dose of succinylcholine in patients with myasthenia gravis

Q: The dose of succinylcholine in patients with myasthenia gravis (MG) should be? (select one) 

A) Increased 
B) Decreased


Answer: A

There is a misconception that the dose of succinylcholine should be decreased in myasthenia gravis to avoid the risk of hyperkalemia. Patients with myasthenia gravis are relatively resistant to succinylcholine. The dose should be adjusted to 2 mg/kg to stimulate the remaining acetylcholine receptors unaffected by the MG. Severe hyperkalemia rarely occurs with appropriate dosing

#pharmacology


Reference: 

Levitan R. Safety of succinylcholine in myasthenia gravis. Ann Emerg Med 2005; 45:225.