title: Catastrophic hyperkalaemia following administration of suxamethonium chloride to a patient with undiagnosed amyotrophic lateral sclerosis.
abstract: The depolarising neuromuscular blocking agent suxamethonium chloride, frequently used during endotracheal intubation, is contraindicated in patients with chronic denervation in whom it can cause a life-threatening hyperkalaemic reaction, thought to be mediated through upregulation of nicotinic alpha7 acetylcholine receptors. An underlying neuromuscular disorder should be considered in all patients with acute respiratory insufficiency, and an alternative neuromuscular blocking drug must be used if there is any possibility of widespread denervation.
authors: Oxford University Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford. martin.turner@clneuro.ox.ac.uk
authors: M R
authors: MR
authors: Turner
authors: H
authors: H
authors: Lawrence
authors: I
authors: I
authors: Arnold
authors: O
authors: O
authors: Ansorge
authors: K
authors: K
authors: Talbot
mesh_terms: D000690:Amyotrophic Lateral Sclerosis; D005207:Fasciculation / Q000139:chemically induced; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced* / Q000188:drug therapy; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D013390:Succinylcholine / Q000009:adverse effects*; D013610:Tachycardia / Q000139:chemically induced
chemical_list: D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine