Procainamide Propranolol

Noninterfering N-acetylprocainamide, amitriptyline, caffeine, chlordiazepoxide, chlor-promazine, diazepam, flurazepam, lorazepam, oxazepam, prazepam, procainamide, propranolol, thioridazine... 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, ampicil-lin, carbamazepine, cefamandole, cefazolin, cefoperazone, cefotaxime, cefoxitin, ceftazidime, ceftizoxime, cephalexin, cephalothin, cephapirin, chloramphenicol, ciprofloxacin, clonazepam, (yclosporine, desipramine, digoxin, disopyramide, ethosuximide, gentamicin, haloperidol, imipramine, kanamycin, lidocaine, mezlocillin, netilmicin, nortriptyline, phenobarbital, phenytoin, primidone, procainamide, propranolol, quinidine, salicylic acid, streptomycin, sulfamethoxazole, theophylline, thiamphenicol, ticarcillin, tobramycin, trimethoprim, vancomycin... 

Boulieu, R. Bonnefous, J.L. Ferry, S. Solid-phase extraction of diltieizem and its metabolites from plasma prior to hi -performance liquid chromatography. J.Chromatogr., 1990, 528, 542-546 [plasma propionyldeacetyldiltiazem (IS) SPE extracted metabolites LOD 0.3 ng non-interfering diazepeun, ilunitreizepam, midazolam, nifedipine, pancuronium bromide, procainamide, propranolol, quinidine, verapamil]... 

Simultaneous acebutolol, N-acefylprocainamide, alprenolol, atenolol, hufetolol, buprano-lol, carteolol, disopyramide, indenolol, lidocaine, nifedipine, pindolol, procainamide, propranolol, quinidine, timolol... 

Simultaneous N-acetylprocainamide, ajmaline, chlorpromeizine, desipramine, dipyridamole, doxazosin, flecainide, durazepam, gallopamil, imipramine, keteuiserin, metoprolol, mexiletine, mianserin, nadolol, nitrazepam, orphenadrine, oxprenolol, penbutolol, pindolol, prqjmalium, procainamide, propranolol, protriptyline, p3Timethamine, quinidine, quinine, triamterene, trimipramine, verapamil... 

Pieper, J.A. Rutledge, D.R. Determination of verapamU and its primaiy metabolites in serum by ion-pair adsorption high-performance liquid chromatography. J.Chromatogr.Sci., 1988,26,473-477 [fluorescence detection normal phase LOD 0.22 ng extracted metabolites, N-acetylprocainamide, procainamide, propranolol, quinidine non-interfering digoxin, diltiazem, hydrochlorothiazide, lidocaine, phenobarbital, phenytoin, theophylline]... 

Noninterfering acetaminophen, N-acetylprocainamide, amikacin, amitriptyline, amlodi-pine, carbamazepine, cefotaxime, ceftazidime, chloramphenicoL ciprofloxacin, cisapride, clindamycin, clonidine, codeine, cyclosporine, digoxin, diphenhydramine, disopyramide, ethosuximide, fluconazole, gentamicin, gentamicin, heparin, labetalol, levothyroxine, li-docaine, lithium, methotrexate, metronidazole, minoxidil, nafdllin, nifedipine, phenobar-bital, phenobarbital, phenytoin, phenytoin, primidone, procainamide, propranolol, quini-dine, ranitidine, salicylic acid, theophylline, tobramycin, tobramycin, valproic acid, warfarin... 

Propranolol may increase procainamide plasma levels. Additive cholinergic effects may occur when procainamide is administered with other drugp with anticholinergic effects. There is the potential of additive cardiodepressant effects when procainamide is administered with lidocaine. When a beta blocker, such as Inderal, is administered with lidocaine, there is an increased risk of lidocaine toxicity. 

Propranolol Procainamide Pyrithioxine Autoimmunity Autoimmunity, drug-induced SLE, rash, vasculitis, myalgias Pemphigus... 

Drugs that may affect procainamide include amiodarone, anticholinergics, antiarrhythmics, beta-blockers, ethanol, histamine H2antagonists, propranolol,... 

Concurrent administration of propafenone with digoxin, warfarin, propranolol, or metoprolol increases the serum concentrations of the latter four drugs. Cimetidine slightly increases the propafenone serum concentrations. Additive pharmacological effects can occur when lidocaine, procainamide, and quinidine are combined with propafenone. 

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... 

Antiarrhythmic agents such as quinidine, procainamide, and propranolol have all been shown to augment d-tubocurarine-induced blockade. Quinidine has also been reported to unmask or worsen the symptoms of myasthenia gravis and to cause postoperative respiratory depression after the use of muscle relaxants. 

The cardiac arrhythmias are life-threatening, so the patient must be closely monitored, with facilities available for possible resuscitation. Drugs such as quinidine and procainamide are contraindicated, but lidocaine, propranolol, or phenytoin has been used safely and effectively. The arterial blood gas levels, pH, and electrolyte concentrations should be monitored so that metabolic acidosis or hypokalemia can be identified that would further aggravate the arrhythmias. Electrical pacing may be required if the antiarrhythmic drugs fail. Hyperpyrexia is treated by cooling. Seizures may be managed by intravenous doses of diazepam. 

Amrinone lactate is physically and chemically incompatible with alkaline solutions. Pharmaceuticals that are incompatible include digoxin, potassium chloride, procainamide hydrochloride, propranolol hydrochloride, verapamil hydrochloride, sodium chloride, and glucose solutions containing frusemide.101... 

C.M. Riley, and P. Junkin, Stability of amrinone and digoxin, procainamide hydrochloride, propranolol hydrochloride, sodium bicarbonate, potassium chloride,... 

Patients should be advised to rest and to avoid extreme heat. They should be warned that symptoms may be aggravated by illness, stress, malnutrition, pain, or surgery. Various drugs have been shown to worsen symptoms of myasthenia gravis. These include the aminoglycoside antibiotics such as tobramycin, gentamicin, and neomycin tetracyclines such as doxycycline and minocycline class 1 antiarrhythmics such as lidocaine, quinidine, and procainamide magnesium in calcium and multivitamin supplements beta-blockers such as timolol and propranolol calcium channel blockers such as verapamil and penicillamine. 

Cardiovascular drugs. Those that possess local anaesthetic properties [quinidine, procainamide, lignocaine (lidocaine)] and certain 3-blockers (propranolol, oxprenolol) interfere with acetylcholine release and may aggravate or reveal myasthenia gravis. 

Remon JP, Belpaire E, Van-Severen R, Braeckman P. Interaction of antacids with anti-arrhythmics. Part 5. Effect of aluminum hydroxide and magnesium oxide on the bioavailability of quinidine, procainamide, and propranolol in dogs. Arzneimittel Forschung 1983 33(1) 117-120. 

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