Posted 21 August 2006 - 01:51 AM
Ffmedic9588, atropine may be considered in the rare event of succ OD. (Repeated doses would be the most common cause) In most cases succ causes what is caused a phase I block. Or the typical depolarizing block we all know and love. Succ attaches at the neuromuscular junction in place of acetylcholine and causes the muscle to depolarize and stay in that state. Hence, the faciculations we all talk about with succ. In cases of succ OD this phase I block may take on superficial characteristics of a phase II block. Or a non depolarizing type block. Non depolarizers attach at the junction in place of AcH, but do not cause the muscle to depolarize. Rather, they prevent depolarization. So, in succ OD we may have a pseudo phase II block. In cases of this block, we may need to give an anticholinesterase medication such as neostigmine. If we give neostigmine, we need to anticipate anticholenesterase type side effects. So, we may need to give an anticholinergic such as atropine to combat these side effects. A WORD OF CAUTION!! Phase II block must be verified and confirmed because if we have a prolonged phase I block and we give neostigmine, we have just complicated our problems 10 fold. Verification of a phase II block requires peripheral nerve stimulation, and I would advise against following your protocol in the field.
I hope this helps.