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Lidocaine / potassium chloride Disease Interactions

There are 14 disease interactions with lidocaine / potassium chloride:

Major

Antiarrhythmics (Includes Lidocaine/potassium chloride) ↔ Cardiovascular Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Hypotension

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

References

  1. Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
  2. Halkin H, Meffin P, Melmon KL, Rowland M "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther 17 (1975): 669-76
  3. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  5. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Ravid S, Podrid PJ, Lampert S, Lown B "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol 14 (1989): 1326-30
  7. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  8. Gottlieb SS, Packer M "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J 118 (1989): 611-2
  9. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  10. Swiryn S, Kim SS "Quinidine-induced syncope." Arch Intern Med 143 (1983): 314-6
  11. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
  12. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. Singh SN, Fletcher RD, Fisher SG, et al. "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med 333 (1995): 77-82
  14. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  15. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
  16. Ochs HR, Grube E, Greenblatt DJ, Arendt R "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol 19 (1981): 173-6
  17. Prescott LF, Adjepon-Yamoah KK, Talbot RG "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J 1 (1976): 939-41
View all 17 references
Major

Antiarrhythmics (Includes Lidocaine/potassium chloride) ↔ Proarrhythmic Effects

Severe Potential Hazard, High plausibility

Applies to: Arrhythmias

Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.

References

  1. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
  2. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  3. Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
  4. "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals, Wilmington, DE.
  5. Said SAM, Somer ST, Luttikhuis HAO "Flecainide-induced JT prolongation, t wave inversion and ventricular tachycardia during treatment for symptomatic atrial fibrillation." Int J Cardiol 44 (1994): 285-7
  6. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
  8. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  9. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  10. Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
  11. Lo KS, Gantz KB, Stetson PL, et al "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
  12. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  13. Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
  14. Boriani G, Biffi M, Frabetti L, Azzolini U, Sabbatani P, Bronzetti G, Capucci A, Magnani B "Ventricular fibrillation after intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation." Am Heart J 131 (1996): 1214-6
  15. Morganroth J, Horowitz LN "Incidence of proarrhythmic effects from quinidine in the outpatient treatment of benign or potentially lethal ventricular arrhythmias." Am J Cardiol 56 (1985): 585-7
  16. Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
  17. Anderson JL, Popat KD "Paradoxical ventricular tachycardia and fibrillation after intravenous bretylium therapy." Arch Intern Med 141 (1981): 801-2
  18. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7
  19. Hii JT, Wyse DG, Gillis AM, et al "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
  20. Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
  21. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
  22. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  23. Exner DV, Muzyka T, Gillis AM "Proarrhythmia in patients with the Wolff-Parkinson-White Syndrome after standard doses of intravenous adenosine." Ann Intern Med 122 (1995): 351-2
  24. Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7
  25. Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
  26. Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
  27. Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
  28. Damle R, Levine J, Matos J, et al "Efficacy and risks of moricizine in inducible sustained ventricular tachycardia." Ann Intern Med 116 (1992): 375-81
  29. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  30. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  31. Stavens CS, McGovern B, Garan H, Ruskin JN "Aggravation of electrically provoked ventricular tachycardia during treatment with propafenone." Am Heart J 110 (1985): 24-9
  32. Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
  33. Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6
  34. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH "Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs." JAMA 270 (1993): 2590-7
  35. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  36. Faggiano P, Gardini A, Daloia A, Benedini G, Giordano A "Torsade de pointes occurring early during oral amiodarone treatment." Int J Cardiol 55 (1996): 205-8
  37. Hohnloser SH, Vandeloo A, Baedeker F "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol 26 (1995): 852-8
  38. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  39. Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
  40. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  41. Au PK, Bhandari AK, Bream R, et al "Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia." J Am Coll Cardiol 9 (1987): 389-97
  42. Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
  43. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
  44. Dhein S, Schott M, Gottwald E, Klaus W "Electrocardiological profile and proarrhythmic effects of quinidine, verapamil and their combination: a mapping study." Naunyn Schmiedebergs Arch Pharmacol 352 (1995): 94-101
  45. Hohnloser SH, Klingenheben T, Singh BN "Amiodarone-associated proarrhythmic effects - a review with special reference to torsade de pointes tachycardia." Ann Intern Med 121 (1994): 529-35
  46. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
  47. Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22
  48. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
  49. Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
  50. Heisler BE, Ferrier GR "Proarrhythmic actions of flecainide in an isolated tissue model of ischemia and reperfusion." J Pharmacol Exp Ther 279 (1996): 317-24
  51. Strasberg B, Sclarovsky S, Erdberg A, et al "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
  52. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  53. Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
  54. Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
  55. Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
  56. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
  57. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  58. Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
  59. Nathan AW, Hellestrand KJ, Bexton RS, Camm AJ "Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent." Postgrad Med J 60 (1984): 155-6
  60. Bauman JL, Bauernfeind RA, Hoff JV, et al "Torsade de pointes due to quinidine: observations in 31 patients." Am Heart J 107 (1984): 425-30
  61. Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
  62. Dougherty AH, Gilman JK, Wiggins S, Jalal S, Naccarelli GV "Provocation of atrioventricular reentry tachycardia: a paradoxical effect of adenosine." Pacing Clin Electrophysiol 16 (1993): 8-12
View all 62 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Hepatic Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Lidocaine is rapidly and extensively metabolized by the liver. Less than 10% is eliminated unchanged in the urine. Several inactive and two active forms (MEGX and GX) have been identified. MEGX and GX exhibit antiarrhythmic and convulsant properties. GX accumulates during prolonged intravenous lidocaine infusion. The pharmacokinetic disposition of lidocaine is altered by changes in hepatic function, including hepatic blood flow. Therapy with lidocaine should be administered cautiously and dosing modifications for repeated or loading and maintenance doses may be necessary. Clinical monitoring of cardiac (continuous ECG) is required and serum metabolite concentrations and monitoring hepatic function are recommended.

References

  1. Thomson AH, Elliott HL, Kelman AW, et al "The pharmacokinetics and pharmacodynamics of lignocaine and MEGX in healthy subjects." J Pharmacokinet Biopharm 15 (1987): 101-15
  2. Huang YS, Lee SD, Deng JF, Wu JC, Lu RH, Lin YF, Wang YJ, Lo KJ "Measuring lidocaine metabolite - monoethylglycinexylidide as a quantitative index of hepatic function in adults with chronic hepatitis and cirrhosis." J Hepatol 19 (1993): 140-7
  3. Barry M, Keeling PW, Weir D, Feely J "Severity of cirrhosis and the relationship of a1-acid glycoprotein concentration to plasma protein binding of lidocaine." Clin Pharmacol Ther 47 (1990): 366-70
  4. Huet P-M, LeLorier J "Effects of smoking and chronic hepatitis B on lidocaine and indocyanine green kinetics." Clin Pharmacol Ther 28 (1980): 208-15
  5. Bauer LA, Brown T, Gibaldi M, et al "Influence of long-term infusions on lidocaine kinetics." Clin Pharmacol Ther 31 (1982): 433-7
  6. Huet PM, Villeneuve JP "Determinants of drug disposition in patients with cirrhosis." Hepatology 3 (1983): 913-8
  7. Villeneuve JP, Thibeault MJ, Ampelas M, et al "Drug disposition in patients with HBsAg-positive chronic liver disease." Dig Dis Sci 32 (1987): 710-4
  8. Forrest JA, Finlayson ND, Adjepon-Yamoah KK, Prescott LF "Antipyrine, paracetamol, and lignocaine elimination in chronic liver disease." Br Med J 1 (1977): 1384-7
  9. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
  10. Colli A, Buccino G, Cocciolo M, et al "Disposition of a flow-limited drug (lidocaine) and a metabolic capacity-limited drug (theophylline) in liver cirrhosis." Clin Pharmacol Ther 44 (1988): 642-9
  11. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  12. Shiffman ML, Luketic VA, Sanyal AJ, Duckworth PF, Purdum PP, Contos MJ, Mills AS, Edinboro LE, Poklis A "Hepatic lidocaine metabolism and liver histology in patients with chronic hepatitis and cirrhosis." Hepatology 19 (1994): 933-40
  13. Williams RL, Blaschke TF, Meffin PJ, et al "Influence of viral hepatitis on the disposition of two compounds with high hepatic clearance: lidocaine and indocyanine green." Clin Pharmacol Ther 20 (1976): 290-9
View all 13 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Lidocaine is primarily eliminated by the kidney. Less than 10% is eliminated unchanged in the urine. Two active metabolites (MEGX and GX) have been identified that exhibit antiarrhythmic and convulsant properties. GX accumulates during prolonged intravenous lidocaine infusion. Serum concentrations of lidocaine and the active metabolites are increased and the half-life prolonged in patients with renal impairment. Therapy with lidocaine should be administered cautiously and dosing modified for repeated or maintenance doses in patients with compromised renal function. Clinical monitoring of cardiac function (continual ECG) is required and serum metabolite concentrations and monitoring renal function are recommended.

