Quinidine Atropine

Galantamine (Razadyne) [Cholinesterase Inhibitor] Uses Alzheimer Dz Action Acetylcholinesterase inhibitor Dose 4 mg PO bid, T to 8 mg bid after 4 wk may T to 12 mg bid in 4 wk Caution [B, ] T Effect w/ suc-cinylcholine, amiodarone, dildazem, verapamil, NSAIDs, digoxin X- effect w/ anticholinergics, T risk of death vs placebo Contra Severe renal/hepadc impair Disp Tabs, soln SE GI disturbances, wt loss, sleep disturbances, dizziness, HA Interactions T Effects W/ amitriptyline, cimeddine, erythromycin, fluoxetine, fluvoxamine, ketoconazole, paroxetine, quinidine EMS Use succinylcholine w/ caudon, may need a reduced dose monitor ECG for induced conduction abnormalities OD May cause cholinergic Sxs (SLUDGE), muscle weakness, resp depression, and Szs atropine may be used as antidote... 

Spectra for the diastereoisomeric pairs quinine-quinidine, cinchonine-cinchonidine alkaloids are mirror images of each other and mixtures have been determined using CD detection [57]. Spectra for the pilocarpine-isopilocarpine pair were such low quality that they could be used only for qualitative distinction. CD detection combined with UV detection was used to measure enantiomeric excesses in mixtures of L-hyoscyamine and atropine, i.e. racemic hyoscyamine. This subject is returned to in greater depth later. 

Cardiac antiarrhythmics. Amiodarone, propafenone and possibly quinidine potentiate the effect of warfarin and dose adjustment is required, but atropine, disopyramide and lignocaine do not interfere. 

---