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Details

Stereochemistry ACHIRAL
Molecular Formula C14H30N2O4.2I
Molecular Weight 544.2085
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of SUCCINYLCHOLINE IODIDE

SMILES

C[N+](C)(C)CCOC(=O)CCC(=O)OCC[N+](C)(C)C.[I-].[I-]

InChI

InChIKey=QMJHHGXCWYZSBV-UHFFFAOYSA-L
InChI=1S/C14H30N2O4.2HI/c1-15(2,3)9-11-19-13(17)7-8-14(18)20-12-10-16(4,5)6;;/h7-12H2,1-6H3;2*1H/q+2;;/p-2

HIDE SMILES / InChI

Molecular Formula C14H30N2O4
Molecular Weight 290.3996
Charge 2
Count
Stereochemistry MIXED
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula HI
Molecular Weight 127.9124
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Succinylcholine also known as suxamethonium is a quaternary skeletal muscle relaxant usually used in the form of its halogen salt. It is is indicated under brand name anectine as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation. Succinylcholine activates the muscle-type nicotinic acetylcholine receptor followed by desensitization. Succinylcholine does not inhibit the presynaptic alpha3beta2 autoreceptor at clinically relevant concentrations, that provides a possible mechanistic explanation for the typical lack of tetanic fade in succinylcholine-induced neuromuscular blockade. Finally, was explored, that cardiovascular side effects (e.g., tachyarrhythmias) of succinylcholine were not mediated via direct activation of the autonomic ganglionic alpha3beta4 subtype because succinylcholine didn’t not activate the neuronal nicotinic acetylcholine receptor (nAChR) subtypes.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
ANECTINE

Approved Use

Succinylcholine chloride is indicated as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Launch Date

-5.48035199E11
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
18.5 μg × min/mL
1 mg/kg bw single, intravenous
dose: 1 mg/kg bw
route of administration: Intravenous
experiment type: SINGLE
co-administered:
SUCCINYLCHOLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
58.6 μg × min/mL
2 mg/kg bw single, intravenous
dose: 2 mg/kg bw
route of administration: Intravenous
experiment type: SINGLE
co-administered:
SUCCINYLCHOLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
25.4 s
1 mg/kg bw single, intravenous
dose: 1 mg/kg bw
route of administration: Intravenous
experiment type: SINGLE
co-administered:
SUCCINYLCHOLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
26.3 s
2 mg/kg bw single, intravenous
dose: 2 mg/kg bw
route of administration: Intravenous
experiment type: SINGLE
co-administered:
SUCCINYLCHOLINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
1.5 mg/kg single, intravenous
Higher than recommended
Dose: 1.5 mg/kg
Route: intravenous
Route: single
Dose: 1.5 mg/kg
Sources: Page: p.866
healthy, 31
n = 22
Health Status: healthy
Condition: General anesthesia
Age Group: 31
Sex: F
Population Size: 22
Sources: Page: p.866
1.1 mg/kg single, intravenous (max)
Recommended
Dose: 1.1 mg/kg
Route: intravenous
Route: single
Dose: 1.1 mg/kg
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: General anesthesia|Skeletal muscle relaxation
Sources: Page: p.1
Disc. AE: Rhabdomyolysis, Ventricular arrhythmia...
AEs leading to
discontinuation/dose reduction:
Rhabdomyolysis (acute, rare)
Ventricular arrhythmia (rare)
Cardiac arrest (grade 5, rare)
Sources: Page: p.1
AEs

AEs

AESignificanceDosePopulation
Rhabdomyolysis acute, rare
Disc. AE
1.1 mg/kg single, intravenous (max)
Recommended
Dose: 1.1 mg/kg
Route: intravenous
Route: single
Dose: 1.1 mg/kg
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: General anesthesia|Skeletal muscle relaxation
Sources: Page: p.1
Cardiac arrest grade 5, rare
Disc. AE
1.1 mg/kg single, intravenous (max)
Recommended
Dose: 1.1 mg/kg
Route: intravenous
Route: single
Dose: 1.1 mg/kg
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: General anesthesia|Skeletal muscle relaxation
Sources: Page: p.1
Ventricular arrhythmia rare
Disc. AE
1.1 mg/kg single, intravenous (max)
Recommended
Dose: 1.1 mg/kg
Route: intravenous
Route: single
Dose: 1.1 mg/kg
Sources: Page: p.1
unhealthy
Health Status: unhealthy
Condition: General anesthesia|Skeletal muscle relaxation
Sources: Page: p.1
PubMed