References

  1. Collinsworth KA, Strong JM, Atkinson AJ Jr, et al "Pharmacokinetics and metabolism of lidocaine in patients with renal failure." Clin Pharmacol Ther 18 (1975): 59-64
  2. Jacobi J, McGory RW, McCoy H, Matzke GR "Hemodialysis clearance of total and unbound lidocaine." Clin Pharm 2 (1983): 54-7
  3. Thomson PD, Rowland M, Melmon KL "The influence of heart failure, liver disease, and renal failure on the disposition of lidocaine in man." Am Heart J 82 (1971): 417-21
  4. Grossman S, Davis D, Kitchell B, Shand D, Routledge P "Diazepam and lidocaine plasma protein binding in renal disease." Clin Pharmacol Ther 31 (1982): 350-7
  5. Vaziri ND, Saiki JK, Hughes W "Clearance of lidocaine by hemodialysis." South Med J 72 (1979): 1567-8
  6. Eriksson E, Granberg P-O, Ortengren B "Study of renal excretion of prilocaine and lidocaine." Acta Chem Scand 358 (1966): 55-69
  7. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
  8. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
View all 8 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Seizures

Severe Potential Hazard, High plausibility

Applies to: Seizures

Seizures have occurred during lidocaine therapy and have been associated with the rapid administration of a large intravenous doses or accumulation of active metabolites with maintenance therapy. Therapy with lidocaine should be administered cautiously to patients with or predisposed to seizure disorders. Clinical monitoring of cardiac (continuous ECG) is required, and serum metabolite concentrations are recommended.

References

  1. Wu FL, Razzaghi A, Souney PF "Seizure after lidocaine for bronchoscopy: case report and review of the use of lidocaine in airway anesthesia." Pharmacotherapy 13 (1993): 72-8
  2. Crampton RS, Oriscello RG "Petit and grand mal convulsions during lidocaine hydrochloride treatment of ventricular tachycardia." JAMA 204 (1968): 109-12
  3. Ryan CA, Robertson M, Coe JY "Seizures due to lidocaine toxicity in a child during cardiac catheterization." Pediatr Cardiol 14 (1993): 116-8
  4. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  5. Fortuna A, Fortuna AO "Convulsion during lignocaine infiltration." Anaesth Intensive Care 21 (1993): 483
  6. Pelter MA, Vollmer TA, Blum RL "Seizure-like reaction associated with subcutaneous lidocaine injection ." Clin Pharm 8 (1989): 767-8
  7. Sundaram MB "Seizures after intraurethral instillation of lidocaine." Can Med Assoc J 137 (1987): 219-20
View all 7 references
Major

Lidocaine (Includes Lidocaine/potassium chloride) ↔ Sinus/Av Node Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Heart Block

The use of lidocaine is contraindicated in patients with Stokes-Adam syndrome, Wolff-Parkinson White syndrome, or second- or third-degree AV block in the absence of a functional artificial pacemaker, or congenital QT prolongation.

