Procainamide Ranitidine

Lidocaine Morphine Ondansetron Pravastatin Procainamide Ranitidine Sumatriptan Vigabatrin ... 

PROCAINAMIDE H2 RECEPTOR BLOCKERS Cimetidine may t plasma concentrations of procainamide Cimetidine is a potent inhibitor of organic cation transport in the kidney, and elimination of procainamide is impaired. Cimetidine also inhibits CYP2D6-mediated metabolism of procainamide. Ranitidine is a much weaker CYP2D6 inhibitor Monitor PR and BP at least weekly until stable. Warn patients to report symptoms of hypotension (lightheadedness, dizziness on standing, etc.). Consider alternative acid-suppression therapy... 

There is a risk of acute renal failure when iodi-nated contrast material that is used for radiological studies is administered with metformin. Metformin therapy is stopped for 48 hours before and after radiological studies using iodinated material. Alcohol, amiloride, digoxin, morphine, procainamide, quini-dine, quinine ranitidine, triamterene, trimethoprim, vancomycin, cimetidine, and furosemide all increase the risk of hypoglycemia. There is an increased risk of lactic acidosis when metformin is administered with the glucocorticoids. 

Procainamide 12-1 7 mg/kg, no faster than 20 mg/minute 1-4 mg/minute Cimetidine, ranitidine, and trimethoprim inhibit procainamide elimination... 

T Pancreatic insulin release Metformin Peripheral insulin sensitivity hepatic glucose output/production i intestinal glucose absorption Dose Ist-line (naive pts), 1.25/250 mg PO daily-bid 2nd-line, 2.5/500 mg or 5/500 mg bid (max 20/2000 mg) take w/ meals, slowly T dose hold before 48 h after ionic contrast media Caution [C, -] Contra SCr >1.4 mg/dL in females or >1.5 mg/dL in males hypoxemic conditions (sepsis, recent MI) alcoholism metabolic acidosis liver Dz Disp Tabs SE HA, hypoglycemia, lactic acidosis, anorexia, N/V, rash Additional Interactions T Effects W/ amiloride, ciprofloxacin cimetidine, digoxin, miconazole, morphine, nifedipine, procainamide, quinidine, quinine, ranitidine, triamterene,... 

Procainamide [P] Decreased renal excretion of procainamide Increased serum procainamide levels. Similar effect with ranitidine but smaller. 

Procainamide (Pronestyl, Pronestyl SR, Procanbid) [Antiarrhythmic] WARNING Only use in life-treating arrhythmias hematologic tox can be severe Uses Supraventricular/ventricular arrhythmias Action Class 1A antiarrhythmic (Table VI-7) Dose Adults. Recurrent VF/pulseless VT 20 mg/min slow IV inf to a max of 17 mg/kg or until QRS T by 50% or dysrhythmia resolves Maint inf 4 mg/min (mix 1 gm in 250 mL NS to make 4 mg/mL use 60 gtt set—60 gtt/min = 4 mg) Peds. Loading dose 15-50 mg/kg IV/IO Caution [C, +] Contra Complete heart block, 2nd- or 3rd-degree heart block w/o pacemaker, torsades de pointes, SLE Disp Tabs caps 250, 500 mg SR tabs 500, 750, 1000 mg inj 100, 500 mg/mL SE 1 BP, lupus-like synd, GI upset, taste perversion, arrhythmias, tach, heart block, angioneurotic edema, blood dyscrasias Interactions T Effects W/ acetazolamide, amiodarone, cimetidine, ranitidine, trimethoprim T effects OF anticholinergics, antihypertensives i effects W/ procaine, EtOH EMS Monitor BP and ECG use caution to prevent rapid... 

Interactions of cimetidine and other H -receptor antagonists with the renal secretion of several drugs have been repeatedly described, and comprehensively listed [146]. Thus, cimetidine inhibits renal secretion of procainamide in humans and prolongs its elimination half-life [147,148]. Similar inhibitory effects have been shown on creatinine, ranitidine and many other cationic compounds [149]. 

Drugs corticosteroids (Sampson 1995 McAfee et al. 1984), ethanol (McAfee et al. 1984), cyclosporin, azathioprine, ranitidine, nifedipine, procainamide (Sampson 1995), others... 

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... 

---