PubMed

TitleDatePubMed
Influence of tetrahydro-aminacrine on muscle pains after suxamethonium.
1975 Jan 18
Survey of local anesthetic toxicity in the families of patients with atypical plasma cholinesterase.
1975 Nov
Suxamethonium and mivacurium sensitivity from pregnancy-induced plasma cholinesterase deficiency.
1998 Nov
Anaphylaxis due to suxamethonium--manifested at induction of anaesthesia by bradycardia and cardiac arrest.
1999 Apr-Jun
Effects of pretreatment with cisatracurium, rocuronium, and d-tubocurarine on succinylcholine-induced fasciculations and myalgia: a comparison with placebo.
1999 Dec
Succinylcholine and temporal muscle damage.
2000 Aug
Is succinylcholine after pretreatment with d-tubocurarine and lidocaine contraindicated for outpatient anesthesia?
2000 Aug
Cardiac arrest due to succinylcholine-induced hyperkalemia in a patient with wound botulism.
2000 Feb
Out-of-hospital succinylcholine-assisted endotracheal intubation by paramedics.
2000 Jun
[Anesthetic complications. The incidence of severe anesthetic complications in patients and families with progressive muscular dystrophy of the Duchenne and Becker types].
2000 Mar
Rapacuronium: clinical pharmacology.
2001
Choice of the muscle relaxant for rapid-sequence induction.
2001
Choice of the hypnotic and the opioid for rapid-sequence induction.
2001
Muscle relaxants in paediatric day case surgery.
2001
Muscle relaxants suitable for day case surgery.
2001
Tracheal intubation without muscle relaxant--a technique using sevoflurane vital capacity induction and alfentanil.
2001 Aug
Increased sensitivity to depolarization and nondepolarizing neuromuscular blocking agents in young rat hemidiaphragms.
2001 Aug
The influence of fentanyl vs. s-ketamine on intubating conditions during induction of anaesthesia with etomidate and rocuronium.
2001 Aug
Effects of combined methohexitone-remifentanil anaesthesia in electroconvulsive therapy.
2001 Aug
Why do we still use suxamethonium for caesarean section?
2001 Dec
Analysis of mutations in the plasma cholinesterase gene of patients with a history of prolonged neuromuscular block during anesthesia.
2001 Dec
The effect of rocuronium on intraocular pressure: a comparison with succinylcholine.
2001 Dec
Second dose thiopentone attenuates the haemodynamic response to laryngoscopy and intubation.
2001 Feb
Sore throat following tracheal intubation.
2001 Feb
The use of esmolol as an alternative to remifentanil during desflurane anesthesia for fast-track outpatient gynecologic laparoscopic surgery.
2001 Feb
[Concerning the new presentation of Celocurine].
2001 Jan
[A case of ventricular tachycardia immediately after electroconvulsive therapy in a schinzophrenic patient].
2001 Jan
Intramuscular ketamine in a parturient in whom pre-operative intravenous access was not possible.
2001 Jun
Asystole during electroconvulsive therapy: a case report.
2001 Jun
[Short-term anesthesia to stop persistent hiccups].
2001 Jun 22
Effectiveness and safety of rocuronium-hypnotic sequence for rapid-sequence induction.
2001 Mar
[Systemic lupus erythematosus in the pregnant patient. Implications for anesthesia].
2001 Mar
Conquer difficult airways. Strategies to help you identify & control a problem airway.
2001 Mar
The intubating laryngeal mask airway after induction of general anesthesia versus awake fiberoptic intubation in patients with difficult airways.
2001 May
Duration of action of vecuronium after an intubating dose of rapacuronium, vecuronium, or succinylcholine.
2001 May
Rapacuronium: an alternative to succinylcholine for electroconvulsive therapy.
2001 May
Is succinylcholine appropriate or obsolete in the intensive care unit?
2001 Oct
Goal oriented general anesthesia for Cesarean section in a parturient with a large intracranial epidermoid cyst.
2001 Oct
The substitute for the intravenous route.
2001 Oct
[Anesthesia for electroconvulsive therapy during pregnancy--a case report].
2001 Sep
Succinylcholine in the intensive care unit.
2002 Jan
Patents

