Suxamethonium Cl Martindale

Suxamethonium Cl Martindale





International Med
Concise Prescribing Info
Suxamethonium Cl
Muscle relaxant to facilitate endotracheal intubation, mechanical ventilation & a wide range of surgical & obstetrics procedures. Reduction of intensity of muscular contractions associated w/ pharmacologically or electrically-induced convulsions.
Dosage/Direction for Use
Adult & childn >12 yr Individualised dosage, usually by bolus inj. Max total dose (by repeated IV inj or continuous infusion): 500 mg/hr. Endotracheal intubation 1 mg/kg IV. Maintenance of muscle relaxation during short surgical procedures performed under general anaesth Supplementary doses of 50-100% of the initial dose administered at 5-10 min interval. Prolonged surgical procedures May be given by IV infusion as 0.1-0.2% soln at a rate of 2.5-4 mg/min. Childn 1-<12 yr 1-2 mg/kg IV. May be given IM to childn at doses of up to 4 mg/kg. Max total dose: 150 mg. Infant <1 yr 2 mg/kg IV. May be given IM to infant at doses of up to 4-5 mg/kg. Max total dose: 150 mg.
Hypersensitivity. Patients not fully anaesthetised; patients w/ personal or family history of malignant hyperthermia; inherited atypical cholinesterase activity; patients recovering from major trauma or severe burns; patients w/ neurological deficits involving spinal cord injury, peripheral nerve injury or acute muscle wasting; pre-existing hyperkalaemia; presence of open eye injuries; congenital myotonic diseases eg, myotonia congenita & dystrophia myotonica; Duchenne muscular dystrophy.
Special Precautions
Monitor patients fully w/ a peripheral nerve stimulator during prolonged administration. Intensified or prolonged neuromuscular blockade may occur secondary to reduced plasma cholinesterase activity in: pregnancy, abnormal plasma cholinesterase, tetanus, TB, burns, debilitating disease, malignancy, chronic anaemia & malnutrition, hepatic failure, renal failure, autoimmune diseases eg, myxoedema & collagen diseases, following plasma exchange, plasmapheresis, cardiopulmonary bypass & as a result of drug interactions. Occasional mild transient bradycardias on initial administration. Do not administer to patients w/ advanced myasthenia gravis. Occurrence of tachyphylaxis after repeated administration of suxamethonium. Patients w/ severe sepsis. Concomitant use w/ digitalis-like drugs. Should not be mixed w/ highly alkaline soln eg, barbiturates. Do not attempt to drive or operate machinery. Do not administer during pregnancy & lactation. Observe extra care or perform monitoring in infants & childn.
Adverse Reactions
Bradycardia, tachycardia, HTN, hypotension, arrhythmias; bronchospasm, prolonged resp depression & apnoea; muscle fasciculation, post-op muscle pains, myoglobinaemia, myoglobinuria; anaphylactic reactions, hyperthermia, increased IOP, increased intragastric pressure, rash, skin flushing, excessive salivation.
Drug Interactions
Enhanced muscle relaxant effect w/ lidocaine, procaine, procainamide, chloroprocaine, cocaine, quinidine; verapamil; aminoglycosides eg, dibekacin, kanamycin, neomycin, ribostamycin, streptomycin; propranolol; nifedipine, verapamil; lithium. Antagonised muscle relaxant effect w/ carbamazepine & phenytoin. Enhanced effects w/ vancomycin, azlocillin, clindamycin, colistin, piperacillin & polymyxin B; anticholinesterases eg, aprotinin, cyclophosphamide, dexpanthenol, ecothiopate, metoclopramide (nonselective drug), neostigmine, phenelzine (MAOI), promazine, quinine & chloroquine (antimalarials), tacrine & trimetaphan (ganglion blocking drug), oestrogen & testosterone; exposure to pesticides eg, diazinon, malathion & sheep dips; trimetaphan; cyclophosphamide, chlormethine, thiotepa & tretamine; general anaesth eg, propofol, fentanyl citrate-droperidol, halothane, isoflurane, enflurane, cyclopropane, propanidid & ether; high conc of cimetidine; parenteral Mg; demecarium & ecothiopate eye-drops, neostigmine & pyridostigmine, & possibly donepezil; bambuterol. Altered depth/duration w/ diazepam & midazolam. Hypotension, myocardial depression, & hyperkalaemia w/ IV dantrolene & verapamil. Increased risk of arrhythmias w/ digoxin.
ATC Classification
M03AB01 - suxamethonium ; Belongs to the class of choline derivative agents used as peripherally-acting muscle relaxants.
Suxamethonium Cl Martindale soln for inj 50 mg/mL
2 mL x 10 × 1's
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