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Donnaphen (atropine / hyoscyamine / phenobarbital / scopolamine) Disease Interactions

There are 34 disease interactions with Donnaphen (atropine / hyoscyamine / phenobarbital / scopolamine):

Major

Anticholinergics (Includes Donnaphen) ↔ Autonomic Neuropathy

Severe Potential Hazard, High plausibility

Applies to: Autonomic Neuropathy, Autonomic Neuropathy, Autonomic Neuropathy

Agents with anticholinergic activity can exacerbate many of the manifestations of autonomic neuropathy, including tachycardia, anhidrosis, bladder atony, obstipation, dry mouth and eyes, cycloplegia and blurring of vision, and sexual impotence in males. Therapy with antimuscarinic agents and higher dosages of antispasmodic agents (e.g., dicyclomine or oxybutynin) should be administered cautiously in patients with autonomic neuropathy.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
Major

Anticholinergics (Includes Donnaphen) ↔ Gi Obstruction

Severe Potential Hazard, High plausibility

Applies to: Esophageal Obstruction, Gastrointestinal Obstruction, Gastrointestinal Obstruction, Esophageal Obstruction, Gastrointestinal Obstruction, Esophageal Obstruction

Anticholinergics are contraindicated in patients with obstructive diseases such as achalasia, esophageal stricture or stenosis, pyloroduodenal stenosis, stenosing peptic ulcer, pyloric obstruction, and paralytic ileus. Anticholinergics may further suppress intestinal motility with resultant precipitation or aggravation of toxic megacolon.

References

  1. "Azatadine (optimine)--a new antihistamine." Med Lett Drugs Ther 19 (1977): 77-9
  2. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
View all 17 references
Major

Anticholinergics (Includes Donnaphen) ↔ Glaucoma

Severe Potential Hazard, High plausibility

Applies to: Glaucoma/Intraocular Hypertension, Glaucoma/Intraocular Hypertension, Glaucoma/Intraocular Hypertension

Anticholinergic agents are contraindicated in patients with primary glaucoma, a tendency toward glaucoma (narrow anterior chamber angle), or adhesions (synechiae) between the iris and lens, as well as for the elderly and others in whom undiagnosed glaucoma or excessive pressure in the eye may be present. Because anticholinergics cause mydriasis, they may exacerbate these conditions.

References

  1. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
View all 23 references
Major

Anticholinergics (Includes Donnaphen) ↔ Obstructive Uropathy

Severe Potential Hazard, High plausibility

Applies to: Urinary Retention, Urinary Retention, Urinary Retention

In general, the use of anticholinergic agents is contraindicated in patients with urinary retention and bladder neck obstruction caused by prostatic hypertrophy. Dysuria may occur and may require catheterization. Also, anticholinergic drugs may aggravate partial obstructive uropathy. Caution is advised even when using agents with mild to moderate anticholinergic activity, particularly in elderly patients.

References

  1. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  3. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
View all 21 references
Major

Anticholinergics (Includes Donnaphen) ↔ Reactive Airway Diseases

Severe Potential Hazard, Moderate plausibility

Applies to: Asthma, Asthma, Asthma

The use of systemic anticholinergics is contraindicated in the treatment of lower respiratory tract symptoms including asthma. Muscarinic receptor antagonists reduce bronchial secretions, which can result in decreased fluidity and increased thickening of secretions. However, ipratropium does not produce these effects and can be used safely in treating asthma.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  3. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 5 references
Major

Antimuscarinics (Includes Donnaphen) ↔ Myasthenia Gravis

Severe Potential Hazard, Moderate plausibility

Applies to: Myasthenia Gravis, Myasthenia Gravis, Myasthenia Gravis

Because antimuscarinic agents have anticholinergic effects, they are contraindicated in patients with myasthenia gravis. Their use may be appropriate to reduce adverse muscarinic effects caused by an anticholinesterase agent.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. Shutt LE, Bowes JB "Atropine and hyoscine." Anaesthesia 34 (1979): 476-90
Major

