Pharmacokinetics - Neonatal Intensive Care Drug Manual

|
Neonatal Intensive Care Drug Manual
|
bet | 589/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
Pharmacokinetics
Suxamethonium has a rapid onset of action (30 seconds) and a short duration of action (3 to 6 minutes) with IV administration. The increased dose (2–3 mg/kg vs. 1 mg/kg in adults) requirement of succinylcholine in younger patients is thought to be due to its rapid distribution into an enlarged volume of extracellular fluid rather than an altered response to the action of the drug at neuromuscular junction nicotinic acetylcholine receptors.8 (Level III Grade C)
Practice points
|
Suxamethonium in combination with other drugs (analgesics and vagolytic agents) resulted in superior intubation conditions and a shorter procedure duration.1-6(Level II, Grade A)
Chloride anhydrous salt equates to 110mg in 2 mL of suxamethonium chloride which is 10% more suxamethonium than suxamethonium chloride dihydrate salt.
|
References
|
Barrington K. Premedication for endotracheal intubation in the newborn infant. Paediatrics & child health 2011;16(3):159-171.
Barrington KJ, Finer NN, Etches PC. Succinylcholine and atropine for premedication of the newborn infant before nasotracheal intubation: a randomized, controlled trial. Critical care medicine 1989;17(12):1293-1296.
Ghanta S, Abdel-Latif ME, Lui K, Ravindranathan H, Awad J, Oei J. Propofol compared with the morphine, atropine, and suxamethonium regimen as induction agents for neonatal endotracheal intubation: a randomized, controlled trial. Pediatrics 2007;119(6):e1248-1255.
Ghazal E, Amin A, Wu A, Felema B, Applegate RL, 2nd. Impact of rocuronium vs succinylcholine neuromuscular blocking drug choice for laparoscopic pyloromyotomy: is there a difference in time to transport to recovery? Paediatr Anaesth 2013;23(4):316-321.
Norman E, Wikstrom S, Hellstrom-Westas L, Turpeinen U, Hamalainen E, Fellman V. Rapid sequence induction is superior to morphine for intubation of preterm infants: a randomized controlled trial. The Journal of pediatrics 2011;159(6):893-899 e891.
Oei J, Hari R, Butha T, Lui K. Facilitation of neonatal nasotracheal intubation with premedication: a randomized controlled trial. Journal of paediatrics and child health 2002;38(2):146-150.
Ho VW, Osiovich H. A case of pseudocholinesterase deficiency in the neonate. American journal of perinatology. 1999;16(7):351-353.
Meakin G, McKiernan EP, Morris P, Baker RD. Dose-response curves for suxamethonium in neonates, infants and children. British journal of anaesthesia 1989;62(6):655-658.
Micromedex. Accessed on 8 December 2016.
Australian Injectable Drugs Handbook 8th Ed accessed on www.aidh.hcn.com.au on 28th May 2020.
Suxamethonium Chloride 50mg/mL Solution for Injection Product Information. Revised 2018. MercuryPharma
Succinolin Product Information 2015 accessed via https://www.hps.com.au/wp-content/uploads/2015/05/SUX100-Succinolin-Suxamethonium-Injection-%E2%80%93-Product-Information.pdf
|
Original version Date: 12/12/2016
|
Author: NeoMed Consensus Group
|
Current Version number: 2
|
Current Version Date: 15/06/2020
|
Risk Rating: Low
|
Due for Review: 15/6/2025
|
Approved by: DTC
|
Approval Date: TBA
|
|
| |