References

  1. Tagliente TM, Jayagopal S "Transient left bundle branch block following lidocaine." Anesth Analg 69 (1989): 545-7
  2. Hilleman DE, Mohiuddin SM, Destache CJ "Lidocaine-induced second-degree mobitz type II heart block." Drug Intell Clin Pharm 19 (1985): 669-73
  3. Keidar S, Grenadier E, Palant A "Sinoatrial arrest due to lidocaine injection in sick sinus syndrome during amiodarone administration." Am Heart J 104 (1982): 1384-5
  4. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
View all 4 references
Major

Potassium Chloride (Includes Lidocaine/potassium chloride) ↔ Dehydration/Diarrhea

Severe Potential Hazard, High plausibility

Applies to: Dehydration, Diarrhea

Potassium chloride liquid suspension contains the stool softener, docusate sodium, as a dispersing agent. Clinical studies with potassium chloride liquid suspension indicate that minor changes in stool consistency may be common though usually well tolerated. However, patients may rarely experience diarrhea or cramping abdominal pain. Patients with severe or chronic diarrhea or who are dehydrated ordinarily should not be prescribed potassium chloride liquid suspension.

References

  1. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Dehydration

Severe Potential Hazard, High plausibility

Applies to: Dehydration, Diarrhea

Administration of potassium salts in severe dehydration may predispose to renal impairment. Therapy with potassium salts should be administered cautiously in patients with acute dehydration (e.g., due to severe or prolonged diarrhea or heat stress). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  4. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
View all 4 references
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Familial Periodic Paralysis

Severe Potential Hazard, High plausibility

Applies to: Familial Periodic Paralysis

Administration of potassium salts may precipitate attacks in familial hyperkalemic periodic paralysis or paramyotonia congenita. Therapy with potassium preparations should be administered cautiously in patients with these conditions.

References

  1. 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):
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Hyperkalemia

Severe Potential Hazard, High plausibility

Applies to: Acidosis, Hyperkalemia, Adrenal Insufficiency, Burns - External, Diabetes Mellitus, Hemolytic Anemia

The use of potassium salts is contraindicated in patients with hyperkalemia, since a further increase in serum potassium concentration in such patients can lead to cardiac arrhythmias or arrest. Potassium therapy should be administered cautiously in patients with conditions predisposing to hyperkalemia, such as chronic renal failure, systemic acidosis, acute dehydration, hypoaldosteronism (e.g., due to primary adrenal insufficiency or congenital adrenal enzyme deficiency), uncontrolled diabetes mellitus, and extensive tissue breakdown (e.g., due to severe burns, intravascular hemolysis, tumor lysis syndrome, or rhabdomyolysis). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  2. Saxena K "Death from potassium chloride overdose." Postgrad Med 84 (1988): 97-8,101-2
  3. Perez GO, Oster JR, Pelleya R, Caralis PV, Kem DC "Hyperkalemia from single small oral doses of potassium chloride." Nephron 36 (1984): 270-1
  4. Lankton JW, Siler JN, Neigh JL "Letter: Hyperkalemia after administration of potassium from nonrigid parenteral-fluid containers." Anesthesiology 39 (1973): 660-1
  5. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  6. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
  7. Cox J, Starbuck M "Hyperkalemic cardiac arrest during an infusion of potassium chloride following an overdose of propranolol." Resuscitation 14 (1986): 255-6
  8. Ceuppens H, Hitchcock JF, Damen J, Jambroes G, Ae Dion R "Severe hypotension due to potassium-induced pericardial injury." Thorax 37 (1982): 546-7
  9. Wetli CV, Davis JH "Fatal hyperkalemia from accidental overdose of potassium chloride." JAMA 240 (1978): 1339
  10. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
  11. Lawson DH "Adverse reactions to potassium chloride." Q J Med 43 (1974): 433-40
  12. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  13. Chakko SC, Frutchey J, Gheorghiade M "Life-threatening hyperkalemia in severe heart failure." Am Heart J 117 (1989): 1083-91
  14. Illingworth RN, Proudfoot AT "Rapid poisoning with slow-release potassium." Br Med J 281 (1980): 485-6
  15. Kallen RJ, Rieger CH, Cohen HS, Sutter MA, Ong RT "Near-fatal hyperkalemia due to ingestion of salt substitute by an infant." JAMA 235 (1976): 2125-6
  16. Schrier RW, Regal EM "Influence of aldosterone on sodium, water and potassium metabolism in chronic renal disease." Kidney Int 1 (1972): 156-68
  17. 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):
  18. Kopman EA, Ramirez-Inawat RC "Persistent electromechanical cardiac arrest following administration of cardioplegic and glucose-insulin-potassium solutions." Anesth Analg 59 (1980): 69-71
  19. Lawson DH "Clinical use of potassium supplements." Am J Hosp Pharm 32 (1975): 708-11
View all 19 references
Major

