{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:14:16Z","timestamp":1790802856059,"version":"4.1.0"},"reference-count":78,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Succinylcholine, a commonly used neuromuscular blocker, is hydrolyzed by the pseudocholinesterase (also known as butyrylcholinesterase) enzyme in the plasma to inactive metabolites. Individuals who have inherited genetic variants in the\n                    <jats:italic>BCHE<\/jats:italic>\n                    gene that result in decreased or no pseudocholinesterase enzyme activity are at increased risk of prolonged neuromuscular blockade with succinylcholine. Although succinylcholine\/\n                    <jats:italic>BCHE<\/jats:italic>\n                    is one of the earliest identified pharmacogenomic drug\/gene associations, clinical implementation remains the exception rather than the norm today. This review will explore the historical roots of pseudocholinesterase deficiency, its therapeutic implications for succinylcholine use, and future considerations for\n                    <jats:italic>BCHE<\/jats:italic>\n                    genetic testing to minimize the occurrence of prolonged neuromuscular blockade that can cause serious physical (i.e., apnea) and psychological (i.e., post\u2010traumatic stress) consequences for patients. A summary and critical examination of the published literature that includes\n                    <jats:italic>BCHE<\/jats:italic>\n                    genetic testing in relation to succinylcholine response is also provided. Prolonged paralysis with succinylcholine may be prevented with preemptive\n                    <jats:italic>BCHE<\/jats:italic>\n                    genetic testing.\n                  <\/jats:p>","DOI":"10.1002\/phar.70048","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T10:39:29Z","timestamp":1754649569000},"page":"600-620","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hereditary Pseudocholinesterase Deficiency and Succinylcholine: Historical Perspective, Therapeutic Implications, and Future Considerations"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7190-1231","authenticated-orcid":false,"given":"Jenny Q.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Personalized Care Program Children's Hospital Los Angeles  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9537-2103","authenticated-orcid":false,"given":"Courtney","family":"Paetznick","sequence":"additional","affiliation":[{"name":"Pharmacogenomics Program Children's Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7550-042X","authenticated-orcid":false,"given":"Roseann S.","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Massachusetts College of Pharmacy and Health Sciences  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev096"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janh.2018.07.003"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102710.2005.00680.x"},{"key":"e_1_2_9_5_1","unstructured":"PubChem \u201cSuccinylcholine Structure \u201daccessed July 22 2025 https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/5314#section=2D\u2010Structure."},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0000000000000170"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1319"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03005788"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.5493\/wjem.v14.i1.87202"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2006.11.005"},{"key":"e_1_2_9_11_1","unstructured":"A.Benner N. 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