All of the following are cardiac effects of succinylcholine when administered in a 12 year old child, EXCEPT:
Children are paicularly susceptible to profound bradycardia following administration of succinylcholine. Bradycardia will sometimes occur in adults when a second bolus of succinylcholine is administered approximately 3-8 min after the first dose. The dogma is that the succinylcholine metabolite, succinylmonocholine, sensitizes muscarinic cholinergic receptors in the sinoatrial node to the second dose of succinylcholine, resulting in bradycardia. Intravenous atropine is normally given prophylactically to children prior to the first and subsequent doses, and usually before a second dose of succinylcholine is given to adults. Succinylcholine not only stimulates nicotinic cholinergic receptors at the neuromuscular junction, it stimulates all ACh receptors. Low doses of succinylcholine can produce negative chronotropic and inotropic effects, but higher doses usually increase hea rate and contractility and elevate circulating catecholamine levels. Ref: Butterwoh IV J.F., Butterwoh IV J.F., Mackey D.C., Wasnick J.D., Mackey D.C., Wasnick J.D. (2013). Chapter 11. Neuromuscular Blocking Agents. In J.F. Butterwoh IV, J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e.
Stimulates nicotinic cholinergic receptors at the neuromuscular junction
Second dose will cause profound tachycardia
Stimulates all ACh receptors
Higher doses increase hea rate and contractility of the hea