Succinylcholine Flashcards Preview

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Flashcards in Succinylcholine Deck (15):
1

What is the drug class of Succ?

the only depolarizing neuromuscular blocker that is used clinically

2

What is the MOA of Succ?

attaches to one or both of the alpha subunits of the nicotinic, Ach receptors, and mimics the action of Ach (partial agonist). It depolarizes the post-junctional membrane causing a brief pd of excitation (fasciculations in muscle cells), followed by flaccid paralysis. The paralysis occurs b/c the open cholinergic channels maintain the cell membrane in a depolarized state effecting the inactivation of VG-Na channels so that they cannot open to support further action potentials

3

How is succ metabolized and eliminated?

-metabolized rapidly by hydrolysis via plasma cholinesterases (pseudo-cholinesterases), an enzyme synthesized by the liver. It is not present in significant amounts at the NMJ

4

How are the effects of Succ terminated?

by diffusion away from the NMJ (redistribution) and into the ECF

5

What is the Vd of Succ?

similar to ECF 200ml/Kg

6

What are the side effects of Succ?

-Cardiac Dysrhythmias (sinus BRADY, junctional, sinus arrest) due to mimicking of Ach at cardiac muscarinic receptors and hyperkalemia
-Hyperkalemia!!! avg increase of 0.5-1 meq/L (increased risk with burns, trauma, NM disease, Muscular dystrophy, prolonged immobility)
-Masseter spasms
-Increased IOP, ICP, IGP
-Malignant Hyperthermia!!!
-Histamine release
-Myalgia
-Myoglobinuria

7

What are the contraindications to the use of Succ?

-Hyperkalemia
-3rd degree burns
-Severe muscular disorders
-Stroke (CVA)
-Neurologic injury (quads/paraplegic)
-muscle wasting
-MH
-Children under 8

8

What are the common drug interactions with Succ?

-anticholinesterases increase relaxation and prolong effects of succ
-anticonvulsants may increase hyperkalemia and prolong Succ
-Lithium prolongs succ

9

What is the intubating dose of Succ?

1-1.5 mg/kg IV

10

What is the onset of succ?

30-60 secs

11

What is the E 1/2 t of succ?

2-4 minutes

12

What is the DOA of succ?

4-8 mins (8-15 min)

13

What is the Laryngospasm dose of succ?

20-40 mg IV

14

What is the cont. infusion dose of succ?

2-4mg/min (dilute 1-2mg/ml)

15

Who do you want to avoid giving succ to? Why?

Peds:
-contraindicated in routine managemnt due to SE
-must give with Atropine 0.02mg/kg
-MH trigger
-may result in malignant ventricular arrhythmias and cardiac arrest 2dary to acute rhabdomyolysis with hyperkalemia
-can result in profound bradycardia and asystole!!!!