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What is Which of the following is earliest and shortest acting skeletal muscle relaxant? and explain in detail?
(D) Suxamethonium# Classification of non depolarising NM blocking drugs (according to time from inj. to 90% recovery of twitch tension of adductor pollicis).1. Short acting: 10-20 min. -- Mivacurium2. Intermediate acting: 20-30 min.-- Atracurium, Vecuronium, Rocuronium3. Long acting: 30-60 mins.-- Alcuronium, Gallamine.# SUXAMETHONIUM CHLORIDE> Pharmacokinetics: Is two molecules of Ach linked back to back through the acetate methyl groups (Dicholine ester of succinic acid). Provides profound relaxation with rapid onset of action (30-60 sec) & short duration of action (<10 mins.) & Half life of drug is 2-4 mins. Rapid hydrolysis by pseudocholinesterase, an enzyme of liver & plasma, initial metabolite Succinylmonocholine is weaker neuromuscular blocker, metabolised slowly to succinic acid & choline. 90% of Suxamethonium given intravenously is destroyed & 10% reaches Neuromuscular junction. Distribution limited to extracellular space.> Succinylmonocholine can be prolonged by: Reduced quantity of normal enzyme; A typical form of Pseudocholinesterase.> Low Pseudocholinesterase levels are seen in: Liver disease, Renal disease; Pregnancy; Phenelzine; Echothiophate; Cytotoxic drugs; Hexafluorine, Trimethaphan; Cancer; Ache inhibitors, Metoclopramide. Dibucaine, a local anaesthetic inhibits normal pseudocholinesterase activity by 80%. Percentage of inhibition of pseudocholinesterase activity is termed the Dibucaine number (Proportional to pseudocholin-esterase function).> Shortest acting depolarization agent is Succinylcholine (duration - 3 to 6 mm).> Shortest acting non-depolarizing agent is - Mivacurium (duration -12-20 min).