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Author InformationAn event is serious (based on the ICH definition) when the patient outcome is:• * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important eventA 27-year-old man developed hyperkalaemia after receiving suxamethonium chloride for neuromuscular blockade during intubation [dosage, route and time to reaction onset not stated]. [Extracted from the article]

The woman, who had major depressive disorder, post-traumatic stress disorder, temporomandibular joint pain and fibromyalgia, was receiving maintenance electroconvulsive therapy (ECT) with suxamethonium chloride [succinylcholine] 60mg as neuromuscular blockade therapy. The myalgia and jaw pain were attributed to suxamethonium chloride and ECT procedure. She reported whole body pain and moderate to severe post-ECT jaw pain lasting 24-72 hours after each treatment over a two-year period. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 37-year-old man developed malignant hyperthermia during treatment with isoflurane and suxamethonium chloride [ I routes and dosages not stated; time to reaction onset not clearly stated i ]. The malignant hyperthermia was attributed to isoflurane and suxamethonium chloride. [Extracted from the article]

She was not breathing at the end of anaesthesia, which was indication of differential diagnosis of apnoea due to suxamethonium chloride. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 32-year-old woman developed apnoea during treatment with suxamethonium chloride for general anaesthesia during delivery. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 57-year-old man developed sudden cardiac arrest (SCA) secondary to hyperkalaemia during treatment with suxamethonium chloride for endotracheal re-intubation. Based on the clinical presentation and laboratory findings, sudden SCA secondary to severe hyperkalaemia was considered, which were attributed to the suxamethonium chloride therapy. Thereafter, he received endotracheal re-intubation with a single dose of suxamethonium chloride [Chlorsuccillin; succinylcholine] 200mg at a dose of 1 mg/kg [ I route not stated i ] concomitantly with fentanyl and propofol. [Extracted from the article]

The table below provides a list of the drugs associated with non-serious adverse events identified in the scientific literature over the last week. Reactions Weekly 18 Nov 2020. [Extracted from the article]

Whole blood test sample collected at 1 hour and 25 minute after the reaction showed increased histamine and tryptase concentration that eventually decreased. Whole blood test sample collected at 20 minute after the reaction showed increased histamine and tryptase concentration that eventually decreased. Whole blood test sample collected at 55 minute after the reaction showed increased histamine concentration that eventually decreased, where as tryptase concentration remained at 4 µg/L, 4.8 µg/L and 2.7 µg/L at 55 minute, 2 hour and 50 minute and more than 24 hours respectively. [Extracted from the article]

Later, she confirmed that she intentionally administered suxamethonium chloride during outpatient visit, which indicated the possibility of suxamethonium chloride drug misuse. B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event * Drug overdose A 28-year-old woman developed unconsciousness, altered mental status, hypoxia, cardiac arrest, hypotension, seizure, mixed acidosis, increased lactate level, respiratory arrest and hyperkalaemia following suxamethonium chloride misuse and overdose. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 25-year-old woman experienced prolonged neuromuscular blockade following muscle relaxation with suxamethonium chloride. The vagal nerve stimulator was turned off prior to the ECT, and anaesthesia was induced using etomidate. Thereafter, she was offered continued treatment with ECT using rocuronium [rocuronium bromide] with sugammadex reversal for short-lasting muscle relaxation, which would remain unaffected by her pseudocholinesterase deficiency. [Extracted from the article]

Case 2: A 6-year-old boy developed malignant hyperthermia during treatment with suxamethonium-chloride [suxamethonium] and isoflurane. The general anaesthesia was induced using fentanyl, propofol and suxamethonium-chloride [suxamethonium] 20mg followed by orotracheal intubation. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 77-year-old woman developed hypertension and tachycardia due to inadvertent neuromuscular blockade following administration of suxamethonium chloride instead of fentanyl for induction of anaesthesia [ I route, dosage and duration of treatment to reaction onset not stated i ]. It was suspected that she had received suxamethonium chloride in place of fentanyl at induction of anaesthesia [ I not all outcomes stated i ]. [Extracted from the article]