Antiperistaltic Agents (Includes Donnaphen) ↔ Infectious Diarrhea

Severe Potential Hazard, High plausibility

Applies to: Infectious Diarrhea/Enterocolitis/Gastroenteritis, Infectious Diarrhea/Enterocolitis/Gastroenteritis, Infectious Diarrhea/Enterocolitis/Gastroenteritis

The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. Marshall WF Jr, Rosenthal P, Merritt RJ "Atropine therapy and paralytic ileus in an infant." J Pediatr Gastroenterol Nutr 9 (1989): 532-4
  3. "Product Information. Imodium (loperamide)." Janssen Pharmaceutica, Titusville, NJ.
View all 6 references
Major

Barbiturates (Includes Donnaphen) ↔ Acute Alcohol Intoxication

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Acute Alcohol Intoxication

The use of barbiturates is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of barbiturates may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with barbiturates should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 8 references
Major

Barbiturates (Includes Donnaphen) ↔ Drug Dependence

Severe Potential Hazard, High plausibility

Applies to: Drug Abuse/Dependence, Alcoholism

Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with barbiturates. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of barbiturates should be undertaken gradually using a dosage-tapering schedule.

References

  1. Boisse NR, Okamoto M "Physical dependence to barbital compared to pentobarbital. II. Tolerance characteristics." J Pharmacol Exp Ther 204 (1978): 507-13
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 9 references
Major

Barbiturates (Includes Donnaphen) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Barbiturates are extensively metabolized by the liver. The plasma clearance of barbiturates may be decreased and the half-lives prolonged in patients with impaired hepatic function. Therapy with barbiturates should be administered cautiously and initiated at reduced dosages in patients with liver disease. Barbiturates are not recommended for use in patients with cirrhosis, hepatic failure, hepatic coma, or other severe hepatic impairment.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  2. Kallberg N, Agurell S, Ericsson O, et al "Quantitation of phenobarbital and its main metabolites in human urine." Eur J Clin Pharmacol 9 (1975): 161-8
  3. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 9 references
Major

Barbiturates (Includes Donnaphen) ↔ Porphyria

Severe Potential Hazard, High plausibility

Applies to: Porphyria

The use of barbiturates is contraindicated in patients with a history of porphyria. Barbiturates may exacerbate acute intermittent porphyria or porphyria variegata by inducing the enzymes responsible for porphyrin synthesis.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  2. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
View all 8 references
Major

Barbiturates (Includes Donnaphen) ↔ Rash

Severe Potential Hazard, High plausibility

Applies to: Dermatitis - Drug-Induced

Skin eruptions may precede rare but potentially fatal barbiturate-induced reactions such as systemic lupus erythematosus and exfoliative dermatitis, the latter of which may be accompanied by hepatitis and jaundice. Therapy with barbiturates should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to barbiturates. Barbiturate therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. However, cutaneous reactions may proceed to an irreversible stage even after cessation of medication due to the slow rate of metabolism and excretion of barbiturates. Patients should be advised to promptly report signs that may indicate impending development of barbiturate-related cutaneous lesions, including high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Rashes may be more likely to occur with phenobarbital and mephobarbital.

References

  1. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. Pagliaro L, Campesi G, Aguglia F "Barbiturate jaundice. Report of a case due to a barbital-containing drug, with positive rechallenge to phenobarbital." Gastroenterology 56 (1969): 938-43
View all 12 references
Major

Barbiturates (Includes Donnaphen) ↔ Respiratory Depression

Severe Potential Hazard, High plausibility

Applies to: Pulmonary Impairment, Asphyxia, Sleep Apnea, Respiratory Arrest

Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 9 references
Major

Barbiturates Iv (Includes Donnaphen) ↔ Cardiovascular

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertension, Hypotension, Heart Disease

The intravenous administration of barbiturates may produce severe cardiovascular reactions such as bradycardia, hypertension, or vasodilation with fall in blood pressure, particularly during rapid infusion. Parenteral therapy with barbiturates should be administered cautiously in patients with hypertension, hypotension, or cardiac disease. The intravenous administration of barbiturates should be reserved for emergency treatment of acute seizures or for anesthesia.

