Succinylcholine: Difference between revisions
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==Contraindications==
== Contraindications ==
 
#Known hyperK (current)
 
#Massive burns >10% BSA (>4dys-healed)
1)  Known hyperK   (current)
#Massive crush injuries (>4dys-healed)
 
#Denervation^ (>4dys-6mo)
2)  Massive burns >10% BSA   (>4dys-healed)
#Neuromuscular dz^^ (indefinite)
 
#Intra-abdominal sepsis (>5dys-resolution)
3)  Massive crush injuries   (>4dys-healed)
#Increased ICP (may use w/ defacic dose)
 
4)  Denervation*        (>4dys-6mo)
 
5)  Neuromuscular dz**    (indefinite)
 
6)  Intra-abdominal sepsis   (>5dys-resolution)
 
7)  Increased ICP (may use w/ defacic dose)


(From-To)
(From-To)
^CVA (in particular those with residual deficits), spinal cord injury


*CVA (in particular those with residual deficits), spinal cord injury
^^ALS, MS, skeletal muscle myopathies, cholinesterase def, h/o malignant hyperthermia
 
**ALS, MS, skeletal muscle myopathies, cholinesterase def, h/o malignant hyperthermia
 
-no evidence to support contraindication in penetrating eye injuries-
 
 
N.B. Myasthenia Gravis- theoretically need more succ to induce vs nondepolarizing agents which have a prolonged effect.
 
This is 2/2 to lack of post-synaptic receptors, i.e. succ cannot potentiate a reaction 2/2 too few receptors.


Vs. it takes few "molecules" of roc/vec to block the few remaining functioning receptors.
*No evidence to support contraindication in penetrating eye injuries
*N.B. Myasthenia Gravis- theoretically need more succ to induce vs nondepolarizing agents which have a prolonged effect.
*This is 2/2 to lack of post-synaptic receptors, i.e. succ cannot potentiate a reaction 2/2 too few receptors.
*Vs. it takes few "molecules" of roc/vec to block the few remaining functioning receptors.
*Overall, most practitioners tend to avoid succ in all patients with possible neuromuscular disease.


Overall, most practitioners tend to avoid succ in all patients with possible neuromuscular disease.
== Source ==


2/06 DONALDSON (Adapted from Rosen)


==Source ==
Levitan, R. Annals of EM. Vol 45, Issue 2. Safety of succinylcholine in myasthenia gravis.
2/06  DONALDSON (Adapted from Rosen)


Levitan, R. Annals of EM. Vol 45, Issue 2. Safety of succinylcholine in myasthenia gravis.
[[Category:Drugs]]
[[Category:Drugs]]
[[Category:Airway/Resus]]
[[Category:Airway/Resus]]

Revision as of 04:49, 13 March 2011

Contraindications

  1. Known hyperK (current)
  2. Massive burns >10% BSA (>4dys-healed)
  3. Massive crush injuries (>4dys-healed)
  4. Denervation^ (>4dys-6mo)
  5. Neuromuscular dz^^ (indefinite)
  6. Intra-abdominal sepsis (>5dys-resolution)
  7. Increased ICP (may use w/ defacic dose)

(From-To) ^CVA (in particular those with residual deficits), spinal cord injury

^^ALS, MS, skeletal muscle myopathies, cholinesterase def, h/o malignant hyperthermia

  • No evidence to support contraindication in penetrating eye injuries
  • N.B. Myasthenia Gravis- theoretically need more succ to induce vs nondepolarizing agents which have a prolonged effect.
  • This is 2/2 to lack of post-synaptic receptors, i.e. succ cannot potentiate a reaction 2/2 too few receptors.
  • Vs. it takes few "molecules" of roc/vec to block the few remaining functioning receptors.
  • Overall, most practitioners tend to avoid succ in all patients with possible neuromuscular disease.

Source

2/06 DONALDSON (Adapted from Rosen)

Levitan, R. Annals of EM. Vol 45, Issue 2. Safety of succinylcholine in myasthenia gravis.

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