Chloroquine arrhythmia with

PROPAFENONE I. ANTIARRHYTHMICS - disopyra-mide, procainamide 2. ANTIBIOTICS - macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinolones (especially moxifloxacin), quinupristin/ dalfopristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS -arsenic trioxide 4. ANTIDEPRESSANTS - TCAs, venlafaxine 5. ANTIEMETICS-dolasetron 6. ANTIFUNGALS-fluconazole, posaconazole, voriconazole 7. ANTIHISTAMINES - terfenadine, hydroxyzine, mizolastine 8. ANTI-M ALARIALS - artemether with lumefantrine, chloroquine, hydroxychloroquine, mefloquine, quinine 9. ANTIPROTOZOALS - pentamidine isetionate 10. ANTIPSYCHOTICS-atypicals, phenothiazines, pimozide II. BETA-BLOCKERS - sotalol 12. BRONCHODILATORS -parenteral bronchodilators 13. CNS STIMULANTS - atomoxetine Risk of ventricular arrhythmias, particularly torsades de pointes Additive effect these drugs prolong the Q-T interval. Also, amitriptyline, clomipramine and desipramine levels may be t by propafenone. Amitriptyline and clomipramine may t propafenone levels. Propafenone and these TCAs inhibit CYP2D6-mediated metabolism of each other Avoid co-administration... 

Adverse effects. Halofantrine may cause gastrointestinal symptoms pruritis occurs but to a lesser extent than with chloroquine which may be reason for it to be preferred. It prolongs the cardiac QT interval and may predispose to hazardous arrhythmia. The drug should therefore not be taken ... 

Acute intestinal amebic dysentery is most commonly treated with metronidazole (1, Flagyl) (Table 1). An alternative drug is iodoquinol (2, diiodohydroxyquin, diiodohydroxyquinoline [83-73-8]), which has also been used advantageously in combination with metronidazole or oxytetracydine (3, Terramycin [79-57-2]). For patients too sick to take iodoquinol orally, emetine (4) or dehydroemetine (5, 2,3-dehydroemetine) hydrochloride is administered either subcutaneously or intramusculady. The latter sometimes is followed by chloroquine (6, Aralen) phosphate or iodoquinol. Because emetine and dehydroemetine cause cardiac arrhythmias, muscle weakness, and inflammation at the injection site, these toxic compounds are used primarily for patients whose lives are threatened by the disease. Antibiotics, such as tetracycline (7, Achromycin [60-54-8]) and paromomycin (8, Humatin), are also effective against moderate intestinal amebiasis. 

Taken in proper doses, chloroquine is an extraordinarily safe drug however, its safety margin is narrow, and a single dose of 30 mg/kg may be fatal. Acute chloroquine toxicity is encountered most frequently with too rapid administration of parenteral doses. Cardiovascular effects include hypotension, vasodilation, depressed myocardial function, cardiac arrhythmias, and cardiac arrest. Confusion, convulsions, and coma denote central nervous system (CNS) dysfunction. Chloroquine doses of >5 g given parenterally usually are fatal. Prompt treatment with mechanical ventilation, epinephrine, and diazepam may be lifesaving. 

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