Description and indication for use
Suxamethonium is an ultra short-acting
depolarising neuromuscular blocking agent.
Use to produce brief paralysis for endotracheal intubation or other
procedures requiring brief paralysis.
Dose
IV:
2 to 3 mg/kg/dose repeated when required.
IM:
4 mg/kg/dose repeated when required.
Reconstitution/Dilution
Ampoule = 50 mg/mL.
IV 1:
For Intubation pre-med dose please see neat
dosing guidelines in Medicines for
Intubation and Resuscitation Quick
Reference Guide page 121
[Appendix C].
IV 2:
Withdraw 0.2 mL of 50 mg/mL solution and
add to 0.8 mL of water for injection in a second 1 mL syringe = 10 mg/mL.
Discard excess volume to obtain required
dose or withdraw dose using another syringe.
IM:
No dilution of dose required.
Route and method of administration
IV:
Should be administered only with medical
staff present.
Given stat over 10 to 30 seconds, and flush
afterwards.
Side effects
Bradycardia.
Hyper/hypotension.
Prolonged respiratory depression.
Hyperthermia.
Hyperkalaemia.
Incompatibilities
Rapidly decomposes in alkaline solutions.
Suxamethonium must not be mixed together
with the following drugs:
Aminophylline, Barbiturates,
Chloramphenicol, Heparin Sodium (high concentration), Potassium Chloride.
Special precautions
CAUTION in patients with hyperkalaemia.
Patients with hypokalaemia or hypocalcaemia
require reduced doses of suxamethonium.
Drug interactions
|
Tobramycin, Amikacin, Gentamicin, beta-adrenergic
blockers.
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Drugs which may enhance or prolong the effects of
Suxamethonium.
|
|
Diazepam
|
May reduce the duration of neuromuscular blockage
produced by Suxamethonium.
|
|
Amphotericin B and Thiazide diuretics
|
May increase the effects of Suxamethonium
secondary to induced electrolyte imbalance.
|
|
Neostigmine
|
Can considerably prolong the depolarising action
of Suxamethonium.
|
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Pancuronium
|
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Nursing responsibilities
Intubation equipment available and ready.
Cardiorespiratory monitor.
Suction available.
Monitor BP.