Suxamethonium

2,2'-* bis* dichloride
CAS number 306-40-1	ATC code M03AB01
Chemical formula	C14H30N2O4
Molecular weight	290.401
Bioavailability	?
Metabolism	?
Elimination half-life	?
Excretion	?
Pregnancy category	?
Legal status	?
Routes of administration	Intravenous

Suxamethonium chloride (also known as succinylcholine, or scoline) is a white crystalline substance, it is odourless and highly soluble in water. The compound consists of two acetylcholine molecules that are linked by their acetyl groups. Suxamethonium is sold under several trademark names such as Anectine®.

Suxamethonium acts as a depolarizing muscle relaxant. It imitates the action of acetylcholine at the neuromuscular junction, but it is not degraded by acetylcholinesterase but by pseudocholinesterase, a plasma cholinesterase. This hydrolysis by pseudocholinesterase is much slower than that of acetylcholine by acetylcholinesterase. The prolonged stimulation of the acetylcholine receptor results first in disorganized muscle contractions (fasciculations, considered to be a side effect as mentioned below), then in profound relaxation.

Its medical uses are limited to short-term muscle relaxation in anesthesia and intensive care, usually for facilitation of endotracheal intubation. Despite its many undesired effects on the circulatory system and skeletal muscles (including malignant hyperthermia, a rare but life-threatening disease), it is still much used because it arguably has the fastest onset of action of all muscle relaxants.

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