Potassium Salts (Includes Lidocaine/potassium chloride) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

The use of potassium salts is contraindicated in patients with severe renal impairment characterized by oliguria, anuria, or azotemia. Since potassium is excreted by the kidney, the administration of potassium salts in such patients, particularly by the intravenous route, may produce hyperkalemia and cardiac arrhythmias or arrest. Therapy with potassium salts should be administered cautiously in patients with diminished renal function or other conditions which impairs potassium excretion (e.g. adrenal insufficiency). Close monitoring of serum potassium concentrations is recommended, as potentially fatal hyperkalemia can develop rapidly and is often asymptomatic, manifested only by an increased potassium level (6.5 to 8 mEq/L) and characteristic electrocardiographic changes (peaking of T waves, loss of P waves, depression of ST segment, prolongation of the QT interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9 to 12 mEq/L). Continuous or serial electrocardiography may be appropriate in some patients during replacement therapy, particularly if given intravenously.

References

  1. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  2. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  3. "Product Information. K-Lyte (potassium bicarbonate-potassium citrate)." Bristol-Myers Squibb, Princeton, NJ.
  4. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  5. "Product Information. Potassium Acetate (potassium acetate)." Abbott Pharmaceutical, Abbott Park, IL.
View all 5 references
Major

Potassium Salts (Oral) (Includes Lidocaine/potassium chloride) ↔ Gi Irritation

Severe Potential Hazard, High plausibility

Applies to: Gastrointestinal Obstruction, Peptic Ulcer, Gastrointestinal Hemorrhage, History - Peptic Ulcer, Duodenitis/Gastritis, Gastrointestinal Perforation, Esophageal Disease

The use of all solid oral formulations of potassium is contraindicated in patients with arrested or delayed gastrointestinal (GI) transit, whether due to structural, pathological, or pharmacological causes. Potassium is irritating to the GI mucosa and may cause ulcerative and/or stenotic lesions during prolonged physical contact. Based on spontaneous adverse reaction reports, the frequency of small bowel lesions associated with enteric-coated preparations of potassium chloride is 40 to 50 per 100,000 patient-years, while that for wax matrix controlled-release formulations is less than one per 100,000 patient years. Esophageal ulceration has also been reported following administration of controlled-release formulations of potassium chloride in cardiac patients with esophageal compression due to enlarged left atrium. Potassium supplementation should be administered as a liquid preparation or as an aqueous suspension in patients with esophageal obstruction and/or delayed gastrointestinal transit time.

Because of ulcerogenic effects, oral potassium should be administered cautiously in patients with peptic ulcers or other upper gastrointestinal diseases associated with inflammation, bleeding, or perforation. Patients should be advised not to crush, chew, or break potassium tablets or capsules, and to take them with meals and a full glass of water or other liquid. Potassium liquids should be diluted prior to consumption.

