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| Interactions: | Aprotinin
Adverse Effect: prolongation of neuromuscular blockade Clinical Management: If succinylcholine is administered to a patient on aprotinin therapy, monitor the patient for enhanced or prolonged neuromuscular blockade. The enhanced responses to succinylcholine may be more pronounced in patients who have a pathologically depressed cholinesterase activity.
Atracurium
Adverse Effect: Antagonism of neuromuscular blocking activity Clinical Management: When coadministering succinylcholine and atracurium, larger than expected doses may be necessary to induce and maintain neuromuscular blockade. Monitor the patient for neuromuscular response and adjust doses accordingly.
Bambuterol
Adverse Effect: prolongation of neuromuscular blockade Clinical Management: Monitor neuromuscular function in patients who are receiving therapy with bambuterol and succinylcholine. Neuromuscular blockade may be prolonged by as much as four-fold
Capreomycin
Adverse Effect: enhancement of neuromuscular blockade Clinical Management: Monitor patients for prolongation or enhancement of neuromuscular blockade following the concomitant use of capreomycin and succinylcholine.
Chloroxylenol
Adverse Effect: Prolonged succinylcholine effect Clinical Management: If an interaction is suspected, carefully monitor the neuromuscular blockade of succinylcholine and adjust the dose accordingly. If concurrent use cannot be avoided, select another H2-antagonist (eg, ranitidine or famotidine) that has less potential to alter drug metabolism.
Cimetidine
Adverse Effect: Prolonged succinylcholine effect Clinical Management: If an interaction is suspected, carefully monitor the neuromuscular blockade of succinylcholine and adjust the dose accordingly. If concurrent use cannot be avoided, select another H2-antagonist (eg, ranitidine or famotidine) that has less potential to alter drug metabolism.
Cyclophosphamide
An increased risk of potentiated succinylcholine efficacy Clinical Management: If cyclophosphamide has been administered within 10 days of succinylcholine administration, extreme caution should be used during and after succinylcholine administration.
Digoxin
Adverse Effect: An increased risk of cardiac arrhythmias Clinical Management: Cardiac rhythm should be closely monitored when administering succinylcholine to a digitalized patient.
Frusemide
Adverse Effect: Alterations of neuromuscular blockade Clinical Management: Patients who receive furosemide during succinylcholine-induced neuromuscular blockade should be monitored for alterations in the blockade. Depending on the dose of furosemide, the block may be intensified or antagonized.
Gentamicin
Adverse Effect: enhanced neuromuscular blockade Clinical Management: Titrate the dose of Succinyl Choline carefully. Monitor patients not on a ventilator for respiratory paralysis.
Halothane
Adverse Effect: faster development of phase II block and tachyphylaxis and cardiac arrhythmias Clinical Management: Patients receiving halothane and succinylcholine should be monitored for the depth of neuromuscular blockade and cardiac arrhythmias. Ample time for spontaneous recovery from neuromuscular blockade should be given.
Lignocaine
Adverse Effect: succinylcholine toxicity (respiratory depression, apnea) Clinical Management: If used concurrently, monitor carefully for prolonged neuromuscular blockade and respiratory depression.
Lithium
Adverse Effect: Prolongation of succinylcholine-induced neuromuscular blockade Clinical Management: Caution should be observed when administering succinylcholine to patients undergoing surgery who are stabilized on lithium therapy. Monitor the patient for enhanced neuromuscular blockade.
Metoclopramide - Antispas
Adverse Effect: prolonged neuromuscular blockade Clinical Management: Monitor patients for slower recovery times from neuromuscular blockade.
Mg. salts
Adverse Effect: Enhanced neuromuscular blockade Clinical Management: The dose of succinylcholine may need to be adjusted downward in patients receiving large doses of magnesium salts.
Neostigmine
Adverse Effect: increased neuromuscular blockade Clinical Management: Succinylcholine should generally be avoided during anesthesia in patients receiving cholinesterase inhibitors. The use of succinylcholine in these situations will lead to prolonged paralysis, which will require ventilation and supportive care until muscle function returns.
Netilmicin
Adverse Effect: succinylcholine toxicity (respiratory depression, apnea) Clinical Management: Titrate the dose of the neuromuscular blocking agent carefully. Monitor patients not on a ventilator for respiratory paralysis.
Pancuronium
Adverse Effect: pancuronium toxicity (respiratory depression, apnea) Clinical Management: Monitor patients for slower recovery from neuromuscular blockade.
Prednisolone
Adverse Effect: Prolongation of succinylcholine-induced neuromuscular blockade Clinical Management: In patients who have received long-term, high-dose therapy with prednisolone, monitor for a prolongation of succinylcholine-induced neuromuscular blockade. The enhanced response to succinylcholine may be more pronounced in patients who already have pathologically depressed cholinesterase activity.
Procainamide
Adverse Effect: excessive neuromuscular blockade Clinical Management: A reduction in the succinylcholine dose may be necessary when administered with procainamide.
Propofol
Adverse Effect: bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully. Pre-treatment with atropine may prevent the bradycardia response reported with concomitant administration.
Pyridostigmine
Adverse Effect: increased neuromuscular blockade Clinical Management: Succinylcholine should generally be avoided during anesthesia in patients receiving cholinesterase inhibitors. The use of succinylcholine in these situations will lead to prolonged paralysis, which will require ventilation and supportive care until muscle function returns.
Quinidine
Adverse Effect: succinylcholine toxicity (respiratory depression, apnea) Clinical Management: Monitor patients for respiratory depression and prolonged neuromuscular blockade.
Streptomycin
Adverse Effect: succinylcholine toxicity (respiratory depression) Clinical Management: Titrate the dose of the Succinyl Choline carefully. Monitor patients not on a ventilator for respiratory paralysis.
Terbutaline
Adverse Effect: Enhanced neuromuscular blockade Clinical Management: Patients receiving terbutaline and succinylcholine should be monitored for prolonged neuromuscular blockade. If prolongation occurs, neostigmine (1 to 3 mg) with atropine (0.6 to 1.2 mg) may be given.
Thiotepa
Adverse Effect: prolonged succinylcholine effect Clinical Management: Use caution when administering succinylcholine (or other skeletal muscle blockers) in patients receiving thiotepa.
Tobramycin
Adverse Effect: succinylcholine toxicity (respiratory depression, apnea) Clinical Management: Titrate the dose of Succinyl Choline carefully. Monitor patients not on a ventilator for respiratory paralysis.
Vancomycin
Adverse Effect: potentiation of neuromuscular blockade Clinical Management: Titrate the dose of the Succinyl Choline carefully. Monitor patients not on a ventilator for respiratory paralysis.
Verapamil
Adverse Effect: Enhanced neuromuscular blockade Clinical Management: When using verapamil and succinylcholine concurrently, it may be necessary to reduce the dosage of one or both of the drugs. Prolonged neuromuscular blockade may be clinically insignificant in patients on a ventilator; however, continued monitoring is especially important post-operatively if theres a possibility of incomplete reversal of neuromuscular blockade. |
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