Chemistry:Suxethonium chloride

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Short description: Chemical compound
Suxethonium chloride
Suxethonium chloride.svg
Identifiers
PubChem CID
ChemSpider
Chemical and physical data
FormulaC16H34Cl2N2O4
Molar mass389.36 g·mol−1
3D model (JSmol)

Suxethonium (trade name: Brevidil-E) is a depolarising muscle relaxant which is presented as a dry powder in an ampoule. This is re-constituted with sterile water prior to use. It is available in Australia as a schedule 4 drug,[1] and the US.[2]

Advantages

It has some advantages over suxamethonium:

  • Less K+[3]
  • Possibly less muscle pain after use
  • Storage does not require refrigeration

The last advantage was what keeps it in occasional use.

Previous use

In the UK, it was used by the Obstetric Flying Squads at patient's homes to resuscitate mothers during major obstetric complications (mostly major haemorrhage) during home births.

In Australia, it was included in "Resuscitation drugs packs" in hospitals. These packs were sealed boxes containing all the drugs required for an in-hospital resuscitation. They were prepared by the hospital pharmacy and because these were sealed (usually just sticky tape) the drug contents were guaranteed to be there for use in a cardiac arrest. These packs contained ampoules of powdered suxethonium so a relaxant was available to facilitate intubation. Suxamethonium could not be used in these packs because of the requirement for refrigeration. This was certainly an issue in Queensland as it could be quite warm and hospitals wards were in the past generally not air-conditioned.

It can still be used where the storage issue is a concern (e.g. by the military, rural locations, 3rd world countries). The most recent reference to it in Medline is 1976, but it is occasionally mentioned in passing in other journals.[4]

References

  1. [1][|permanent dead link|dead link}}]
  2. "Suxethonium Chloride". https://www.drugs.com/international/suxethonium-chloride.html. 
  3. "Plasma potassium changes following suxamethonium and suxethonium in normal patients and in patients in renal failure". British Journal of Anaesthesia 48 (10): 1011–5. October 1976. doi:10.1093/bja/48.10.1011. PMID 791307. 
  4. "Muscle Relaxant in the 21st Century". Kathmandu University Medical Journal 1 (1): 60–65. 2003. PMID 16340268. http://www.kumj.com.np/past/Vol1/issue1/vol1_18.pdf.