TYK155

Side effects of succinylcholine (1 mg/kg IV) administration include all of the following EXCEPT:

a) Hyperkalemia

b) Increased intraocular pressure

c) Prolonged neuromuscular blockade in patients with a low dibucaine number (<20)

d) Prolonged neuromuscular blockade in patients with a high dibucaine number (>80)

e) Myoglobinuria

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Answer

Answer d.

Succinylcholine is the only drug in its class still in use in the modern era; it has the benefits of rapid onset and short duration of action, but is fraught with unintended effects, including dysrhythmias, muscle breakdown, myoglobinuria, and hyperkalemia, risk of malignant hyperthermia, increased intraocular pressure and others. In addition, its pharmacokinetics depend on pseudocholinesterase for removal from the neuromuscular junction; patients with a low dibucaine number (< 20) may have prolonged (hours) paralysis after a single dose. On the other hand, even patients with normal pseudocholinesterase function (dibucaine number > 80) may have prolonged blockade with a dose of 4- 6 mg/kg (or repeated doses in short succession).

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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