References

  1. Leijonmarck CE, Fenyo G, Raf L "Nontraumatic perforation of the small intestine." Acta Chir Scand 150 (1984): 405-11
  2. "Small-intestine ulceration and enteric-coated potassium chloride." Med Lett Drugs Ther 7 (1965): 57-8
  3. Lech Y, Hey H, Jorgensen F, Matzen P, Ostergaard O "Evaluation of the ulcerogenic effect of potassium chloride by endoscopy and fecal blood loss." J Clin Pharmacol 27 (1987): 206-9
  4. Davies DR, Brightmore T "Idiopathic and drug-induced ulceration of the small intestine." Br J Surg 57 (1970): 134-9
  5. Jacobs E, Pringot J "Gastric ulcers due to the intake of potassium chloride." Am J Dig Dis 18 (1973): 289-94
  6. McMahon FG, Ryan JR, Akdamar K, Ertan A "Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial." Lancet 2 (1982): 1059-61
  7. "Potassium and gastrointestinal lesions. I." Nutr Rev 24 (1966): 138-41
  8. Delaney T, Hoxworth PI "Enteric-coated potassium chloride enteropathy." Surg Gynecol Obstet 127 (1968): 76-80
  9. Dietz MW "Iatrogenic jejunal ulcer." Am J Roentgenol Radium Ther Nucl Med 99 (1967): 136-8
  10. Folk FS, Spellman MW, Hoffler OW "Stenosing small bowl ulceration. Apparently secondary to enteric- coated potassium chloride." J Natl Med Assoc 61 (1969): p315-8assim
  11. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  12. Barkin JS, Harary AM, Shamblen CE, Lasseter KC "Potassium chloride and gastrointestinal injury." Ann Intern Med 98 (1983): 261-2
  13. Moore JG, Alsop WR, Freston JW, Tolman KG "The effect of oral potassium chloride on upper gastrointestinal mucosa in healthy subjects: healing of lesions despite continuing treatment." Gastrointest Endosc 32 (1986): 210-2
  14. Naiken VS, Rachman R "Giant ulcers of the transverse colon." JAMA 217 (1971): 344
  15. Rosenthal T, Adar R, Militianu J, Deutsch V "Esophageal ulceration and oral potassium chloride ingestion." Chest 65 (1974): 463-5
  16. Hartman SW, Greaney EM Jr, Rottapel D "Small-bowel ulceration due to enteric-coated potassium ingestion in a two-year-old child." Surgery 61 (1967): 814-5
  17. Javett S "Slow k ulcer." S Afr J Surg 13 (1975): 64
  18. Lawson DH "Adverse reactions to potassium chloride." Q J Med 43 (1974): 433-40
  19. "Potassium chloride and bowel ulceration." Br Med J 5475 (1965): 1383-4
  20. McLoughlin JC "Gastrointestinal lesions and potassium chloride supplements." Lancet 1 (1985): 581-2
  21. Mason SJ, O'Meara TF "Drug-induced esophagitis." J Clin Gastroenterol 3 (1981): 115-20
  22. Holland GW "Stenosing ulcers of the small bowel associated with thiazide and potassium therapy." N Z Med J 64 (1965): 383-5
  23. Ball JR "Letter: Potassium strictures of the upper alimentary tract." Lancet 1 (1976): 495-6
  24. Moorhouse RA "Letter: Ulceration of small intestine and slow-release potassium tablets." Br Med J 3 (1975): 542
  25. Trechot P, Moore N, Bresler L, Castot A, Gay G, Netter P, Royer R "Potassium chloride tablets and small bowel stenoses and perforations: two studies in the french pharmacovigilance system." Am J Gastroenterol 89 (1994): 1268
  26. Learmonth I, Weaver PC "Letter: Potassium stricture of the upper alimentary tract." Lancet 1 (1976): 251-2
  27. Leijonmarck CE, Raf L "Gastrointestinal lesions and potassium chloride supplements." Lancet 1 (1985): 56-7
  28. Wynn V "Potassium chloride and bowel ulceration." Br Med J 5477 (1965): 1546
  29. Antonescu CG, Barritt AS 3d "Potassium chloride and gastric outlet obstruction." Ann Intern Med 111 (1989): 855-6
  30. Roberts HJ "Potassium chloride and intestinal ulceration." Lancet 2 (1965): 1127
  31. "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  32. Phillips BL "Potassium-induced bowel ulceration." Br J Clin Pract 28 (1974): 143-4
