サクシニルコリン / スキサメトニウム
Succinylcholine Chloride
Suxamethonium chloride
別名: Anectine · Quelicin · choline chloride succinate · succicurarium chloride · suxamethonii chloridum · suxametonklorid · suxamethonium chloride
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.07 mg/kg | IV | Single dose | — | 🌎 NA |
| Muscle relaxation | 0.22 mg/kg | IV | Single dose | — | 🌎 NA |
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.06 mg/kg | IV | Single dose | — | 🌎 NA |
| Muscle relaxation | 0.11 mg/kg | IV | Single dose | — | 🌎 NA |
爬虫類
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| To relax an animal to allow intubation | 0.5-1 mg/kg | IM | Single dose | — | 🌎 NA |
- To relax an animal to allow intubation: Especially helpful with turtles and crocodilians.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.088-0.11 mg/kg | IV, IM | Single dose | — | 🌎 NA |
- Muscle relaxation: See Precautions. ARCI UCGFS Class 2 Drug. 0.088 mg/kg IV may paralyze skeletal muscles without causing respiratory depression, but higher doses cause apnea.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
塩化サクシニルコリンは、超短時間作用型の脱分極性骨格筋弛緩薬（麻痺薬）です。
臨床上の重要なポイント：
- 鎮痛・鎮静作用なし： サクシニルコリンには鎮痛作用や意識消失作用は全くありません。患者は完全に覚醒し痛みを感じますが、完全に麻痺状態となります。必ず適切な鎮静薬、麻酔薬、鎮痛薬と併用する必要があります。
- 人工呼吸管理が必須： 横隔膜や肋間筋を麻痺させるため、薬効が切れるまで機械的換気が必須です。
- 臨床用途： 主に気管挿管（迅速導入挿管）、外科的・診断的処置のための短時間の筋弛緩、または痙攣時の筋収縮の軽減に使用されます。
- 種差： ヒトや多くの動物では作用時間が非常に短い（2〜3分）ですが、犬では特異的に作用時間が延長（約20分）します。
- 現代の使用状況： 獣医療における使用は、副作用が少なく拮抗可能な非脱分極性筋弛緩薬（アトラクリウム、ロクロニウムなど）に大きく取って代わられています。
作用機序
Succinylcholine acts as a depolarizing neuromuscular blocker.
- Binding: It acts as a structural analog of acetylcholine (ACh) and binds to nicotinic acetylcholine receptors (nAChRs) at the motor endplate of the neuromuscular junction.
- Depolarization: Unlike ACh, which is instantly degraded by acetylcholinesterase, succinylcholine remains bound, causing prolonged depolarization of the muscle membrane. This initial depolarization manifests clinically as transient muscle twitches (fasciculations).
- Paralysis: Because the membrane cannot repolarize, it becomes unresponsive to subsequent ACh release → flaccid paralysis (Phase I block).
- Metabolism: The blockade persists until succinylcholine diffuses away from the receptor and is rapidly hydrolyzed by plasma pseudocholinesterase (butyrylcholinesterase) in the blood.
安全性・警告
禁忌
- Severe liver disease
- Chronic anemias
- Chronic malnourishment
- Glaucoma or penetrating eye injuries
- Predisposition to malignant hyperthermia
- Increased CPK values with resultant myopathies
- Recent use of organophosphate agents
有害事象
- Muscle soreness
- Histamine release
- Malignant hyperthermia
- Excessive salivation
- Hyperkalemia
- Rash
- Myoglobinemia
- Myoglobinuria
- Bradycardia
- Tachycardia
- Hypertension
- Hypotension
- Arrhythmias
注意事項
CRITICAL WARNING: Succinylcholine has NO analgesic or anesthetic effects. It must be used with appropriate analgesic, sedative, and anesthetic agents. Mechanical ventilation is required.
- Hyperkalemia Risk: Use with extreme caution in patients with traumatic wounds, burns, preexisting hyperkalemia, or electrolyte imbalances, as fatal arrhythmias or cardiac arrest may occur due to sudden potassium efflux from muscle cells.
- Organ Dysfunction: Use with caution in patients with pulmonary, renal, cardiovascular, metabolic, or hepatic dysfunction.
- Equine Specifics (AAEP Recommendations): Inform owners it is a restraining agent, not an anesthetic. Do not use if the horse has received 'mycin' antibiotics, organophosphates, cholinesterase inhibitors, or procaine within 30 days. Do not use in debilitated/exhausted horses. Withhold food 4-6 hours prior. Be prepared to administer oxygen and artificial respiration. Have a handler prevent the horse from falling forward.
医薬品相互作用
May increase succinylcholine's effects by causing electrolyte imbalances
Succinylcholine may cause a sudden outflux of potassium from muscle cells, causing arrhythmias in digitalized patients
Potential for increased incidences of bradycardia and sinus arrest
May increase succinylcholine's effects by causing electrolyte imbalances
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade (Contraindicated)
監視
- Level of muscle relaxation
- Cardiac rate and rhythm (ECG)
- Respiratory depressant effect (Apnea)
- Oxygenation (Pulse oximetry) and Ventilation (Capnography)
- Body temperature (risk of malignant hyperthermia)
薬物動態
半減期
吸収
IV onset of action is usually within 30-60 seconds. IM onset is generally within 2-3 minutes.
分布
Diffuses away from the motor end plate. Crosses the placenta in low concentrations.
代謝
Rapidly hydrolyzed by plasma pseudocholinesterases to succinylmonocholine (weak blocking activity) and choline.
消失
10% is excreted unchanged in the urine. Succinylmonocholine is partially excreted in the urine and may accumulate in renal impairment.
過剰投与
Inadvertent overdoses, or standard doses in patients deficient in pseudocholinesterase, may result in prolonged apnea.
- Treatment: Mechanical ventilation with 100% O2 must be maintained until full spontaneous recovery occurs.
- Phase II Block: Repeated or prolonged high dosages may cause patients to convert from a depolarizing (Phase I) block to a non-depolarizing-like (Phase II) block.
製品
製剤
- Injection solution
- Powder for infusion
ヒト用医薬品
- Succinylcholine Chloride Injection: 20 mg/mL in 10 mL vials and 5 mL syringes
- Succinylcholine Chloride Injection, Solution: 100 mg/mL in 5 mL & 10 mL vials
- Succinylcholine Chloride Powder for Infusion: 500 mg & 1 gram in vials
規制ステータス
規制データなし: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Commercial injectable solutions should be stored refrigerated (2°-8°C). Multiple dose vials of Anectine are stable up to 2 weeks at room temperature. Powder forms are stable indefinitely unopened at room temperature. Reconstituted powder is stable for 4 weeks at 5°C or 1 week at room temperature, but use within 24 hours is recommended as it contains no preservatives.
飼主向け情報
この薬は、臨床環境において訓練を受けた獣医療従事者のみが使用するものです。
- 重要： この薬は筋弛緩薬（麻痺薬）です。呼吸に使われる筋肉を含め、筋肉の動きを止めますが、鎮痛作用や鎮静作用は一切ありません。
- この薬を投与する前に、ペットが完全に眠り、痛みを感じない状態にするための別の薬が投与されます。
- 呼吸筋を止めてしまうため、獣医療チームが呼吸用のチューブを挿入し、薬の効き目が完全に切れるまで人工呼吸器を使用してペットの呼吸をサポートします。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。