 mg kg− 1 does not produce more often excellent conditions compared with 1 mg kg− 1, while 2.0 mg kg− 1 does ... Conclusions: With succinylcholine regimens ≤0.5 mg kg− 1, excellent intubating conditions are less likely and apnoea times are ...
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Succinylcholine Unfortunately, shortages of succinylcholine persist due to problems stemming from the supply and quality of raw ... In such instances, it is possible that procedures may need to be deferred until succinylcholine is available. As always, the ... Succinylcholine is a first line drug for emergency intubation, treatment of refractory laryngospasm and certain very brief ... ASA Update on Succinylcholine and Other Drug Shortages The American Society of Anesthesiologists is acutely aware of the ...
Coronavirus Treatment: Indoco Remedies Gets Usfda Approval For Succinylcholine Chloride Injection
Stability of Succinylcholine Chloride Injection at Ambient Temperature and 4 Degree C in Polypropylene Syringes
Concentration levels of succinylcholine chloride injection were determined at 0, 1, 4, 7, 15, 30, 45, 60, and 90 days after ... The stability of 20-mg/mL succinylcholine chloride injection in 12-mL polypropylene syringes stored at ambient temperature and ... Succinylcholine Chloride 50-mg/mL Injection. Allen Loyd V Jr Jul/Aug 2013. 335. Buy. ... Room Temperature Stability of Injectable Succinylcholine Dichloride. Roy Julie J, Boismenu Daniel, Mamer Orval A, Nguyen Bao T ...
Succinylcholine induced masseter spasm during rapid sequence intubation may require a surgical airway: case report | Emergency...
succinylcholine. Succinylcholine has long been the neuromuscular blockade agent of choice for the emergency physician for rapid ... Succinylcholine is the neuromuscular blocking agent of choice in rapid sequence intubation due to its rapid onset of action and ... Succinylcholine: adverse effects and alternatives in emergency medicine. Am J Emerg Med1999;17:715-21. ... First and foremost, succinylcholine has many adverse effects that must be anticipated. Secondly, a patients external anatomy ...
Succinylcholine and Intracranial Pressure | Anesthesiology | American Society of Anesthesiologists
Succinylcholine and Intracranial Pressure James E. Cottrell, M.D. James E. Cottrell, M.D. ... We decided to give an injection of succinylcholine to buy the small amount of time needed give one last dose of nifedipine. To ... Subsequent to our finding in cats, Lanier et al.22,23 found convincing evidence that succinylcholine induces sufficient muscle ... Bolus injections of succinylcholine (1.5 mg/kg) significantly increased intracranial pressure (ICP) in cats under normal ...
Local Anesthetic Toxicity Medication: Anticonvulsants, Barbiturates, Anxiolytics, Benzodiazepines, Neuromuscular Blockers,...
An intrasubject comparison of two doses of succinylcholine in modified electroconvulsive therapy - Publications of the IAS...
We recommend 1 mg/kg of succinylcholine dose be used in the first ECT session. For subsequent sessions, the dose may be altered ... The electroconvulsive therapy (ECT) guideline of the Royal College of Psychiatrists recommends a 0.5 mg/kg of succinylcholine ... Implications: The dose of muscle relaxant (succinylcholine) recommended in modified electroconvulsive therapy is not based on ... An intrasubject comparison of two doses of succinylcholine in modified electroconvulsive therapy ...
Pseudocholinesterase deficiency: MedlinePlus Genetics
These fast-acting drugs, such as succinylcholine and mivacurium, are given to relax the muscles used for movement (skeletal ... Zelinski T, Coghlan G, Mauthe J, Triggs-Raine B. Molecular basis of succinylcholine sensitivity in a prairie Hutterite kindred ... Butyrylcholinesterase (BCHE) genotyping for post-succinylcholine apnea in an Australian population. Clin Chem. 2003 Aug;49(8): ... Two novel mutations in the BCHE gene in patients with prolonged duration of action of mivacurium or succinylcholine during ...
August 1966 - Volume 10 - Issue 4 : Survey of Anesthesiology
20180607-429C30 Succinylcholine 20mg per mL in 5mL Room Temp-signed1 - New England Life Care
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VENTRICULAR FIBRILLATION IN HYPOTHERMIC DOGS AS INFLUENCED BY THIOPENTAL PENTOBARBITAL AND SUCCINYLCHOLINE | Anesthesiology |...
