Description of the medicine: Ditilinum (Dithylinum)
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 firm "Hafslund Nycomed Pharma AG"], Miorelaxin, Anectin, Brevilil M., Celocaine, Celocurin, Chlorsuccilin, Сurasholin, Сuracit, Сuralest, Diacetylcholine, Lertosuccin )), Lysthenon, Myo-Relaxin, Rantolax, Quelicin Сhloride, Scoline, Succinylcholini Chloridum, Sucostrin, Suhamethonii chloridum, Suxinyl, Syncuror, and others.
White fine crystalline powder. Easily soluble in water, very little - in alcohol.
By chemical structure, the dithiline molecule can be considered as a doubled molecule of acetylcholine [diacetylcholine]. He is the main representative of depolarizing muscle relaxants. With intravenous administration, it breaks the neuromuscular excitation and causes relaxation of skeletal muscles.
Dithilin is destroyed by pseudocholinesterase and decomposes into choline and succinic acid. The drug has a fast and short-term effect; Cumulative effect does not possess. For a long relaxation of the muscles, a repeated injection of the drug is necessary. The rapid onset of the effect and the subsequent rapid restoration of muscle tone allow the creation of a controlled and controlled relaxation of the muscles.
The main indications for the use of dithilin (ispenone) are intubation of the trachea, endoscopic procedures (broncho- and esophagoscopy, cystoscopy, etc.), short-term operations (suturing the abdominal wall, directing the dislocations, etc.). With appropriate dose and repeated administration of dithilin (canine) can be used for longer operations, but for prolonged relaxation of the muscles, antidepolarizing muscle relaxants are usually used, which are administered after a pre-intubation of the trachea against the background of dithiline. The drug can also be used to eliminate seizures in tetanus.
Introduce dithilin intravenously. For intubation and for complete relaxation of skeletal and respiratory muscles during the operation, the drug is administered in a dose of 1, 5 - 2 mg / kg. For a long relaxation of the musculature during the entire operation, the drug can be injected fractionally after 5 to 7 minutes at 0.5-1 mg / kg. Repeated doses of dithiline last longer.
Complications with the use of dithiline is usually not observed. It should be borne in mind, however, 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 prolonged action of the drug may also be hypokalemia.
Dithilin can be used for various types of anesthesia (ether, nitrous oxide, fluorotane, barbiturates). In all cases, the introduction of dithilin in large doses is allowed only after the patient is transferred to artificial (controlled) breathing. When small doses are used, independent breathing can be maintained. However, in these cases, it is necessary to have ready all the devices for artificial ventilation.