Three females developed anaphylaxis due to anaesthesia including suxamethonium chloride [suxamethonium] and thiopental sodium [thiopental; 1 patient], lidocaine (1 patient) and sugammadex (1 patient), while 2 females died due to anaphylaxis reactions to suxamethonium chloride (1 patient) and amoxicillin/clavulanic-acid [co-amoxyclav; 1 patient]. Of the 10 female patients, who developed anaphylaxis after delivery, 4 patients underwent caesarean delivery and developed anaphylaxis to plasma [fresh frozen plasma; 1 patient], oxytocin (1 patient) and gelatin [gelofusine; 2 patient]. The remaining 6 patients had vaginal deliveries and developed anaphylaxis to oxytocin (1 patient), ergometrine (1 patient), dinoprostone [prostaglandin-E2; 1 patient], carboprost (1 patient), gelatin (1 patient) and temazepam (1 patient). [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 34-year-old woman developed rhabdomyolysis during induction or maintenance of anaesthesia with lidocaine, fentanyl, suxamethonium chloride and propofol for elective oesophagogastroduodenoscopy (EGD) and placement of Bravo oesophageal pH monitor. Her anaesthesia induction included lidocaine 50mg, fentanyl 100µg, suxamethonium chloride [succinylcholine] 80mg and propofol 150mg. Her vital signs remained stable throughout the procedure and at her stay in post anaesthesia care unit. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 32-year-old woman developed rhabdomyolysis following treatment with propofol and sevoflurane as a general anaesthesia along with dexamethasone and suxamethonium chloride [ I not all routes, dosages and indications stated i ]. The rhabdomyolysis was considered to have developed secondary to propofol, sevoflurane, dexamethasone and suxamethonium chloride. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event An approximately 35-year-old man developed masseter muscle rigidity (MMR) during treatment with suxamethonium chloride. The rapid sequence intubation was done with IV suxamethonium chloride [succinylcholine] 160mg, along with etomidate. He then received the remaining suxamethonium chloride 40mg as an IV bolus as it was readily available. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 52-year-old man developed rhabdomyolysis following treatment with suxamethonium chloride for anesthesia [ I route and dosage not stated i ]. Suxamethonium chloride therapy was suspected to have contributed in the development of rhabdomyolysis. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 64-year-old man developed malignant hyperthermia during treatment with isoflurane and suxamethonium chloride [ I routes and dosages not stated i ]. Malignant hyperthermia was attributed to isoflurane (volatile anaesthetic) and suxamethonium chloride. [Extracted from the article]

B Author Information b An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly * other medically important event A 61-year-old man developed shortness of breath, dysarthria, muscle spasms and fasciculation following accidental administration of suxamethonium chloride test dose instead of bupivacaine. The man was immediately proceeded to induction to general anaesthesia with additional IV suxamethonium chloride [succinylcholine] 75mg for rapid sequence induction along with other medications. It was thus speculated that suxamethonium chloride injection 100mg was accidentally administered as a test dose via epidural catheter instead of bupivacaine. [Extracted from the article]

In a descriptive study conducted between 2014 and 2017 in Tunisia, four women aged 13-42 years were described, of whom, a 29-year-old woman developed bronchospasm during general anesthetic (GA) treatment with fentanyl, propofol, atracurium besilate and suxamethonium chloride (1 patient), a 13-year-old girl developed Quincke's oedema with cyanosis following cross reactivity between atracurium besilate and suxamethonium chloride (1 patient), a 42-year-old woman developed anaphylactic shock during GA treatment with fentanyl, propofol, atracurium besilate and suxamethonium chloride (1 patient), whereas a 35-year-old woman developed Quincke's oedema during GA treatment with fentanyl, propofol, atracurium besilate, suxamethonium chloride, cisatracurium besilate and midazolam and after cross reactivity between atracurium besilate, suxamethonium chloride and cisatracurium besilate [ I dosages, routes and outcomes not stated; not all durations of treatments to reactions onsets stated i ]. Allergological assessment after an immediate hypersensitivity reaction to general anesthetics. [Extracted from the article]

