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Succinylcholine

A short acting depolarizing agent.

Works as a acetylcholine receptor agonist.

Initially the drug binds to the acetylcholine receptors and initiates depolarization of the motor endplate, over time the bound drug causes conformational changes in the neuromuscular junction.

Works within 30 seconds and lasts for 10 minutes.

Its quick onset, enables optimal intubation conditions to be obtained in less than a minute after intravenous administration.

Pseudocholinesterase metabolizes the drug before the drug reaches the site of action.

Used for depolarization in the U.S. and used for inducing muscle paralysis for intubation and surgery.

Side effects include negative chronotropic and inotropic effects at low dose.

Succinylcholine a muscle relaxant with rapid onset and short duration of action but this drug has important contraindications; it can trigger malignant hyperthermia in susceptible individuals, it has a prolonged duration of action in patients with pseudocholinesterase deficiency and it causes an increase in plasma potassium concentration which is dangerous in some circumstances. 

High dose effects are positive chronotropic and inotropic effects and raises cholamine levels.

Associated with myalgias, fasciculations, hyperkalemia and malignant hyperthermia.

Is the principal paralytic agent recommended for facilitating tracheal intubation in patients needing out of hospital tracheal intubation.

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