Patents

Sample Use Guides

Adults: For Short Surgical Procedures: the average dose required to produce neuromuscular blockade and to facilitate tracheal intubation is 0.6 mg/kg ANECTINE (Succinylcholine Chloride Injection) given intravenously. The optimum dose will vary among individuals and may be from 0.3 to 1.1 mg/kg for adults. Following administration of doses in this range, neuromuscular blockade develops in about 1 minute; maximum blockade may persist for about 2 minutes, after which recovery takes place within 4 to 6 minutes. However, very large doses may result in more prolonged blockade. A 5- to 10-mg test dose may be used to determine the sensitivity of the patient and the individual recovery time (see PRECAUTIONS). For Long Surgical Procedures The dose of succinylcholine administered by infusion depends upon the duration of the surgical procedure and the need for muscle relaxation. The average rate for an adult ranges between 2.5 and 4.3 mg per minute. Solutions containing from 1 to 2 mg per mL succinylcholine have commonly been used for continuous infusion. The more dilute solution (1 mg per mL) is probably preferable from the standpoint of ease of control of the rate of administration of the drug and, hence, of relaxation. This IV solution containing 1 mg per mL may be administered at a rate of 0.5 mg (0.5 mL) to 10 mg (10 mL) per minute to obtain the required amount of relaxation. Intermittent IV injections of succinylcholine may also be used to provide muscle relaxation for long procedures. An IV injection of 0.3 to 1.1 mg/kg may be given initially, followed, at appropriate intervals, by further injections of 0.04 to 0.07 mg/kg to maintain the degree of relaxation required. Pediatrics: for emergency tracheal intubation or in instances where immediate securing of the airway is necessary, the IV dose of succinylcholine is 2 mg/kg for infants and small children; for older children and adolescents the dose is 1 mg/kg. Rarely, IV bolus administration of succinylcholine in infants and children may result in malignant ventricular arrhythmias and cardiac arrest secondary to acute rhabdomyolysis with hyperkalemia. In such situations, an underlying myopathy should be suspected. Intravenous bolus administration of succinylcholine in infants or children may result in profound bradycardia or, rarely, asystole. As in adults, the incidence of bradycardia in children is higher Intramuscular Use: If necessary, succinylcholine may be given intramuscularly to infants, older children, or adults when a suitable vein is inaccessible. A dose of up to 3 to 4 mg/kg may be given, but not more than 150 mg total dose should be administered by this route. The onset of effect of succinylcholine given intramuscularly is usually observed in about 2 to 3 minutes.
Route of Administration: Other
In Vitro Use Guide
The rat diaphragm was used as an in vitro model for studies of contractures synergistically-induced by halothane and suxamethonium (succinylcholine). The effects of three agents reported to inhibit phospholipase A2 activity (quinacrine, spermine and indomethacin), tubocurarine and dantrolene were examined on these contractures. Contractures induced by 1% halothane (0.26 +/- 0.02 g) (mean +/- SEM) were increased (0.60 +/- 0.04 g) if suxamethonium 50 mmol litre-1 was also in the bathing medium. Suxamethonium-induced contractures (0.22 +/- 0.03 g) were also enhanced when halothane was present (0.51 +/- 0.03 g). Spermine, indomethacin and dantrolene antagonized both halothane- and suxamethonium-induced contractures. Quinacrine potentiated contractures induced by either halothane or suxamethonium. Contractures induced by suxamethonium were antagonized by tubocurarine; however, contractures induced by halothane were not antagonized by tubocurarine. These results suggest that free fatty acids may be involved in contractures induced synergistically by halothane and suxamethonium. Different mechanisms are involved in the induction of contractures by suxamethonium than by halothane.
Substance Class Chemical
Created
by admin
on Sat Jun 26 04:54:24 UTC 2021
Edited
by admin
on Sat Jun 26 04:54:24 UTC 2021
Record UNII
PG6H2852BK
Record Status Validated (UNII)
Record Version
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Name Type Language
SUCCINYLCHOLINE IODIDE
MI  
Common Name English
NSC-221197
Code English
SUCCINYLCHOLINE IODIDE [MI]
Common Name English
2,2'-SUCCINYLDIOXYBIS(ETHYLTRIMETHYLAMMONIUM) DIIODIDE
Systematic Name English
SUXAMETHONIUM IODIDE [WHO-DD]
Common Name English
SUXAMETHONIUM IODIDE
WHO-DD  
Common Name English
Code System Code Type Description
EVMPD
SUB04655MIG
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY
ECHA (EC/EINECS)
208-770-1
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY
MERCK INDEX
M10277
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY Merck Index
CAS
541-19-5
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY
FDA UNII
PG6H2852BK
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY
PUBCHEM
68325
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY
RXCUI
262295
Created by admin on Sat Jun 26 04:54:24 UTC 2021 , Edited by admin on Sat Jun 26 04:54:24 UTC 2021
PRIMARY RxNorm
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