-----Original Message-----
From: Dr J. M. Fisher <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 07 January 1999 19:59
Subject: Re: sedation in head injuries.


>Does this mean you need not refrigerate it and can carry in the car for
>pre-hospital care? It would shortern our response time if so. I woulld be
>interested in further details. Thank you
>Judith Fisher
>Cons. A&E PAH Harlow (with RRV)

It seems that if you buffer sux correctly it can last for quite a long time
unrefrigerated.(1,2). If you are prepared to up the dose slightly and
replace your stocks every two months the articles below suggest that
refrigeration is unnecessary.

As to the effect from radiation (noticed on the lit search) who knows??

PS. What's an RRV?

Simon

Simon Carley
SpR in Emergency Medicine
Hope Hospital
Salford
England
[log in to unmask]




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1.
Authors
Schmutz CW. Muhlebach SF.
Institution
Hospital Pharmacy, Kantonsspital Aarau, Switzerland.
Title
Stability of succinylcholine chloride
injection.

Source
American Journal of Hospital Pharmacy. 48(3):501-6, 1991 Mar.

Abstract
The stability of succinylcholine chloride injection prepared by a hospital
pharmacy was studied under a wide variety of conditions. Batches of
succinylcholine chloride injection 10 mg/mL containing sodium chloride,
methyl-4-hydroxybenzoate, hydrochloric acid, and water were prepared.
Samples were tested for the effect of initial pH (3.0 and 4.2) and
sterilization (steam treatment at 100 degrees C for 30 minutes and 121
degrees C for 20 minutes) on stability after three weeks; long-term
stability under refrigeration (12, 17, and 23 months of storage at 4 degrees
C); and the effect of storage temperature (4-6 degrees C, 20-26 degrees C,
35 degrees C, and 70 degrees C) and light exposure at various intervals up
to 12 months. Samples were analyzed by thin-layer chromatography (TLC) and
high-performance liquid chromatography (HPLC). Unlike heating at 121 degrees
C, heating at 100 degrees C produced no significant loss of succinylcholine
chloride, independent of the initial pH. Succinylcholine chloride was
hydrolyzed only minimally over 23 months if the solution was stored at 4-6
degrees C. A 10% loss of drug content occurred if solutions were kept at
20-26 degrees C for five months, at 35 degrees C for one month, or at 70
degrees C for one day. Initial degradation was slowed if the solution was
protected from light. The assessments by TLC proved to be more sensitive
than the HPLC measurements. Succinylcholine chloride injection sterilized at
100 degrees C for 30 minutes can be stored for up to five months at room
temperature if protected from light. The preparation is stable for at least
two years under refrigeration.


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2.
Authors
Boehm JJ. Dutton DM. Poust RI.
Title
Shelf life of unrefrigerated succinylcholine chloride
injection.

Source
American Journal of Hospital Pharmacy. 41(2):300-2, 1984 Feb.

Abstract
The shelf life of succinylcholine chloride injection at several pH values
when stored at room temperature was evaluated. Solutions containing 20 mg/ml
of succinylcholine chloride were stored at 25 and 40 degrees C. The reaction
was studied at pH values ranging from 3.0 to 4.5. At two-week intervals, the
solutions were assayed by high-pressure liquid chromatography. The initial
amount of succinylcholine chloride in all samples was 100.1 +/- 2.37% of
label claim. Hydrolysis of succinylcholine chloride in unbuffered solutions
followed apparent zero-order kinetics. The pH range of maximum stability was
found to be from 3.75 to 4.50. Succinylcholine chloride decomposed at a
considerably higher rate at 40 degrees C. Allowing for the effects of pH
adjustment during manufacture and degradation during shipping, losses of
7.0% and 9.0% potency can be expected after storage at 25 degrees C for four
and six weeks, respectively. Succinylcholine Chloride Injection, USP, should
be stored in the refrigerator; if unbuffered succinylcholine chloride
injection complying with USP pH limits must be stored at room temperature,
it should not be kept for longer than four weeks.

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3.
Authors
Perkowski E. Szyszko E. Zagorski ZP. Wozniak W.
Title
[Effect of ionizing radiation on the stability of
suxamethonium chloride]. [Polish]

Source
Acta Poloniae Pharmaceutica. 28(4):369-74, 1971.


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