  33. McMahon FG, Ryan JR, Akdamar K, Ertan A "Effect of potassium chloride supplements on upper gastrointestinal mucosa." Clin Pharmacol Ther 35 (1984): 852-5
  34. Strahan J, Sweeney PJ "A case of small bowel perforation." Ulster Med J 34 (1965): 22
  35. Barloon TJ, Moore SA, Mitros FA "A case of stenotic obstruction of the jejunum secondary to slow- release potassium." Am J Gastroenterol 81 (1986): 192-4
  36. Billig DM, Jordan GL Jr "Nonspecific ulcers of the small intestine." Am J Surg 110 (1965): 745-9
  37. Teplick JG, Teplick SK, Ominsky SH, Haskin ME "Esophagitis caused by oral medication." Radiology 134 (1980): 23-5
  38. Reinus FZ, Weinberger HA, Fischer WW "Medication-induced ulceration of the small bowel." Am J Surg 112 (1966): 97-101
  39. Lubbe WF, Cadogan ES, Kannemeyer AH "Oesophageal ulceration due to slow-release potassium in the presence of left atrial enlargement." N Z Med J 90 (1979): 377-9
  40. Henry JG, Shinner JJ, Martino JH, Cimino LE "Fatal esophageal and bronchial artery ulceration caused by solid potassium chloride." Pediatr Cardiol 4 (1983): 251-2
  41. Watson MR, Mark JB "Ulceration of the small intestine. Relation to enteric-coated potassium." Am J Surg 112 (1966): 421-5
  42. Leijonmarck CE, Raf L "Ulceration of the small intestine due to slow-release potassium chloride tablets." Acta Chir Scand 151 (1985): 273-8
  43. Weiss SM, Rutenberg HL, Paskin DL, Zaren HA "Gut lesions due to slow-release KCI tablets." N Engl J Med 296 (1977): 111-2
  44. Emerson DN "Potassium therapy and gastrointestinal lesions." Nebr State Med J 55 (1970): 518-23
  45. Skoutakis VA, Acchiardo SR, Wojciechowski NJ, Carter CA "Liquid and solid potassium chloride: bioavailability and safety." Pharmacotherapy 4 (1984): 392-7
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  48. Lewis JH "Gastrointestinal injury due to medicinal agents." Am J Gastroenterol 81 (1986): 819-34
  49. Lakhani M, Stewart WK "Hazards of potassium chloride solution." Lancet 2 (1985): 453
  50. Collins FJ, Matthews HR, Baker SE, Strakova JM "Drug-induced oesophageal injury." Br Med J 1 (1979): 1673-6
  51. Graham DY, Smith JL, Bouvet AA "What happens to tablets and capsules in the stomach: endoscopic comparison of disintegration and dispersion characteristics of two microencapsulated potassium formulations." J Pharm Sci 79 (1990): 420-4
  52. Eng J, Sabanathan S "Drug-induced esophagitis." Am J Gastroenterol 86 (1991): 1127-33
  53. Strom BL, Carson JL, Schinnar R, Sim E, Maislin G, Soper K, Morse ML "Upper gastrointestinal tract bleeding from oral potassium chloride. Comparative risk from microencapsulated vs wax-matrix formulations." Arch Intern Med 147 (1987): 954-7
  54. Ward C, Hamid S, Dow J "Gastric complication of massive Slow-K overdose." Br J Surg 74 (1987): 490
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  56. Farquharson-Roberts MA, Giddings AE, Nunn AJ "Perforation of small bowel due to slow release potassium chloride (slow-K)." Br Med J 3 (1975): 206
  57. Peters JL "Benign oesophageal stricture following oral potassium chloride therapy." Br J Surg 63 (1976): 698-9
  58. Lambert JR, Newman A "Ulceration and stricture of the esophagus due to oral potassium chloride (slow release tablet) therapy." Am J Gastroenterol 73 (1980): 508-11
  59. Watts CD, Curry C, Randolph RP "Intestinal complications found from potassium chloride. Case report." J Natl Med Assoc 57 (1965): 492-3
  60. Sinar DR, Bozymski EM, Blackshear JL "Effects of oral potassium supplements on upper gastrointestinal mucosa: multicenter clinical comparison of three formulations and placebo." Clin Ther 8 (1986): 157-63
