Tubocurarine Quinidine

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. 

Octi (Slc22al) Rat TEA, MPP+, NMN, monoamine neurotransmitters Drugs AZT, cimetidine, cladribine, cytambine, D-tubocurarine Corticosterone, guanidine, histamine, nicotine, o-methylisoprenaline Drugs clonidine, desipramine, mepiperphenidol, procainamide, reserpine, quinine, quinidine... 

The effects of both depolarising neuromuscular blockers (e.g. suxamethonium (succinylcholine)) and competitive neuromuscular blockers (e.g. tubocurarine) can be increased by quinidine. Re-curarisation and apnoea have been seen in patients when quinidine was given during the recoveiy period from neuromuscular blockade. 

The interaction between quinidine and neuromuscular blockers is an established interaction of clinical importance, but the documentation is limited. The incidence is uncertain, but it was seen in one report cited to a greater or lesser extent in 5 of the 6 patients studied.- It has only been reported clinically with metocurine, tubocurarine and suxamethonium, but it occurs in animals with gallamine, and it seems possible that it could occur clinically with any depolarising or non-depolarising neuromuscular blocker. Be alert for increased neuromuscular blocking effects during and after surgery. 

Many of the most important therapeutic agents for man are alkaloids among these are atropine, berberine, caffeine, cocaine, codeine, colchicine, emetine, ephedrine, ergota-mine, hyoscyamine, morphine, physostigmine, pilocarpine, quinidine, quinine, reserpene, scopolamine, strychnine, theophylline, tubocurarine, and yohimbine. 

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