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You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > suxamethonium
Expert: Dr Alan Galbraith
Date: 4/13/2008
Subject: suxamethonium
Question
suxamethonium causes prolonged paralysis in about 1 in 3000 patients. why is the half life increased to 2-3 hours in these cases? 6 marks
Answer
Dear Mahria
There is a drug idiosyncrasy with suxamethonium due to lack of pseudocholinesterases and other non-specific cholinesterases in some persons. Suxamethonium can be metabolised with acetylcholine esterase but at a greatly reduced rate and thus in those with genetically determined deficiency an increase in neuromuscular block is experienced which can last several hours in some cases. In heterozygous individuals the metabolism is also slowed but not as much in individuals with homozygosity of the gene need for production of this cholinesterase. Acquired deficiency can also occur in patients with liver disease due to a decrease in the production of the esterase enzymes. This deficiency can be detected by biochemical analyses.
Regards
Dr Alan Galbraith
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