Succinylcholine

What is Succinylcholine

Succinylcholine is a parenteral, short-acting, depolarizing neuromuscular blocking agent (NMBA) indicated as an adjunct to general anesthesia to facilitate tracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Succinylcholine has the fastest onset time of any NMBA, typically allowing intubation within 60 seconds. In addition to its rapid onset and short duration, advantages of succinylcholine include its organ-independent metabolism and ability to be administered intramuscularly in patients without venous access.

Succinylcholine induces histamine release and vagal stimulation. Bradycardia is more common in infants and children compared to adults; repeated dosing also increases the risk of bradycardia.

Succinylcholine-induced muscle contraction and fasciculation can cause sudden, large releases of potassium, which may induce cardiac dysrhythmias. 

Brand Names

Anectine

Quelicin

Indications & Dosage

  • electroconvulsive therapy (ECT)
  • endotracheal intubation
  • neuromuscular blockade during surgery
  • rapid-sequence intubation

Side Effects

  1. acute quadriplegic myopathy syndrome
  2. anaphylactoid reactions
  3. angioedema
  4. anxiety
  5. apnea
  6. asystole
  7. bradycardia
  8. bronchospasm
  9. cardiac arrest
  10. conjunctivitis
  11. dyspnea
  12. erythema
  13. flushing
  14. hyperkalemia
  15. hypersalivation
  16. hypertension
  17. hypotension
  18. hypoxia
  19. increased intracranial pressure
  20. keratitis
  21. malignant hyperthermia
  22. muscle paralysis
  23. myalgia
  24. myoglobinuria
  25. myopathy
  26. ocular hypertension
  27. pruritus
  28. rash
  29. renal failure (unspecified)
  30. respiratory depression
  31. rhabdomyolysis
  32. sinus tachycardia
  33. skin erosion
  34. skin ulcer
  35. thrombosis
  36. tolerance
  37. urticaria
  38. weakness
  39. wheezing
  40. xerophthalmia

Monitoring Parameters

  • arterial blood gases (ABGs)
  • serum electrolytes
  • serum magnesium

Contraindications

  • accidental exposure
  • acid/base imbalance
  • adrenal insufficiency
  • anemia
  • asthma
  • bone fractures
  • breast-feeding
  • burns
  • cardiac disease
  • children
  • cholinesterase inhibitor toxicity
  • chronic lung disease (CLD)
  • chronic obstructive pulmonary disease (COPD)
  • corticosteroid therapy
  • dehydration
  • digitalis toxicity
  • electrolyte imbalance
  • glaucoma
  • Guillain-Barre syndrome
  • hepatic disease
  • hypercalcemia
  • hyperkalemia
  • hypermagnesemia
  • hypocalcemia
  • hypokalemia
  • hypothermia
  • infants
  • infection
  • labor
  • malignant hyperthermia
  • metabolic acidosis
  • metabolic alkalosis
  • myasthenia gravis
  • myopathy
  • myxedema
  • neonates
  • neuromuscular blocking agent hypersensitivity
  • neuromuscular disease
  • obesity
  • obstetric delivery
  • ocular trauma
  • peptic ulcer disease
  • pregnancy
  • pseudocholinesterase deficiency
  • pulmonary disease
  • renal disease
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory acidosis
  • respiratory alkalosis
  • rhabdomyolysis
  • trauma

Interactions

  • Acebutolol
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Acetazolamide
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Amide local anesthetics
  • Aminoglycosides
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Apomorphine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atracurium
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Bacitracin
  • Belladonna; Opium
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Benzonatate
  • Beta-blockers
  • Betaxolol
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Botulinum Toxins
  • Brimonidine; Timolol
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Calcium
  • Calcium Acetate
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Calcium Chloride
  • Calcium Gluconate
  • Calcium-channel blockers
  • Calcium; Vitamin D
  • Capreomycin
  • Carbamazepine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbonic anhydrase inhibitors
  • Carteolol
  • Carvedilol
  • Chloroquine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chromium
  • Cisatracurium
  • Clevidipine
  • Clozapine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Colistimethate, Colistin, Polymyxin E
  • Corticosteroids
  • Cyclophosphamide
  • Cyclosporine
  • Demeclocycline
  • Desflurane
  • Dexpanthenol
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Digoxin
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Donepezil
  • Donepezil; Memantine
  • Dorzolamide; Timolol
  • Doxycycline
  • Enalapril; Felodipine
  • Enflurane
  • Esmolol
  • Ester local anesthetics
  • Felodipine
  • Fentanyl
  • Fosphenytoin
  • Galantamine
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Hetastarch; Dextrose; Electrolytes
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Indapamide
  • Irinotecan
  • Irinotecan Liposomal
  • Isoflurane
  • Isradipine
  • Labetalol
  • Levobetaxolol
  • Levobunolol
  • Levomethadyl
  • Levorphanol
  • Lincosamides
  • Lithium
  • Loop diuretics
  • Magnesium
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Methadone
  • Methazolamide
  • Methohexital
  • Metoclopramide
  • Metoprolol
  • Minocycline
  • Mivacurium
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nadolol
  • Nalbuphine
  • Nebivolol
  • Nebivolol; Valsartan
  • Neostigmine
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Omadacycline
  • Oral Contraceptives
  • Oxycodone
  • Oxymorphone
  • Oxytocin
  • Pancuronium
  • Penbutolol
  • Perindopril; Amlodipine
  • Phenelzine
  • Phenylephrine; Promethazine
  • Phenytoin
  • Physostigmine
  • Pindolol
  • Polymyxin B
  • Polymyxins
  • Procainamide
  • Promethazine
  • Propoxyphene
  • Propranolol
  • Pyridostigmine
  • Quinidine
  • Quinine
  • Remifentanil
  • Rivastigmine
  • Rocuronium
  • Sarecycline
  • Sedating H1-blockers
  • Sevoflurane
  • Skeletal Muscle Relaxants
  • Sotalol
  • Sufentanil
  • Tapentadol
  • Terbutaline
  • Tetracycline
  • Tetracyclines
  • Thalidomide
  • Theophylline, Aminophylline
  • Thiazide diuretics
  • Thiopental
  • Timolol
  • Trandolapril; Verapamil
  • Vancomycin
  • Vecuronium
  • Verapamil
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top