References

  1. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 5 references
Major

Barbiturates Iv/Im (Includes Donnaphen) ↔ Prolonged Hypotension

Severe Potential Hazard, High plausibility

Applies to: Altered Consciousness, Shock

Barbiturates should not be administered by injection to patients in shock or coma or who have recently received another respiratory depressant. The hypnotic and hypotensive effects of these agents may be prolonged and intensified in such patients.

References

  1. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  2. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  3. "Multum Information Services, Inc. Expert Review Panel"
View all 5 references
Major

Mepho-Phenobarbital (Includes Donnaphen) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

The long-acting barbiturate, phenobarbital, is partially eliminated by the kidney. The plasma clearance of phenobarbital may be decreased and the half-life prolonged in patients with impaired renal function. Therapy with phenobarbital should be administered cautiously and initiated at reduced dosages in patients with renal impairment. Since approximately 75% of a mephobarbital dose is metabolized to phenobarbital, the same precaution should be observed with mephobarbital. The remaining barbiturates, which are short- and intermediate-acting, are all negligibly excreted in the urine and may be appropriate alternatives in these patients.

References

  1. Turk JW, Ladenson JH "Phenytoin and phenobarbital concentrations in renal insufficiency ." Ann Intern Med 101 (1984): 569
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
Moderate

Anticholinergics (Includes Donnaphen) ↔ Cardiac Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease, Cardiovascular Disease, Cardiovascular Disease

Anticholinergics block vagal inhibition of the SA nodal pacemaker. Therapy with anticholinergics should be administered cautiously to patients with tachycardia, congestive heart failure, or coronary artery disease. Premature ventricular depolarization, ventricular tachycardia, and fibrillation associated with anticholinergics are rare.

References

  1. Knoebel SB, McHenry PL, Phillips JF, Widlansky S "Atropine-induced cardioacceleration and myocardial blood flow in subjects with and without coronary artery disease." Am J Cardiol 33 (1974): 327-32
  2. Lazzari JO, Benchuga EG, Elizari MV, Rosenbaum MB "Ventricular fibrillation after intravenous atropine in a patient with atrioventricular block." Pacing Clin Electrophysiol 5 (1982): 196-200
  3. Horgan J "Atropine and ventricular tachyarrhythmia." JAMA 223 (1973): 693
View all 16 references
Moderate

Anticholinergics (Includes Donnaphen) ↔ Tachycardia

Moderate Potential Hazard, Moderate plausibility

Applies to: Arrhythmias, Arrhythmias, Arrhythmias

Anticholinergics block vagal inhibition of the SA nodal pacemaker. Therapy with anticholinergics should be administered cautiously in patients with tachycardia, congestive heart failure, or coronary artery disease. Premature ventricular depolarization or ventricular tachycardia or fibrillation associated with anticholinergics is rare.

References

  1. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
Moderate

Antiepileptics (Includes Donnaphen) ↔ Suicidal Tendency

Moderate Potential Hazard, Moderate plausibility

Applies to: Depression, Psychosis

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs across multiple indications in either monotherapy or adjunctive therapy for a median treatment duration of 12 weeks (up to a maximum of 24 weeks) showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. The estimated rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% for 16,029 placebo-treated patients, representing an increase of approximately one case for every 530 patients treated. There were four suicides in AED-treated patients and none in placebo-treated patients, although the number is too small to establish any causal relationship. The increased risk of suicidal thoughts or behavior was observed as early as one week after starting AEDs and persisted for the duration of treatment assessed. The risk did not vary substantially by age (5 to 100 years) in the clinical trials analyzed. Therapy with AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. For clinically significant or persistent symptoms, a dosage reduction or treatment withdrawal should be considered. If patients have symptoms of suicidal ideation or behavior, treatment should be discontinued.

Moderate

Antimuscarinics (Includes Donnaphen) ↔ Coronary Artery Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Ischemic Heart Disease, Arrhythmias, Arrhythmias, Ischemic Heart Disease, Ischemic Heart Disease, Arrhythmias

Antimuscarinic agents block vagal inhibition of the SA nodal pacemaker. These agents should be administered cautiously in patients with tachycardia, congestive heart failure, or coronary artery disease. Premature ventricular depolarization or ventricular tachycardia or fibrillation associated with antimuscarinic drugs is rare.

