Succinylcholine Chloride

What it is and how it works

Mechanism of Action Succinylcholine is a depolarizing neuromuscular blocker. As does acetylcholine, it combines with the cholinergic receptors of the motor end plate to produce depolarization. This depolarization may be observed as fasciculations. Subsequent neuromuscular transmission is inhibited so long as adequate concentration of succinylcholine remains at the receptor site. Onset of flaccid paralysis is rapid (less than one minute after intravenous administration), and with single administration lasts approximately 4 to 6 minutes. The paralysis following administration of succinylcholine is progressive, with differing sensitivities of different muscles.

Indications

Succinylcholine Chloride Injection is indicated in adults and pediatric patients: • as an adjunct to general anesthesia • to facilitate tracheal intubation • to provide skeletal muscle relaxation during surgery or mechanical ventilation. Succinylcholine Chloride Injection is a depolarizing neuromuscular blocker indicated in adults and pediatric patients: • as an adjunct to general anesthesia • to facilitate tracheal intubation • to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Dosage and administration (summary)

• For intravenous or intramuscular use only. • Individualize dosage after careful assessment of the patient. • Accidental administration of neuromuscular blocking agents may be fatal. Store succinylcholine chloride injection with the cap and ferrule intact and in a manner that minimizes the possibility of selecting the wrong product. • See full prescribing information for succinylcholine chloride injection dosage recommendations, preparation instructions, and administration information. ( 2.2 , 2.3 , 2.4 , 2.5 , 2.6 ) Important Dosage and Administration Information • Succinylcholine chloride injection is for intravenous or intramuscular use only.

Contraindications

Succinylcholine chloride injection is contraindicated: • in patients with skeletal muscle myopathies • in patients with known hypersensitivity to succinylcholine. Severe anaphylactic reactions to succinylcholine have been reported • after the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury, which may result in severe hyperkalemia and cardiac arrest • in patients with known or suspected genetic susceptibility to …

Warnings and precautions

• Anaphylaxis : Severe anaphylactic reactions to neuromuscular blocking agents, including succinylcholine, have been reported. Some cases have been life-threatening and fatal. Take necessary precautions, such as the immediate availability of appropriate emergency treatment. • Risk of Death due to Medication Errors : Unintended administration of succinylcholine chloride may result in paralysis, respiratory arrest and death. Confirm proper selection of intended product and avoid confusion with other injectable solutions that are present in critical care and other clinical settings.

Pregnancy

Pregnancy Risk Summary Available data from published literature from case reports and case series over decades of use with succinylcholine during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.

Storage and supply

Succinylcholine Chloride Injection, USP is supplied as a clear, colorless solution in the following concentration and package: NDC Succinylcholine Chloride Injection, USP (20 mg/mL) Package Factor 68083-450-25 200 mg/10 mL in a Multiple-Dose Fliptop Vial 25 Vials per Carton Refrigeration of undiluted Succinylcholine Chloride Injection, USP will ass…

Source: Succinylcholine Chloride (Succinylcholine Chloride) — US FDA prescribing information, 2022-11-23, DailyMed. Summarised and shortened; the full label governs. Iranian registration, indications and labelling may differ.