The patients, who were planned for surgery received aprotinin (n=1), tranexamic acid (n=1), midazolam (1 patient), vancomycin (1 patient), cefuroxime (1 patient), gentamicin (1 patient), amoxicillin/clavulanic acid [coamoxiclav] (1 patient), iohexol [Omnipaque] (1 patient), gelatin [Bovine gelatin; 1 patient], sterculia [Normacol; 1 patient], rocuronium bromide (1 patient), suxamethonium chloride (1 patient), mivacurium chloride (1 patient), ketorolac (1 patient), cefazolin (2 patients), teicoplanin (2 patients) or atracurium besilate (8 patients). However, the patients experienced life-threatening perioperative anaphylaxis (grade 3 anaphylaxis in 22 patients and grade 4 anaphylaxis in 4 patients). The patients, who experienced grade 4 anaphylaxis, also developed cardiac arrest with non-recordable systolic BP. [Extracted from the article]

A 45-year-old man developed arterial hypotension during rapid sequence induction of general anaesthesia with propofol and suxamethonium chloride. Owing to lidocaine failure, rapid sequence induction of general anaesthesia comprising of propofol 200mg (2.5 mg/kg) and suxamethonium chloride [suxamethonium] 80mg (1 mg/kg) was initiated [ I routes not stated i ], followed by orotracheal intubation. [Extracted from the article]

A 64-year-old man developed prolonged respiratory paralysis during treatment with suxamethonium chloride to facilitate the intubation. He received suxamethonium chloride [succinylcholine] approximately 1.25 mg/kg [ I route not stated i ] to facilitate the intubation. An underlying pseudocholinesterase deficiency along with the administration of suxamethonium chloride were suspected to be the causes of prolonged respiratory paralysis. [Extracted from the article]

A 53-year-old woman developed prolonged neuromuscular paralysis after receiving suxamethonium chloride during oesogastric endoscopy. The woman had a history of liver cirrhosis and eradicated hepatitis C virus with HIV coinfection. B Author comment: b I "We describe a case of prolonged neuromuscular paralysis associated with succinylcholine administration in connection with a Bcase deficiency associated with two conditions: liver cirrhosis and heterozygous Kalow variant BChE mutation." i. [Extracted from the article]

In a French pharmacovigilance survey performed between 1 January 2000- 31 December 2012, a male patient [ I age not stated i ] was described, who developed fatal anaphylactic shock secondary to suxamethonium chloride for neuromuscular blocking. Thus, a diagnosis of anaphylactic shock secondary to suxamethonium chloride was confirmed [ I time to reaction onset not stated i ]. B Author comment: b I "Finally, we suggest that patients should be better informed about their perioperative anaphylaxis to improve adherence to their scheduled appointment for allergy skin testing. [Extracted from the article]

The article describes the case of nine patients, aged 8-34 years, who developed malignant hyperthermia after receiving treatment with various drugs. It references a study by T. Y. Chan et al, published in the November 2017 issue of the journal "Anaesthesia and Intensive Care." Topics discussed include the medical history of each patients, drugs administered such as halothane, fentanyl and suxamethonium chloride, and findings from laboratory tests conducted on each patient.

An 11-year-old girl developed rhabdomyolysis following treatment with sevoflurane for induction of anaesthesia and suxamethonium chloride [ I dosages and routes not stated i ]. She received induction of anaesthesia with sevoflurane along with suxamethonium chloride [succinylcholine] and glycopyrrolate. [Extracted from the article]

A 36-year-old man developed apnoea following treatment with suxamethonium chloride as part of anaesthesia therapy. A differential diagnosis of suxamethonium chloride-associated apnoea was considered and he was transferred to the ICU [ I duration of treatment to reaction onset not stated i ]. B Author comment: b I "[Suxamethonium-chloride] apnoea is a rare but important cause of apnoea after general anaesthesia." i. [Extracted from the article]

A 25-year-old woman pregnant developed anaphylaxis and severe bronchospasm following induction of general anaesthesia with suxamethonium chloride and thiopental sodium. After pre-oxygenation, a rapid sequence induction was performed using suxamethonium chloride [suxamethonium] and thiopental sodium [thiopental; I dosages and routes not stated i ]. "In this case absolute bronchospasm effectively mimicked oesophageal intubation leading to multiple erroneous attempts at intubation." i. [Extracted from the article]

The article reports on the voluntary recall of the sterile products of RXQ Compounding for both human and veterinary use due to a lack of sterility process assurance, according to the U.S. Food and Drug Administration (FDA). Topics discussed include statement from the FDA about the administration of a non-sterile product, list of the recalled products, and advice for consumers to report any adverse reactions or quality issues they may have experienced with the recalled products.