Succinylcholine 

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GENERIC NAME: SUCCINYLCHOLINE

Brand Name:

CLASS: Ultra-short-acting depolarizing-type skeletal muscle relaxant

Mechanism of Action:

Combines with cholinergic receptors of the motor end plate to produce depolarization Hydrolyzed by acetylcholinesterase

Indications and Field Use:

Endotracheal intubation requiring paralysis (RSI) by a qualified EMT-P with authorization from the EMT-P’s administrative medical director

Contraindications:

Muscle disorders Personal or family history of malignant hyperthermia History of hyperkalemia Burn injured patients* Ocular injuries Patients in whom successful endotracheal intubation is doubtful

Adverse Reactions:

Vagal stimulation leading to bradycardia or asystole Hyperkalemia Rhabdomyolysis Hypersalivation

Elevated intraocular pressure Release of histamine

NOTES ON ADMINISTRATION

Incompatibilities/Drug Interactions: Beta-blockers, procainamide, lithium, and quinidine prolong the effects.

Adult Dosage:

1.5 mg/kg IV push, may repeat in 2-3 minutes to achieve paralysis

Route of Administration:

IV

Onset of Action:

<1 minute

Duration of Action:

Muscle paralysis lasting 4-6 minutes

Dosage Forms/Packaging:

200 mg/10 mL vials

Recommended Arizona Drug Box Minimum Supply:

400 mg

Special Notes:

*Succinylcholine should not be given to patients for the period from 24 hours to 21 days after significant burns or crush injury due to elevated potassium levels and potential for cardiac dysrhythmias. 

© Matt Dillard 2012