Drug Interaction:
Interacting drugs- summary - succinyl choline
+ Succinylcholine:
Diazepan
diazepam reduce the duration of neuromucular blockade produced
by succinyl choline
Amphotericin B / Thiazide diuretics
increase effects of succinylcholine secondary to induced electrolyte
imbalance. Patients with hypocalcemia and hypokalema usually require
reduced succinylcholine doses.
Nondepolarizing muscle relaxants+
consider the possibility of a synergitic or antagonistic effect with
succinyl choline
Cyclophosphamide
(decrease plasma pseudocholinesterae) or IV procaine ( competes
for the enzyme ) prolong the effects of succinylcholine
Digitalis glycosides
succinylcholine cause a sudden extrusion of potassium from
muscle cells , possibly causing arrhythmias in digitalized patients
Toxicity ( cardiac arrhthmias ) of both drugs increased
Inhaltions anesthetics( cyclopropane,diethyl ether, halothane, nitrous oxide
coadmin. with succinylcholine increase incidence of bradycardia,
arrhyhtmias,sinus arrest, and apnea, as well as occurrence of
malignant hyperthermia in suseptible individuals
Narcotic analgesics
increase the incidence of bradycardia and sinus arrest
Adverse Reaction:
As with other neuromuscular blockers, the potential for releasing histamine is present following succinylcholine use.
serious histamine- medicated flushing, hypotension and bronchospasm are however uncommon in normal clinical usage.
Adverse reactions consist primarily as an extension of the drugs pharmaxcological action. Profound and prolonged
muscle relaxation may occur, resulting in respiratory depression to the point of apnea. Hyperactivirty and anaphlactic
reactions have been reported rarely.
Cardiovascular: Bradycardia, (frequently noted after a second IV injection) of a 2% solution in children)tachycardia, hypertension, hypotension, cardiac arrest, arrhythmia, rash, myoglobinemia, myoglobinuria.
Respiratory : Respiratory depression or apnea
Miscellaneous: Malignant hyperthermia, increased intraocular pressure, muscle fasciculation, postoperative muscle pain, excessive salivation, hyperkalemia, rash, myobolbinemia, myobloinuria.
Contra-Indications:
Genetic disorders of plasma,pseudocholinesterase, personal/family H/O malignant
hyperthermia, myopathies with elevated CPK.
Special precautions:
Use with caution in cardiovascular, hepatic, pulmonary, metabolic or renal disorders.
Myoblobinemia.myoglobinuria have associated with single oe repeated IV and IM injections, especially inchildren.
Repiratory depression or prolonged apnea may occur if given in amounts greater than recommended.
Nondepolarizing blockade- During repeated or prolonged administration of succinyl chloine the characyerstic Phase I block may convert to a phase II block. Prolonged respiratory depression or apnea may be observed in patients
manifesting this transition.
Eye surgery- Succinyl choline causes a slight transcient increase in intraocular pressure immediately after its injection and fasciculation phase, slight increase may persist after onset of complete paralysis. Do not use the drug when open eye injury is present and use with caution.
Patients with fracture or muscle spasm- require caution since the muscle fasciculation may cause additional trauma.
Dosages/ Overdosage Etc:
Indications:
Adjunct to general anesthesia
Dosage:
Individualise dose. Usually administered IV,may be given IM to infants, older children or adults when a suitable vein is inaccessible.
Give a dose upto 2.5 mg/kg. Do not exceed 150 mg total dose.. Storage: Refrigerate at 2 to 8C. Multidose vials are stable for upto 14 days at room temp without loss of potency.
Manufacturer Details