B. Apnea: depolarizing agents

Administration of succinylcholine to a patient who is genetically deficient in plasma cholinesterase or who has an atypical form of the enzyme can lead to prolonged apnea due to paralysis of the diaphragm. The rapid release of potassium may also contribute to prolonging apnea in patients with electrolyte imbalances who receive this drug. Patients with electrolyte imbalances who are also receiving digoxin or diuretics (such as congestive heart failure patients) should use succinylcholine cautiously or not at all.