Medication Description: Ditilin (Dithylinum)
DITILIN (Dithylinum). b-Dimethylaminoethyl ester of succinic acid diiodomethylate.
Synonyms: Suxamethonii iodidum, Suxamethonium iodide.
Similar dibromide dichloride sold under the names: listenon [Drug Name (suxamethonium chloride) from "Hafslund Nycomed Pharma AG"], Miorelaksin, Anectine, Vrevidil M. Selocaine, Selocurin, Shlorsuccilin, Surasholin, Suracit, Suralest, Diacetylcholine, Lertosuccin (Yu )), Lysthenon, Myo-Relaxin, Ranolax, Quelicin сhloride, Scoline, Succinylcholini сhloridum, Sucostrin, Suhamethonii сhloridum, Suxinyl, Syncuror, etc.
White fine crystalline powder. Easily soluble in water, very little - in alcohol.
On the chemical structure of the molecule ditilina can be considered as a double acetylcholine molecule [diacetylcholine]. It is the main representative of depolarizing muscle relaxants. When administered intravenously, it disrupts neuromuscular excitation and causes skeletal muscle relaxation.
Ditilin is destroyed by pseudo-cholinesterase 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 relaxation of the muscles, repeated administration of the drug is necessary. The rapid onset of 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 dithylin (closenone) are tracheal intubation, endoscopic procedures (broncho-and esophagoscopy, cystoscopy, etc.), short-term operations (suturing the abdominal wall, dislocation reduction, etc.). With the appropriate dose and repeated administration, ditilin (listenone) can also be used for longer operations, however, for prolonged muscle relaxation, antidepolarizing muscle relaxants are usually used, which are administered after pre-intubation of the trachea against ditilin. The drug can also be used to eliminate tetanus cramps.
Ditilin is administered intravenously. For intubation and for complete relaxation of the skeletal and respiratory muscles during the operation, the drug is administered in a dose of 1, 5 - 2 mg / kg. For prolonged relaxation of the muscles during the entire operation, the preparation can be administered fractionally after 5-7 minutes at 0.5-1 mg / kg. Repeated doses of ditilina act longer.
Complications when using ditilina usually not observed. However, it should be borne in mind that in some cases there may be an increased sensitivity to ditilin with prolonged respiratory depression, which may be due to a genetically determined violation of the formation of cholinesterase. The cause of the prolonged action of the drug may also be hypokalemia.
Ditilin can be used with various types of anesthesia (ether, nitrous oxide, halothane, barbiturates). In all cases, the introduction of ditilina in large doses is allowed only after the patient is transferred to artificial (controlled) breathing. At use of small doses independent breath can remain. However, in these cases it is necessary to have in place all the devices for artificial respiration.