In medical practice, a number of drugs are used, necessary, for example, to bring the patient's body to the state required for performing the surgical intervention. Certain procedures require artificially triggered absolute muscle relaxation. For this purpose, the drug "Suxamethonium chloride" is often used (the trade name of the drug is "Listeon"). This medication is mostly used in specialized medical institutions. What is the essence of its pharmacological action? Is it dangerous to use the drug in question? What should I be prepared for when using Suxamethonium Chloride? The description of the drug and some features of its use will be discussed later in this article.
Structure
The main active ingredient of the drug in question is suxamethonium chloride. The drug also includes auxiliary components such as sodium chloride, ethylenediaminetetraacetic acid disodium salt (Trilon B), or disodium edetate, as well as water for injection.
Release form
"Suxamethonium chloride" is usually produced by manufacturers in the form of a solution (for both intramuscular and intravenous administration).
pharmachologic effect
The drug in question is a depolarizing muscle relaxant. Its action is short-lived. The active components of the drug effectively block neuromuscular transmission.
Muscle relaxation always occurs in the same sequence, which must be considered by medical personnel. So, it begins with the muscles of the eyelids, then affects the chewing muscles and muscles of the fingers, eyes and all limbs. Then muscle relaxation reaches the neck area, the muscles of the back, abdomen and vocal cords are relaxed. The last to respond to the action of the drug are the intercostal muscles and the diaphragm.
If the medicine was administered intramuscularly, then it will begin to act after two to four minutes, and if administered intravenously, after a minute. Maximum muscle relaxation occurs three minutes after administration of the drug. This action lasts for five to ten minutes, depending on the dose of the substance.
The drug is evenly distributed in blood plasma and extracellular fluid shortly after administration of the solution (subject to intravenous administration). About ninety percent of the substance is hydrolyzed, transforming into choline or succinic acid. Provided that the concentration of cholinesterase in the blood remains at a sufficient level, the half-life of the drug is only ninety seconds. The substance is fully excreted by the kidneys (including ten percent - unchanged).
Indications for use
The drug in question is used in cases where an intervention is required that requires complete muscle relaxation. Such conditions include bronchoscopy, endoscopy, abdominal surgery, reposition of fractures, reduction of dislocations, and endotracheal intubation.
Mode of application
The substance "Suxamethonium chloride" can be administered intramuscularly and intravenously (both drip and jet). For a similar method of use, a 0.1% solution of the substance is used. The working dose in which suxamethonium chloride and iodide is used is prescribed individually by a specialist in accordance with the individual characteristics of a particular patient and, as a rule, ranges from 0.1 to 2 milligrams per kilogram for intravenous administration, and from 3 to 4 micrograms per intramuscular kilogram. Moreover, in general, for the course of treatment, the total amount of the administered substance should not exceed one hundred and fifty micrograms.
Contraindications
In some cases, patients should not be given the drug "Suxamethonium chloride." The instructions for the use of this drug report the following contraindications to the use of the drug: individual hypersensitivity to any component of the drug, myasthenia gravis, bronchial asthma, angle-closure glaucoma, pulmonary edema, hyperkalemia, malignant hyperthermia, acute liver failure, congenital and dystrophic myotonia, deficiency cholinesterase, Duchenne muscular dystrophy, mechanical eye injuries. It is also forbidden to use the medicine in question for children under one year of age and women during the period of bearing a child or breastfeeding.
Side effects
In rare cases, "Suxamethonium chloride" (injection) can cause a number of unpleasant symptoms and manifestations from various body systems. Among them are various kinds of allergic reactions (for example, bronchospasm and anaphylactic shock), respiratory muscle paralysis (occurs if there are genetic disorders in the formation of serum cholinesterase), arrhythmia, myalgia, fever, bradycardia, hyperkalemia, hypersalivation, cardiogenic shock, decrease in blood pressure, impaired conduction, increased intraocular pressure. In order to avoid the aforementioned problems, it is important to strictly adhere to the recommendations regarding the use of the drug "Suxamethonium chloride." Analogues of the drug (in any case, some of them) have a much smaller number of side effects. Therefore, sometimes it would be wise to turn to them.
