Suxamethonium Chloride

Generic Details

Generic Name

Suxamethonium Chloride

Other Names

  • Succinylcholine

Drug Class

  • Neuromuscular blocking agent

Chemical Formula

C14H30Cl2N2O4

Molecular Weight

342.3 g/mol

Mechanism of Action

  • Depolarizing neuromuscular blocker, acts as an agonist at the nicotinic acetylcholine receptor causing sustained depolarization of the motor end plate.

Indications

  • Muscle relaxation during anesthesia, facilitation of tracheal intubation, short surgical procedures, electroconvulsive therapy.

Common Dosage Forms

  • Injection

Typical Dosage

  • 1-1.5 mg/kg IV for adults

Pediatric Dosage

  • 1-2 mg/kg IV for children

Geriatric Dosage

  • Reduced dose may be necessary due to decreased plasma cholinesterase levels.

Side Effects

  • Bradycardia, hyperkalemia, malignant hyperthermia, muscle pain, fasciculations, increased intraocular pressure, transient ocular changes, postoperative myalgia.

Contraindications

  • Known hypersensitivity to suxamethonium chloride, personal or family history of malignant hyperthermia, extensive muscle damage or denervation, severe burns or trauma.

Pregnancy Category

  • C - Use with caution if benefits outweigh risks.

Lactation Safety

  • Unknown if excreted in breast milk, use caution.

Drug Interactions

  • Lithium may increase the risk of hyperkalemia, use with caution.

Overdose Symptoms

  • Prolonged neuromuscular blockade, respiratory depression, apnea.

Antidote for Overdose

  • Cholinesterase inhibitors such as neostigmine, and mechanical ventilation if needed.

Storage Conditions

  • Store at controlled room temperature (20-25°C), protect from light and moisture.

Pharmacokinetics

  • Absorption: Rapidly absorbed after IV administration
  • Distribution: Distributed mainly in extracellular fluid
  • Metabolism: Metabolized by plasma cholinesterase
  • Excretion: Excreted unchanged in the urine

Precautions

  • Use with caution in patients with electrolyte disturbances, neuromuscular disorders, liver or kidney disease.

Warnings

  • Malignant hyperthermia can occur, monitor for signs and symptoms, availability of dantrolene is recommended.