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Simulated Succinylcholine Chloride- 20 mg/mL, 10 mL (10 vials/un [suxv] - $15.00 : PharmProps!, Medication Administration...
Sold in units of 10 vials PharmProps simulated succinylcholine chloride provides realistic training in a controlled ... but is labeled to simulate succinylcholine chloride. The marked concentration is 20 mg/mL. The vial contains 10 mL or 200 mg. ... Simulated Succinylcholine Chloride- 20 mg/mL, 10 mL (10 vials/un [suxv] - This vial contains only water, ... Simulated Succinylcholine Chloride- 20 mg/mL, 10 mL (10 vials/un. $15.00. This vial contains only water, but is labeled to ...
Ritedose Brings New Unit Dose Syringe Product to the Market: Succinylcholine Chloride Injection 100 mg/5 mL (20 mg/mL) - The...
Ritedose Brings New Unit Dose Syringe Product to the Market: Succinylcholine Chloride Injection 100 mg/5 mL (20 mg/mL). May 14 ... With extended dating of 120 days, the single-dose syringe of Succinylcholine Chloride Injection 100 mg/5 mL (20 mg/mL) can be ... This comes to market on the heels of a similar product from Ritedose - Succinylcholine Chloride Injection 200 mg/10 mL (20 mg/ ... Succinylcholine Chloride Injection 100 mg/5 mL (20 mg/mL). It is part of a 12-product, six-month rollout from Ritedose for ...
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Symptoms are also more severe with faster-onset hyponatremia. Mild hyponatremia (i.e., serum Na , 120 mEq/L) can be asymptomatic. Below this threshold, clinical signs are usually present, consisting mainly of changes in mental status, such as altered personality, lethargy, and confusion. For more severe hyponatremia (serum Na , 115 mEq/L), stupor, neuromuscular hyperexcitability, hyperreflexia, seizures, coma, and death can result. During treatment of hyponatremia, serum sodium should not be elevated by more than 10 to 12 meq/L in 24 hours or 18 meq/L in 48 hours. In the case of severe hyponatremia where severe neurologic symptoms are present, a faster infusion rate to correct serum sodium concentration may be needed. Patients rapidly treated or with serum sodium ,120mEq/L are more at risk of developing osmotic demyelination syndrome (previously called central pontine myelinolysis). Occurrence is more common among patients with alcoholism, undernutrition, or other chronic debilitating illness. ...
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Frontiers | Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in...
The action of succinylcholine is short in onset and is used during a rapid induction of anesthesia, which at a dose of 1 mg/kg ... A total of 150 mg of propofol and 50 mg of succinylcholine were used for general anesthesia. ECT was applied unilaterally on ... Bryson, E. O., Kellner, C. H., Li, E. H., Aloysi, A. S., and Majeske, M. (2018). Extreme variability in succinylcholine dose ... Anesthesia was induced with propofol 1-1.5 mg/kg body weight and combined 282 with the muscle relaxant succinylcholine 0.7-1.0 ...
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Indication-specific dosing for Chinese club moss, Huperzine Rx-Brain, HUP, HUP A, Memorall, selagine (huperzine A), frequency...