Overdose
In case of unintentional or deliberate exceeding of the recommended dose of the drug, some undesirable consequences for the patient's body may occur. The most dangerous of these is respiratory arrest. In this case, you can’t do without the help of specialists, otherwise a fatal outcome is possible. Urgent ventilation is required. Sometimes in the blood serum the level of cholinesterase drops sharply. Some specialists recommend transfusion of fresh blood or, which is often safer, blood substitutes to treat this condition.
Special instructions
It is recommended to introduce high-quality non-depolarizing muscle relaxants a minute before the administration of the drug "Suxamethonium chloride". The description of the substance contains information that such an interaction eliminates the risk of subsequent manifestations of myalgia and muscle twitching. It is important to use the drug only in specialized departments of medical institutions, subject to the availability of the necessary equipment (including an apparatus for artificial ventilation of the lungs) and competent personnel capable of correctly using this technique and making decisions in stressful situations. Since the use of the drug in question can cause bradycardia in the patient, it is recommended that the patient administer Atropine before using Suxamethonium Chloride.
Ability to combine with other drugs
When using other drugs simultaneously with the drug in question, attention should be paid to whether such an interaction is permissible. "Suxamethonium chloride" instruction for use does not recommend the use in parallel with anti-asthenic drugs, as it significantly reduces the effectiveness of their action. The drug in question also enhances the pharmaceutical effect of glycosides. In no case should Suxamethonium Chloride be used simultaneously with donated blood, as it provokes a hydrolysis reaction with any blood products, alkaline solutions and barbiturate solutions (it contributes to precipitation).
Influence on the ability to concentrate (driving vehicles and complex mechanisms)
"Suxamethonium chloride" has a significant effect on the ability to concentrate and maintain attention. This means that in order to avoid accidents it is necessary to avoid driving vehicles and any other activities that pose a threat to human life and health and require an increased concentration of attention, as well as a quick reaction and instant decision-making on the first day after the termination of the drug in question.
Storage conditions and shelf life
It is possible to store "Suxamethonium chloride" under strictly defined conditions. Namely: the temperature at the storage location should range from two to eight degrees Celsius. The drug should be located outside the reach of children. The maximum shelf life of a drug is three years from the date of manufacture. After the specified period, it is not recommended to use the drug, because in this case it loses its useful properties and can be dangerous for the patient.
The safety of the patient, the safety of his life is the responsibility of the doctors who are involved in his treatment. Therefore, it is important that the heads of medical institutions make sure that the personnel of these institutions are competent in the use of drugs, side effects of these drugs, and methods for eliminating undesired reactions. Likewise, hospital staff must possess the necessary knowledge and skills in order to properly use the available equipment that can save the patient's life. This is especially true for drugs whose possible side effects can be fatal. It is to this group of drugs that Suxamethonium Chloride belongs. Therefore, it should be used only if competent specialists are able to use the mechanical ventilation apparatus during the procedure. This may be necessary if an adverse reaction such as respiratory arrest occurs. In this case, the coherence of the doctors and their professional competence will be decisive factors that determine whether the patient will survive.
Sometimes, for certain reasons (if there are some contraindications), doctors decide to use another muscle relaxant - an analogue of “Suxamethonium chloride” (for example, “Dithilin”, which cannot be used only in the presence of glaucoma). It is important to trust the authoritative opinion of specialists in this matter. Therefore, you should be sure of the professional competence of the doctor with whom you are working.
Before you decide on the drug in question, you should learn all about the substance "Suxamethonium chloride": trade name, analogues, contraindications, possible side effects, features of use and recommended dosages. The patient should also be well-versed in what kind of medicine is administered to him. “Listenone” (“Suxamethonium chloride”) is the trade name of the substance in question. Therefore, when you hear this name from the mouth of a doctor, you will well understand how it will act in your body. This knowledge is necessary in order not to put your life at unnecessary risk. It is important to be as cautious as possible about which drugs are given to you during treatment.
Trust your health only to professionals, choose the best treatment methods and the best drugs! Take care of yourself!