Succinylcholine (Anectine®, Quelicin®)

Succinylcholine is a nicotinic cholinergic receptor agonist used as a paralytic in emergency procedures and surgery.  It binds to and activates postsynaptic nAChR at the neuromuscular junction, which depolarizes muscle end plates.  Since succinylcholine is more resistant than acetylcholine to synaptic acetylcholinesterase degradation, the drug maintains a depolarized neuromuscular block for the duration of its effect.

Succinylcholine manifests a rapid onset and short duration of action.  In patients with previously undiagnosed genetic myopathies (e.g., Duchenne muscular dystrophy), administration of the drug can cause a severe reaction marked by rhabdomyolysis and hyperkalemia.  Other serious adverse reactions include anaphylaxis and malignant hyperthermia.




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