Internet Scientific Publications
ChlorideMasseter spasmNeuromuscular blockSpasmInjectionMuscle relaxantHalothaneIntubationRocuroniumRapid sequenceAirway managementDichlorideParalysisConcentrationAnesthesiaAbsenceDoseSyringesBlockadeInadequatePatientsMusclesSurgicalAdministrationDrugLevelsSummaryProduceExperienceConditionsProcedures
Chloride11
- Succinylcholine Chloride Injection, USP is a sterile, nonpyrogenic solution to be used as an ultra short-acting, depolarizing, skeletal muscle relaxant See HOW SUPPLIED for summary of content and characteristics of the solutions. (nih.gov)
- Succinylcholine Chloride, USP is chemically designated C 14 H 30 Cl 2 N 2 O 4 and its molecular weight is 361.31. (nih.gov)
- Indoco Remedies today said that it has got US FDA approval for its drug succinylcholine chloride (injection). (cnbctv18.com)
- The stability of 20-mg/mL succinylcholine chloride injection in 12-mL polypropylene syringes stored at ambient temperature and 4°C for up to 90 days was investigated. (ijpc.com)
- Concentration levels of succinylcholine chloride injection were determined at 0, 1, 4, 7, 15, 30, 45, 60, and 90 days after preparation of the syringes by means of a high-performance liquid chromatographic stability-indicating assay. (ijpc.com)
- The loss in potency was less than 10% after 45 days of storage at 25°C and less than 1% after 90 days of storage at 4°C. The pH of succinylcholine chloride injection did not change appreciably during the 90-day study period. (ijpc.com)
- This vial contains only water, but is labeled to simulate succinylcholine chloride. (pharmprops.com)
- simulated succinylcholine chloride provides realistic training in a controlled environment. (pharmprops.com)
- COLUMBIA, S.C. (May 14, 2021) - Ritedose, a 503B outsourcing facility located in South Carolina, just launched a new unit dose syringe product, Succinylcholine Chloride Injection 100 mg/5 mL (20 mg/mL). (ritedose.com)
- With extended dating of 120 days, the single-dose syringe of Succinylcholine Chloride Injection 100 mg/5 mL (20 mg/mL) can be stored at room temperature and is already diluted, labeled with cautionary statements, color-coded to ASTM drug class standards, and ready to be administered within OR and acute care settings. (ritedose.com)
- This comes to market on the heels of a similar product from Ritedose - Succinylcholine Chloride Injection 200 mg/10 mL (20 mg/mL), released in March. (ritedose.com)
Masseter spasm2
Neuromuscular block1
- The American Society of Anesthesiologists is acutely aware of the ongoing shortages of a number of anesthesia drugs, including the important neuromuscular blocking agent, succinylcholine. (asahq.org)
Spasm1
- Succinylcholine Induced Masseter Muscle Spasm during Rapid Sequence Induction in a Pregnant Patient with Kypho- Scoliosis: Case Report. (aimdrjournal.com)
Injection1
- Four minutes after succinylcholine injection, a severe bronchospasm was observed in the absence of any skin manifestation. (asahq.org)
Muscle relaxant4
- Succinylcholine is a depolarizing skeletal muscle relaxant. (nih.gov)
- Implications: The dose of muscle relaxant (succinylcholine) recommended in modified electroconvulsive therapy is not based on empirical research. (ias.ac.in)
- Succinylcholine (fast-acting muscle relaxant). (clevelandclinic.org)
- Succinylcholine (Sux) is a depolarizing skeletal muscle relaxant. (theprotectedairway.com)
Halothane1
- one or more of the following drugs: halothane, isoflurane , sevoflurane, desflurane or succinylcholine. (nih.gov)
Intubation4
- Succinylcholine is a first line drug for emergency intubation, treatment of refractory laryngospasm and certain very brief anesthetics requiring muscular paralysis such as electroconvulsive therapy. (asahq.org)
- Succinylcholine has long been the neuromuscular blockade agent of choice for the emergency physician for rapid sequence intubation because of its rapid onset and relatively brief duration of action. (bmj.com)
- Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. (unibas.ch)
- Concerns relate to the side effects of succinylcholine and to slower onset and inferior intubation conditions associated with rocuronium. (unibas.ch)
Rocuronium2
- So far, succinylcholine and rocuronium have not been compared in an adequately powered randomized trial in intensive care. (unibas.ch)
- Accordingly, the aim of the present study was to compare the incidence of hypoxemia after rocuronium or succinylcholine in critically ill patients requiring an emergent RSI. (unibas.ch)
Rapid sequence1
- The evidence base for the widely accepted standard regimen of succinylcholine for rapid sequence induction (1.0 mg kg − 1 ) remains unclear. (medscape.com)
Airway management1
- The Society for Ambulatory Anesthesia (SAMBA) position statement for the use of succinylcholine for emergency airway management is presented. (sambahq.org)
Dichloride1
- Succinylcholine is a diquaternary base consisting of the dichloride salt of the dicholine ester of succinic acid. (nih.gov)
Paralysis2
