NEURONIUM
SUXAMETHONIUM · by SURGE
Composition
Inj 100 mg: Per ml: Suxamethonium chloride 20 mg; 5 ml (100 mg). Inj 200 mg: Per ml: Suxamethonium chloride 20 mg; 10 ml (200 mg). Inj 500 mg: Per ml: Suxamethonium chloride 50 mg; 10 ml (500
Indications & Dosage
Neuromuscular blockade (short duration) during surgery and intubation: BY IV INJ: Adult: 1-1.5 mg/kg; maintenance, usually 0.5-1 mg/kg at 5-10 min intervals; max 500 mg/hr. BY IV INF: Adult: a solution containing 1-2 mg/ml (0.10.2%), 2.5-4 mg/min; max 500 mg/hr. Children: 2 mg/kg produces 5-10 min neuromuscular blockade; Neonate-1 yr: 2 mg/kg; 1-18 yrs: 1 mg/kg, IM (onset in 2-3 minutes): 4 mg/kg produces 10-30 min neuromuscular blockade; 1 month-1 yr: up to 4-5 mg/kg; 1-12 yrs: up to 4 mg/kg, max 150 mg.
Administration
Administer via IV or IM route.
Stability
Stable at room temperature for 14 days; refrigerate
Contraindications
Duchenne muscular dystrophy, family history of malignant hyperthermia, hyperkalaemia, low plasma-cholinesterase activity (including severe liver disease), major trauma, neurological disease involving acute wasting of major muscle, personal or family history of congenital myotonic disease, prolonged immobilization (risk of hyperkalaemia), severe burns
Precautions
Cardiac, respiratory or neuromuscular disease; raised intra-ocular pressure (avoid in penetrating eye injury); severe sepsis (risk of hyperkalaemia).
Interactions
Anticholinesterase, cyclophosphamide, oral contraceptives, lidocaine, pancuronium, lithium, magnesium salts, chloroquine, metoclopramide, terbutaline, procaine, anaesthetics, calcium channel blockers, antiarrhythmics, immunosuppressants.
Pregnancy
Risk cannot be ruled out, caution advised
Lactation
Caution advised or effect undetermined.
Side Effects
Flushing, hyperkalaemia, increased gastric pressure, increased intra-ocular pressure, myoglobinaemia, myoglobinuria, postoperative muscle pain, rash, bradycardia (may occur with repeated doses), hypertension, hypotension, rhabdomyolysis, tachycardia (occurs with single use). Rare: Apnoea, arrhythmias, bronchospasm, cardiac arrest, limited jaw mobility, prolonged respiratory depression and anaphylactic reactions.