Drug Group 4

General anesthetic

Decreases activity of the reticular formation in the brainwith minimal cardiac and respiratory effects

Used for induction of general anesthesia (intubation in the EMSsetting)

None

0.3 mg/kg IV

Nondepolarizing neuromuscular blocker

Competitively binds to cholinergic receptors. Reversiblein the presence of acetylcholinesterase inhibitors, suchas neostigmine

Rapid Sequence Intubation, maintenance of desired paralysis

None

RSI: 0.6 mg/kg

Depolarizing neuromuscular blocking agent

Combines with cholinergic receptors in motor nerves tocause depolarization. Neuromuscular transmission isinhibited, causing temporary skeletal paralysis, untilsuccinylcholine is metabolized and cells becomerepolarized

To achieve temporary paralysis when endotracheal intubation isindicated and muscle tone impedes successful intubation

Hyperkalemia, history of malignant hyperthermia,penetrating eye injury, neuromuscular disorder (MS),paralysis > 1 day, crush injury > 3 days, severe burns > 3days

Adult: 1-2 mg (1.5 generally)/kg IV (The preferred route is IV; IM canbe used if protocols allow.)Pediatric: 2 mg/kg

Arrhythmias, bradycardia, increased intraocular pressure,Increased intracranial pressure, hyperkalemia

Non-depolarizing paralytic agent

Competes with acetylcholine for cholinergic receptorsites on the post junctional membrane, resulting inparalysis

Paralysis to obtain endotracheal intubation where a longer durationof action is desired than that provided by succinylcholine

None

0.1mg/kg IV push