Description of the medicine: Dithylinum (Dithylinum)
DITYLIN (Dithylinum). b-Dimethylaminoethyl ester of succinic acid diiodomethylate.
Synonyms: Suxamethonii iodidum, Suxamethonium iodide.
Similar dichlorides and dibromides are available under the names: Listenon [Name of the drug (suxamethonium chloride) of the company "Hafslund Nycomed Pharma AG"], Miorelaxin, Anectine, Brevidil M., Сelocaine, Сelocurin, Сhlorsuccilin, Сuracitinceline, Сuraсholcein Dialen )), Lysthenon, Myo-Relaxin, Pantolax, Quelicin chloride, Scoline, Succinylcholini chloridum, Sucostrin, Suxemonii chloridum, Suxinyl, Syncuror, etc.
White crystalline powder. Easily soluble in water, very little in alcohol.
According to the chemical structure, the dithylin molecule can be considered as a doubled acetylcholine molecule [diacetylcholine). He is the main representative of depolarizing muscle relaxants. When administered intravenously, it disturbs the conduction of neuromuscular excitation and causes relaxation of the skeletal muscles.
Dithylin is destroyed by pseudocholinesterase and breaks down into choline and succinic acid. The drug has a quick and short-term effect; does not have a cumulative effect. For prolonged muscle relaxation, repeated administration of the drug is necessary. The rapid onset of the effect and the subsequent rapid restoration of muscle tone allow you to create controlled and controlled muscle relaxation.
The main indications for the use of dithilin (listenone) are tracheal intubation, endoscopic procedures (bronchoscopy and esophagoscopy, cystoscopy, etc.), short-term operations (suturing the abdominal wall, reduction of dislocations, etc.). With an appropriate dose and repeated administration of dithylin (listenone), it can also be used for longer operations, however, antidepolarizing muscle relaxants are usually used for prolonged muscle relaxation, which are administered after preliminary intubation of the trachea with dithylin. The drug can also be used to eliminate seizures in tetanus.
Dithylin is administered intravenously. For intubation and for complete relaxation of skeletal and respiratory muscles during surgery, the drug is administered in a dose of 1, 5 - 2 mg / kg. For long-term muscle relaxation during the entire operation, the drug can be administered fractionally in 5-7 minutes at 0.5-1 mg / kg. Repeated doses of dithylin last longer.
Complications with the use of dithilin are usually not observed. However, it should be borne in mind that in some cases there may be an increased sensitivity to dithilin with prolonged respiratory depression, which may be due to a genetically determined violation of cholinesterase formation. The cause of the prolonged action of the drug may also be hypokalemia.
Dithilin can be used for various types of anesthesia (ether, nitrous oxide, fluorotan, barbiturates). In all cases, the introduction of dithylin in large doses is allowed only after the patient is transferred to artificial (controlled) breathing. When using small doses, spontaneous breathing may persist. However, in these cases it is also necessary to have all the devices for mechanical ventilation ready.