Propranolol Disopyramide

Drugs that may affect flecainide include amiodarone, cimetidine, cisapride, disopyramide, propranolol, ritonavir, urinary acidifiers/alkalinizers, and verapamil. Smoking may also have an effect. Drugs that may be affected by flecainide include cisapride, propranolol, and digoxin. 

Antiarrhythmics (e.g., disopyramide, flecainide, and others) P-Blockers (e.g., propranolol, metoprolol, atenolol, and others) Calcium channel blockers (e.g., verapamil and others)... 

Concomitant antiarrhythmic therapy Reserve concomitant use of disopyramide with other class lA antiarrhythmics or propranolol for life-threatening arrhythmias unresponsive to a single agent. Such use may produce serious negative inotropic effects or may excessively prolong conduction, particularly with cardiac decompensation. 

Classes I, III, and IV all involve transmembrane ion channels Classes I and III involve Na+ channels. Class I compounds are designed to block cardiac Na channels in a voltage-dependent manner, similar to local anesthetics. Not surprisingly, many of these Class I agents are either local anesthetics or are structurally based on local anesthetics. Class I compounds include procainamide (7.15), disopyramide (7.16), amiodarone (7.17), lido-caine (7.5), tocainide (7.18), mexiletine (7.19), and flecainide (7.20). The majority of these compounds possess two or three of the fundamental structural building blocks found within local anesthetics. Propranolol (7.21) is the prototypic Class II agent. Class III compounds include molecules that block outward K channels, such as sotalol (7.22) and dofetilide (7.23), and molecules that enhance an inward Na current, such as... 

Alprenolol. propranolol, promethazine, chlorpheniramine and disopyramide Chiral AGP [247]... 

Figure 3 Drugs that display enantioselective binding to a,-acid glycoprotein. I, disopyramide II, propranolol III, verapamil and lY propafenone.

Beta-blockers can also affect the clearance of high clearance drugs by altering hepatic blood flow. This occurs when propranolol is co-administered with lido-caine (400), but it appears that this interaction is due more to inhibition of enzyme activity than to a reduction in hepatic blood flow (401). Atenolol inhibits the clearance of disopyramide, but the mechanism is unknown... 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, amitriptyline, amobarbital, amoxapine, antipsrrine, atenolol, atropine, azata-dine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorqyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, qyclizine, (yclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, dipheno late, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fii-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydro g chloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, midazolam, moclobemide, morphine, nadolol, nalbuphine, naloxone, naphazoline, naproxen, nifedipine, nizatidine, norepinephrine, nortriptyline, oxazepam, oxycodone, oxymetazo-line, paroxetine, pemoline, pentazocine, pentobarbital, pentoxifylline, perphenazine, pheniramine, phenobarbital, phenol, phenolphthalein, phentolamine, phenylbutazone, phenyltoloxamine, phenytoin, pimozide, pindolol, piroxicam, pramoxine, prazepam, prazosin, probenecid, procainamide, procaine, prochlorperazine, procyclidine, promazine, promethazine, propafenone, propantheline, propiomazine, propofol, propranolol, protriptyline, quazepam, quinidine, quinine, racemethorphan, ranitidine, remoxipride, risperidone, salicylic acid, scopolamine, secobarbital, sertraline, sotalol, spironolactone, sulfinpyrazone, sulindac, temazepam, terbutaline, terfenadine, tetracaine, theophylline, thiethyl-perazine, thiopental, thioridazine, thiothixene, timolol, tocainide, tolbutamide, tolmetin, trazodone, triamterene, triazolam, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimipramine, verapamil, warfarin, xylometazoline, yohimbine, zopiclone... 

Simultaneous chlorpromazine, desipramine, desmethyldoxepin, disopyramide, doxepin, imipramine, maprotiline, nortriptyline, procainamide, propoxyphene, propranolol, thioridazine, trimipramine... 

Harrison, P.M. Tonkin, A.M. McLean, A.J. Simple and rapid analysis of atenolol and metoprolol in plasma using solid-phase extraction and high-performance liquid chromatography. J.Chromatogr, 1985, 339, 429-433 [plasma SPE fluorescence detection LOD 10 ng/mL non-interfering chlorothiazide, disopyramide, furosemide, hydralazine, lidocaine, methydopa, prazosin, verapamil simultaneous alprenolol, oxprenolol, pindolol, practolol, propranolol, timolol]... 

Schill, G. Wainer, I.W. Barkan, S.A. Chiral separation of cationic drugs on an al-acid glycoprotein bonded stationary phase. J.Liq.Chromatogr, 1986, 9, 641-666 [chiral also bromdiphenhydramine, brompheniramine, bupivacaine, butorphanol, carbinoxamine, chlorpheniramine, clidinium, cocaine, cyclopentolate, dimethindene, diperidone, disopyramide, doxylamine, ephedrine, homatropine, labe-talol B, labetalol, labetalol A, mepensolate, mepivacaine, methadone, methorphan, methylatropine, methylhomatropine, methylphenidate, metoprolol, nadolol, nadolol A, nadolol B, oxprenolol, oxy-phencyclimine, phenmetrazine, phenoxybenzamine, promethazine, pronethalol, propoxyphene, propranolol, pseudoephedrine, terbutaline, tocainide, tridihexethyl]... 

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