Pregnancy Classes

• Acts similar to acetylcholine, produces depolarization of the motor endplate at the myoneural junction which causes sustained flaccid skeletal muscle paralysis produced by state of accommodation that develops in adjacent excitable muscle membranes

• Neuromuscular blockade for endotracheal intubation or mechanical ventilation

• Hypersensitivity to succinylcholine or any component of the formulation
• Known or suspected genetic susceptibility to malignant hyperthermia
• Skeletal muscle myopathies
• Use after the acute phase of injury following major burns, multiple trauma, extensive denervation of skeletal muscle, or upper motor neuron injury

Adult

IV: 1 to 1.5 mg/kg

Pediatric

Infants ≤ 6 months: IV: 2 to 3 mg/kg/dose

Infants > 6 months: IV: 1 to 2 mg/kg/dose

Children: IV: 1 to 2 mg/kg/dose

Adolescents: IV: 1 to 1.5 mg/kg/dose

Neonates and Infants: ~30 seconds

Children and Adolescents: 35 to 55 seconds

Adults: Flaccid paralysis: <60 seconds

~4 to 10 minutes; Faster recovery rate in infants and children compared to adults

• Burn injury: Use with caution in patients with extensive or severe burns; risk of hyperkalemia is increased following injury.
• Hyperkalemia: Use with extreme caution in patients with preexisting hyperkalemia. Potentially severe hyperkalemia may develop in patients with chronic abdominal infections, burn injuries, multiple trauma/crush injuries, extensive denervation of skeletal muscle, upper motor neuron injury, subarachnoid hemorrhage, or conditions which cause degeneration of the central and peripheral nervous system.
• Fractures/muscle spasm: Use with caution in patients with fractures or muscle spasm; initial muscle fasciculations may cause additional trauma
• Experienced personnel: Should be administered by adequately trained individuals familiar with its use.

• Cardiovascular
  • Peaked T waves on ECG, asystole, bradycardia (higher with second dose; more frequent in children), cardiac arrhythmia, hypertension, hypotension, tachycardia, ventricular arrhythmia
• Dermatologic
  • Skin rash
• Endocrine & metabolic
  • Hyperkalemia
• Gastrointestinal
  • Sialorrhea
• Nervous system
  • Malignant hyperthermia
• Neuromuscular & skeletal
  • Fasciculations, jaw tightness, rhabdomyolysis
• Ophthalmic
  • Increased intraocular pressure
• Respiratory
  • Apnea, respiratory depression
• Miscellaneous
  • Tachyphylaxis