References

  1. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  2. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  3. Richman S "Adverse effect of atropine during myocardial infarction. Enchancement of ischemia following intravenously administered atropine." JAMA 228 (1974): 1414-6
View all 4 references
Moderate

Antimuscarinics (Includes Donnaphen) ↔ Gastric Ulcer

Moderate Potential Hazard, Low plausibility

Applies to: Bleeding, Bleeding, Bleeding

Antimuscarinic agents may cause a delay in gastric emptying and possibly antral stasis in patients with gastric ulcer. Therapy with antimuscarinic agents should be administered cautiously to patients with gastric ulcer.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. Cotton BR, Smith G "Single and combined effects of atropine and metoclopramide on the lower oesophageal sphincter pressure." Br J Anaesth 53 (1981): 869-74
  3. Chernish SM, Brunelle RR, Rosenak BD, Ahmadzai S "Comparison of the effects of glucagon and atropine sulfate on gastric emptying." Am J Gastroenterol 70 (1978): 581-6
View all 4 references
Moderate

Antimuscarinics (Includes Donnaphen) ↔ Gastroesophageal Reflux

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastroesophageal Reflux Disease, Gastroesophageal Reflux Disease, Gastroesophageal Reflux Disease

Antimuscarinic agents decrease gastric motility and relax the lower esophageal sphincter which promotes gastric retention and can aggravate reflux. These drugs should be administered cautiously in patients with gastroesophageal reflux or hiatal hernia associated with reflux esophagitis.

References

  1. Cotton BR, Smith G "Single and combined effects of atropine and metoclopramide on the lower oesophageal sphincter pressure." Br J Anaesth 53 (1981): 869-74
  2. Chernish SM, Brunelle RR, Rosenak BD, Ahmadzai S "Comparison of the effects of glucagon and atropine sulfate on gastric emptying." Am J Gastroenterol 70 (1978): 581-6
  3. Howells TH "The administration of metoclopramide with atropine." Anaesthesia 32 (1977): 677
View all 6 references
Moderate

Antimuscarinics (Includes Donnaphen) ↔ Ulcerative Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Inflammatory Bowel Disease, Inflammatory Bowel Disease, Inflammatory Bowel Disease

Antimuscarinic agents may suppress intestinal motility and produce paralytic ileus with resultant precipitation of toxic megacolon. These drugs should be administered cautiously to patients with ulcerative colitis.

References

  1. Famewo CE "A re-evaluation of anticholergic premedication." Can Anaesth Soc J 24 (1977): 39-41
  2. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  3. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Moderate

Atropine-Like Agents (Includes Donnaphen) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Liver Disease

Atropine-like agents undergo significant hepatic metabolism. Therapy with atropine-like agents should be administered cautiously to patients with liver disease.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
Moderate

Atropine-Like Agents (Includes Donnaphen) ↔ Renal Failure

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction, Renal Dysfunction

Atropine-like agents are primarily eliminated by the kidney. Therapy with atropine-like agents should be administered cautiously to patients with renal disease.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
Moderate

Barbiturates (Includes Donnaphen) ↔ Adrenal Insufficiency

Moderate Potential Hazard, High plausibility

Applies to: Adrenal Insufficiency, Panhypopituitarism

Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.

References

  1. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
View all 6 references
Moderate

Barbiturates (Includes Donnaphen) ↔ Depression

Moderate Potential Hazard, High plausibility

Applies to: Depression

Barbiturates depress the central nervous system and may cause or exacerbate mental depression. Therapy with barbiturates should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. "Multum Information Services, Inc. Expert Review Panel"
  2. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  3. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
View all 7 references
Moderate

Barbiturates (Includes Donnaphen) ↔ Hematologic Toxicity

Moderate Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Hematologic toxicity, including agranulocytosis, thrombocytopenic purpura and megaloblastic anemia, has been reported rarely during use of barbiturates. Therapy with barbiturates should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Blood counts are recommended prior to and periodically during long-term therapy, and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, easy bruising, petechiae, bleeding, pallor, dizziness, or jaundice. Barbiturate therapy should be discontinued if blood dyscrasias occur.

