Drug General Information (ID: DDI387F6IY)
  Drug Name Succinylcholine Drug Info Ethotoin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Analgesics Anticonvulsants
  Structure

 Mechanism of Succinylcholine-Ethotoin Interaction (Severity Level: Moderate)
     Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Succinylcholine Ethotoin
      Mechanism Neuromuscular blocking agent
Acetylcholinesterase  Substrate
Potentiates neuromuscular blockade
Anticonvulsant induced up-regulation of acetylcholine receptors 
      Key Mechanism Factor 1
Factor Name Acetylcholinesterase
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Structure Sequence
MRPPQCLLHTPSLASPLLLLLLWLLGGGVGAEGREDAELLVTVRGGRLRGIRLKTPGGPVSAFLGIPFAEPPMGPRRFLPPEPKQPWSGVVDATTFQSVCYQYVDTLYPGFEGTEMWNPNRELSEDCLYLNVWTPYPRPTSPTPVLVWIYGGGFYSGASSLDVYDGRFLVQAERTVLVSMNYRVGAFGFLALPGSREAPGNVGLLDQRLALQWVQENVAAFGGDPTSVTLFGESAGAASVGMHLLSPPSRGLFHRAVLQSGAPNGPWATVGMGEARRRATQLAHLVGCPPGGTGGNDTELVACLRTRPAQVLVNHEWHVLPQESVFRFSFVPVVDGDFLSDTPEALINAGDFHGLQVLVGVVKDEGSYFLVYGAPGFSKDNESLISRAEFLAGVRVGVPQVSDLAAEAVVLHYTDWLHPEDPARLREALSDVVGDHNVVCPVAQLAGRLAAQGARVYAYVFEHRASTLSWPLWMGVPHGYEIEFIFGIPLDPSRNYTAEEKIFAQRLMRYWANFARTGDPNEPRDPKAPQWPPYTAGAQQYVSLDLRPLEVRRGLRAQACAFWNRFLPKLLSATDTLDEAERQWKAEFHRWSSYMVHWKNQFDHYSKQDRCSDL
Gene Name ACHE
Uniprot ID ACES_HUMAN
KEGG Pathway hsa:43
Protein Family Type-B carboxylesterase/lipase family
Protein Function
Hydrolyzes rapidly the acetylcholine neurotransmitter released into the synaptic cleft allowing to terminate the signal transduction at the neuromuscular junction. Role in neuronal apoptosis.
    Click to Show/Hide
      Mechanism Description
  • Additive neuromuscular blocking effects by the combination of Succinylcholine and Ethotoin 

Recommended Action
      Management Close observation for reduced or prolonged succinylcholine effect is recommended if this drug must be used in a patient receiving chronic anticonvulsant therapy.

References
1 Cerner Multum, Inc. "Australian Product Information.".
2 Ozuna J, Friel P "Effect of enteral tube feeding on serum phenytoin levels." J Neurosurg Nurs 16 (1984): 289-91
3 Melton AT, Antognini JF, Gronert GA "Prolonged duration of succinylcholine in patients receiving anticonvulsants: evidence for mild up-regulation of acetylcholine receptors?" Can J Anaesth 40 (1993): 939-42