Patient (condition)
Aliases:
Topic aliases are alternate phrasings for a particular topic.
Sux apneoa
Scoline apnoea
Suxamethonium sensitivity
Succinylcholine sensitivity
Is it Congenital or Acquired?
-- CONGENITAL (autosomal recessive) Genotype
U = usual
A = Atypical
S = Silent
D = Fluoride resistant
Dibucaine number
Eu:Eu (96%) = 80
Eu:Ea (1/25) = 60
Ea:Ea (1/2800) = 20
Es:Es (1/100,000) = infinity?
Heterozygous Atypical - 7 to 30min apnoea, 1 in 25
Homozygous Atypical - 2- 4hrs apnoea, 1 in 3,000 (Dibucaine number ~20)
-- ACQUIRED
Pregnancy
Burns
Malnutrition
Liver disease
Thyrotoxicosis
Plasmapheresis and
Cardiopulmonary bypass
Drugs
Metoclopramide
Cyclophosphamide
Methotrexate
Neostigmine
MAOIs
Ester local anaesthetics
Esmolol, mivacurium
-- CONGENITAL (autosomal recessive) Genotype
U = usual
A = Atypical
S = Silent
D = Fluoride resistant
Dibucaine number
Eu:Eu (96%) = 80
Eu:Ea (1/25) = 60
Ea:Ea (1/2800) = 20
Es:Es (1/100,000) = infinity?
Heterozygous Atypical - 7 to 30min apnoea, 1 in 25
Homozygous Atypical - 2- 4hrs apnoea, 1 in 3,000 (Dibucaine number ~20)
-- ACQUIRED
Pregnancy
Burns
Malnutrition
Liver disease
Thyrotoxicosis
Plasmapheresis and
Cardiopulmonary bypass
Drugs
Metoclopramide
Cyclophosphamide
Methotrexate
Neostigmine
MAOIs
Ester local anaesthetics
Esmolol, mivacurium
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Oct 23, 2012
Where resources for prolonged ventilation are limited, fresh frozen plasma (FFP) may supplement plasma cholinesterase and avoid a prolonged ventilation in ICU or recovery.
This needs to be balanced against the risk of iatrogenic viral transmission from the blood product.
#MA
This needs to be balanced against the risk of iatrogenic viral transmission from the blood product.
#MA
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Oct 23, 2012
Cocaine metabolism is reduced due to pseudocholinesterase deficiency. This may prolong systemic action and potentially increased plasma levels.
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Sep 18, 2011
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Pseudocholinesterase deficiency is quantified by determining the dibucaine number. Dibucaine inhibits plasma cholinesterase. When dibucaine is added to a patients serum sample, the degree of inhibition of plasma pseudocholinesterase activity (by dibucaine) on benzyl choline is the dibucaine number. eg dibucaine number of 80 means there is plenty of pseudocholinestase to be inhibited
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Oct 18, 2011