References

  1. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  2. Kiorboe E, Plum CM "Megaloblastic anaemia developing during treatment of epilepsy." Acta Med Scand Suppl 445 (1966): 349-57
  3. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
View all 9 references
Moderate

Barbiturates (Includes Donnaphen) ↔ Osteomalacia

Moderate Potential Hazard, Low plausibility

Applies to: Vitamin D Deficiency

Rickets and osteomalacia have rarely been reported following prolonged use of barbiturates, possibly due to increased metabolism of vitamin D as a result of enzyme induction by barbiturates. Long-term therapy with barbiturates should be administered cautiously in patients with vitamin D deficiency.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  2. Doriguzzi C, Mongini T, Jeantet A, Monga G "Tubular aggregates in a case of osteomalacic myopathy due to anticonvulsant drugs." Clin Neuropathol 3 (1984): 42-5
  3. Sotaniemi EA, Hakkarainen HK, Puranen JA, Lahti RO "Radiologic bone changes and hypocalcemia with anticonvulsant therapy in epilepsy." Ann Intern Med 77 (1972): 389-94
View all 6 references
Moderate

Barbiturates (Includes Donnaphen) ↔ Paradoxical Reactions

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperkinetic Syndrome of Childhood

Paradoxical reactions characterized by excitability and restlessness may occur in pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with barbiturates.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  2. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  3. Mayhew LA, Hanzel TE, Ferron FR, Kalachnik JE, Harder SR "Phenobarbital exacerbation of self-injurious behavior." J Nerv Ment Dis 180 (1992): 732-3
View all 9 references
Moderate

Anticholinergics (Includes Donnaphen) ↔ Hypertension

Minor Potential Hazard, Low plausibility

Applies to: Hypertension, Hypertension, Hypertension

Cardiovascular effects of anticholinergics may exacerbate hypertension. Therapy with anticholinergic agents should be administered cautiously in patients with hypertension.

References

  1. "Product Information. Marezine (cyclizine)." Glaxo Wellcome, Research Triangle Park, NC.
  2. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  3. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
View all 7 references
Moderate

Anticholinergics (Includes Donnaphen) ↔ Hyperthyroidism

Minor Potential Hazard, Low plausibility

Applies to: Hyperthyroidism, Hyperthyroidism, Hyperthyroidism

In general, agents with anticholinergic activity may exacerbate hyperthyroidism. Therapy with anticholinergics should be administered cautiously in patients with hyperthyroidism. Thyroid levels should be monitored if usage is prolonged.

References

  1. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
View all 8 references
Moderate

Antimuscarinics (Includes Donnaphen) ↔ Diarrhea

Minor Potential Hazard, Moderate plausibility

Applies to: Diarrhea, Diarrhea, Diarrhea

Diarrhea may be a symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Antimuscarinic agents may further aggravate the diarrhea. Therefore, these drugs should be administered cautiously in patients with diarrhea.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. "Lomotil for diarrhea in children." Med Lett Drugs Ther 17 (1975): 104
Moderate

Atropine-Like Agents (Includes Donnaphen) ↔ Fever

Minor Potential Hazard, Low plausibility

Applies to: Fever, Fever, Fever

Atropine-like agents may increase the risk of hyperthermia in patients with fever by producing anhidrosis. Therapy with atropine-like agents should be administered cautiously in febrile patients.

References

  1. Sarnquist F, Larson CP Jr "Drug-induced heat stroke." Anesthesiology 39 (1973): 348-50
  2. Lee BS "Possibility of hyperpyrexia with antipsychotic and anticholinergic drugs." J Clin Psychiatry 47 (1986): 571
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
View all 6 references

Donnaphen (atropine / hyoscyamine / phenobarbital / scopolamine) drug Interactions

There are 1281 drug interactions with Donnaphen (atropine / hyoscyamine / phenobarbital / scopolamine)

Donnaphen (atropine / hyoscyamine / phenobarbital / scopolamine) alcohol/food Interactions

There are 6 alcohol/food interactions with Donnaphen (atropine / hyoscyamine / phenobarbital / scopolamine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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