All true about dosing of succinylcholine except-
**Core Concept**
Succinylcholine is a depolarizing neuromuscular blocking agent used for rapid sequence intubation and surgical muscle relaxation. Its dosing is critical to prevent adverse effects, particularly hyperkalemia and cardiac arrhythmias.
**Why the Correct Answer is Right**
Succinylcholine is primarily metabolized by plasma cholinesterase, and its dosage must be adjusted in patients with liver disease or those taking certain medications that inhibit this enzyme. The typical dose is 1-2 mg/kg IV, with a maximum dose of 100 mg. Repeated doses can lead to accumulation of succinylcholine metabolites, increasing the risk of adverse effects.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not specify a correct limitation on succinylcholine dosing. Succinylcholine can cause hyperkalemia, but this is not the primary concern with dosing.
**Option B:** This option is incorrect because succinylcholine is contraindicated in patients with burns covering >10% of body surface area, as it can lead to severe hyperkalemia.
**Option C:** This option is incorrect because succinylcholine is not primarily excreted by the kidneys, but rather metabolized by plasma cholinesterase.
**Clinical Pearl / High-Yield Fact**
Succinylcholine should be used cautiously in patients with known or suspected burns, as even small amounts can cause life-threatening hyperkalemia.
**Correct Answer: B. Succinylcholine is contraindicated in patients with burns covering >10% of body surface area, as it can lead to severe hyperkalemia.