Thursday July 10, 2008

Q: You have been called to ED (emergency deptt.) to evaluate a patient with organophosphate poisoning. You determine patient need intubation to protect and avoid aspiration pneumonia. Which drug you would like to avoid during intubation process?



A; succinylcholine

Organophosphate poisoining is marked by "SLUDGE" like syndrome (Salivation, Lacrimation, Urinary Incontinence, Diarrhea, GI hypermotility) and Succinylcholine also increases salivation. Moreover organophosphate may potentiate effects of succinylcholine. Succinylcholine is relatively contraindicated in Organophosphate poisoining.

Previous ICU pearl: Accidental succinylcholine in pseudocholinesterase deficiency


For people interested in "collection", here is one article on succinylcholine written in 1956 and printed in CANADIAN ANAESTHETISTS' SOCIETY JOURNAL (Can. Anaes. Soc J., vol. 3, no. 1, Jan., 1956) - pdf file