  61. Sandor F "Complications of "slow-K" therapy." J R Coll Gen Pract 26 (1976): 595-8
  62. Berg EH, Schuster F, Segal GA "Thiazides with potassium producing intestinal stenosis." Arch Surg 91 (1965): 998-1001
  63. Trewby PN "Drug-induced peptic ulcer and upper gastrointestinal bleeding." Br J Hosp Med 23 (1980): 185-8,190
  64. Riker J, Swanson M, Schweigert B "Esophageal ulceration caused by wax-matrix potassium chloride." West J Med 128 (1978): 542-3
  65. Brower RA "Jejunal perforation possibly induced by slow-release potassium in a patient with Crohn's disease." Dig Dis Sci 31 (1986): 1387-90
  66. Wagner W, Longerbeam JK, Smith LL, Feikes HL "Drug-induced ulcers of the small bowel causing intestinal obstruction or perforation." Am Surg 33 (1967): 7-11
  67. Lofgren RP, Rothe PR, Carlson GJ "Jejunal perforation associated with slow-release potassium chloride therapy." South Med J 75 (1982): 1154-5
  68. Shuster F, Berg EH "Enteric-coated potassium and bowel obstruction." JAMA 194 (1965): 570
  69. Moorhouse RA "Letter: Potassium-induced stricture of the small bowel." Lancet 1 (1976): 365
  70. Ashby WB, Humphreys J, Smith SJ "Small-bowel ulceration induced by potassium chloride." Br Med J 5475 (1965): 1409-12
  71. Tresadern J, Rickwood AM, Spitz L "Multiple small bowel strictures in a child and accidental potassium chloride ingestion." Br Med J 2 (1977): 1124-5
  72. "Product Information. Kaon (potassium gluconate)." Savage Laboratories, Melville, NY.
  73. Bronson DL, Gamelli RL "Jejunal ulceration and stricture due to wax-matrix potassium chloride tablets and amitriptyline." J Clin Pharmacol 27 (1987): 788-9
View all 73 references
Moderate

Antiarrhythmics (Includes Lidocaine/potassium chloride) ↔ Electrolyte Imbalance

Moderate Potential Hazard, High plausibility

Applies to: Hypokalemia, Hyperkalemia, Magnesium Imbalance

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsades de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

References

  1. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  2. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  3. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  4. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  5. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  7. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  9. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  10. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  11. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  12. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  13. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 13 references
Moderate

Potassium Chloride (Includes Lidocaine/potassium chloride) ↔ Acidosis

Moderate Potential Hazard, High plausibility

Applies to: Acidosis

Hypokalemia in patients with metabolic acidosis should be treated with an alkalinizing potassium salt (i.e. acetate, bicarbonate, citrate, or gluconate) rather than potassium chloride, since alkali therapy helps to promote cellular uptake of potassium. Close monitoring of acid-base balance, serum electrolytes, electrocardiogram, and clinical status is recommended.

References

  1. "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  2. 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):
  3. Leiter LA, Josse RG, West ML, Halperin ML "Severe metabolic acidosis induced in a patient during fasting by KCl administration." Clin Invest Med 11 (1988): 266-70

lidocaine / potassium chloride drug Interactions

There are 669 drug interactions with lidocaine / potassium chloride

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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