Concentration1
- Subsequent neuromuscular transmission is inhibited so long as adequate concentration of succinylcholine remains at the receptor site. (nih.gov)
Anesthesia2
Absence2
- In the absence of succinylcholine, anesthesiologists will need to exercise clinical judgment in determining which patients are particularly likely to require rapid onset, short duration muscle relaxation. (asahq.org)
- This statement argues that, in the absence of succinylcholine, the morbidity and mortality from laryngospasm can be significant, indeed, higher than the unlikely scenario of succinylcholine- triggered malignant hyperthermia. (sambahq.org)
Dose3
- Succinylcholine levels were reported to be below the detection limit of 2 µg/mL after 2.5 minutes of an IV bolus dose of 1 or 2 mg/kg in fourteen (14) anesthetized patients. (nih.gov)
- The extent of motor seizure modification was rated on a five-point scale by two independent raters who were blinded to the succinylcholine dose. (ias.ac.in)
- We recommend 1 mg/kg of succinylcholine dose be used in the first ECT session. (ias.ac.in)
Syringes1
- Another report was received describing similar complaints with the labeling of neostigmine 1 mg/mL injectable syringes and succinylcholine 20 mg/mL injectable syringes compounded by KRS Global Biotechnology, Inc., located in Boca Raton, Florida. (fda.gov)
Blockade1
- Garcia DF, Oliveira TG, Molfetta GA, Garcia LV, Ferreira CA, Marques AA, Silva WA Jr. Biochemical and genetic analysis of butyrylcholinesterase (BChE) in a family, due to prolonged neuromuscular blockade after the use of succinylcholine. (medlineplus.gov)
Inadequate1
- Therefore, when a healthy appearing infant or child develops cardiac arrest soon after administration of succinylcholine, not felt to be due to inadequate ventilation, oxygenation or anesthetic overdose, immediate treatment for hyperkalemia should be instituted. (nih.gov)
Patients4
- There have been rare reports of acute rhabdomyolysis with hyperkalemia followed by ventricular dysrhythmias, cardiac arrest and death after the administration of succinylcholine to apparently healthy pediatric patients who were subsequently found to have undiagnosed skeletal muscle myopathy, most frequently Duchenne's muscular dystrophy. (nih.gov)
- These results, when considered in conjunction with results previously obtained in humans, suggest that succinylcholine may be contraindicated in neurosurgical patients. (asahq.org)
- Gatke MR, Bundgaard JR, Viby-Mogensen J. Two novel mutations in the BCHE gene in patients with prolonged duration of action of mivacurium or succinylcholine during anaesthesia. (medlineplus.gov)
- Patients with burns, crush injuries, and myopathies are at high risk of developing hyperkalemia, which is aggravated by the administration of succinylcholine. (medscape.com)
Muscles2
- These fast-acting drugs, such as succinylcholine and mivacurium, are given to relax the muscles used for movement (skeletal muscles), including the muscles involved in breathing. (medlineplus.gov)
- ECT results in direct stimulation of the masseter, temporalis, and pterygoid muscles which is not attenuated by administration of succinylcholine. (scirp.org)
Surgical1
- Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. (bvsalud.org)
Administration1
- Intracranial and Hemodynamic Changes after Succinylcholine Administration in Cats. (asahq.org)
Drug1
- Unfortunately, shortages of succinylcholine persist due to problems stemming from the supply and quality of raw material needed to produce the product at Hospira, the largest manufacturer of the drug. (asahq.org)
Levels1
- Bolus injections of succinylcholine (1.5 mg/kg) significantly increased intracranial pressure (ICP) in cats under normal conditions from control levels of 8 +/- 1 mmHg to 16 +/- 3 mmHg (+/- SEM, P less than 0.01), and in the presence of artificially increased ICP from control levels of 27 +/- 1 mmHg to 47 +/- 4 mmHg ( P less than 0.01). (asahq.org)
Summary1
- PharmGKB summary: succinylcholine pathway, pharmacokinetics/pharmacodynamics. (cdc.gov)
Produce1
- Succinylcholine 1.5 mg kg − 1 does not produce more often excellent conditions compared with 1 mg kg − 1 , while 2.0 mg kg − 1 does, but the database with these regimens is weak and apnoea times remain unknown. (medscape.com)
Experience1
- Until full demand can be met, in December or later, it is likely that providers will continue to experience shortages of succinylcholine. (asahq.org)
Conditions2
- We performed a systematic review and meta-analysis of randomized trials comparing any succinylcholine regimen with the standard regimen (1.0 mg kg − 1 ) and reporting on intubating conditions and/or apnoea times. (medscape.com)
- With succinylcholine regimens ≤0.5 mg kg − 1 , excellent intubating conditions are less likely and apnoea times are shorter, compared with 1 mg kg − 1 . (medscape.com)
Procedures1
- In such instances, it is possible that procedures may need to be deferred until succinylcholine is available. (asahq.org)