Index of drugs

Short-term muscle relaxation required for endotracheal intubation during short surgical procedures. As an aid to the treatment of convulsions caused by electroconvulsive therapy or overdosing of certain medications.

One vial contains 200 mg of suxamethonium chloride.

Depolarizing skeletal muscle relaxant with very short duration of action. The total neuromuscular block is usually preceded by short-lasting fasciculatory tremor, especially in the face, neck and extremities, which disappear after a few seconds and then muscle relaxation occurs. After intravenous administration, the effect of the drug starts after about 30 seconds and lasts for about 5 minutes. T_0,5 is: in adults - approx. 4.3 minutes, in children - 1.8 minutes, in infants - 1.7 minutes. The drug is broken down by plasma pseudocholinoesterases to choline and succinylcholine. Then, under the influence of hepatic esterase, suxamethonium is broken down into choline and succinic acid; however, this hydrolysis occurs slower and takes place over a period of 6-7 times longer than the first hydrolysis. Only 2% of suxamethonium chloride is excreted in the urine.

Hypersensitivity to suxamethonium chloride. Myasthenia gravis. Myopathy (with increased creatine kinase activity). Malignant hyperthermia (also in family history). Severe liver or kidney disease. Intracranial hypertension. Open eyeball injuries. Extensive tissue damage (in severe burns and major injuries). Hyperkalemia. Genetically determined decreased plasma cholinesterase activity.

Do not use in patients whose blood potassium elevation can reach life-threatening values, e.g. severely burned patients (especially during 2-6 weeks after burns), after severe injuries, paraplegia, spinal cord injury and damage muscles. In patients with neurological injury accompanied by flaccidity of large muscles (upper and lower motor neuron disease), the tendency to increase the concentration of potassium occurs in the first 6 months after the sudden onset of neurological disorders and is associated with the degree and extent of muscle paralysis. Patients who need immobilization are at risk. Prolonged and increased neuromuscular blockade may occur in the following conditions associated with a decrease in cholinesterase activity: physiological change during pregnancy and puerperium, genetically determined cholinesterase impairment, severe generalized tetanus, tuberculosis, other severe chronic infections, severe burns, disease with emaciation, cancer, chronic anemia and malnutrition, terminal liver failure, acute or chronic kidney failure, autoimmune diseases, myxedema, collagenosis, iatrogenic effects such as plasma exchange, plasmophoreza, extracorporeal circulation and concomitant use of other drugs, as well as in professional exposed to esterase inhibitors (e.g., those in contact with organophosphorus insecticides). The preparation should be used particularly carefully in people with elevated or low body temperature. Premedication with intravenous administration of atropine significantly reduces the risk of bradycardia caused by the administration of suxamethonium chloride. If malignant hyperthermia develops during treatment, the administration of all anesthetics (also suxamethonium) should be discontinued and all possible measures taken immediately; recommended first-line treatment consists of as soon as possible intravenous infusion of dantrolone sodium.

During pregnancy, use only if the benefit for the mother outweighs the potential risk to the fetus. When considering the use of suxamethonium for muscle relaxation during labor, the possibility of transferring the drug to the fetus and occurring in the newborn apnea should be considered; this effect may occur after use in the nascent drug at a dose of> 1 mg / kg. There are no contraindications to the use of suxamethonium during breastfeeding.

There may be: sudden decreases in blood pressure and bradycardia (especially in children and after administration of high or repeated doses of the drug), hyperkalemia, short-term increase in intraocular pressure, bronchospasm, increased salivation, rash, anaphylactic reactions. Repetition of high-dose injections may result in phase II block, usually accompanied by short-lasting fasciculations, especially in the face, neck and extremities. Direct after administration of the drug, generalized skeletal muscle tone may occur, which may cause malignant hyperthermia. Repetition of tachyphylaxis may occur after too frequent dosing.

Intravenously. The medicine is intended for closed-circuit treatment and may only be used by qualified medical personnel if equipment enabling the use of controlled breaths is available. Individual dosage (depending on the type of surgery, patient's sensitivity, sensitivity to the drug). It is recommended to perform the test to determine the individual sensitivity to the drug, the rate of occurrence and its duration. For this purpose, 10 mg of the preparation is administered intravenously.Adults. In short surgical procedures - intravenously, usually 40 mg, the optimal dose can be 20-80 mg (0.5-1.5 mg / kg). Muscle relaxations take place in about 1 min, maximum sagging is usually maintained for about 2 min, returning to the state before the drug takes place after 8-10 min. In longer surgical procedures - intravenously or in a drip infusion: 0.1-0.5 mg and even 1 mg / kg. The usual dose is a continuous IV infusion of 2.5-4 mg / min. The total dose given in both repeated injections and infusion should not exceed 500 mg / h.Children: 1-2 mg / kg In older children, a lower dose is recommended. Newborns and infants: 2-3 mg / kg The total dose used in pediatrics may not exceed 150 mg.
The powder should be dissolved in water for injections or in isotonic NaCl solution for injection prior to administration. A 2% solution is used for intravenous injections. For drip infusion, 0.1% or 0.2% solution is used. The reconstituted solution should not be mixed with thiopental in the same syringe.