Drug Interactions between ATNAA and mivacurium
This report displays the potential drug interactions for the following 2 drugs:
- ATNAA (atropine/pralidoxime)
- mivacurium
Interactions between your drugs
mivacurium pralidoxime
Applies to: mivacurium and ATNAA (atropine / pralidoxime)
MONITOR: Oximes used in organophosphorous poisoning such as pralidoxime or obidoxime may antagonize the neuromuscular blocking effects of succinylcholine and mivacurium. Oximes reactivate acetylcholinesterase that has been inactivated by phosphorylation due to exposure to an organophosphorous nerve agent or insecticide, and the reactivated acetylcholinesterase then hydrolyzes excess acetylcholine resulting from the exposure to help restore impaired cholinergic neural function. Since succinylcholine and mivacurium are metabolized by plasma cholinesterases, patients with organophosphorous poisoning who have been treated with an oxime may exhibit accelerated reversal of the neuromuscular blocking effects of these agents relative to those who have not received an oxime.
MANAGEMENT: Neuromuscular effects should be monitored when succinylcholine or mivacurium is coadministered with an oxime.
References (2)
- Selden BS, Curry SC (1987) "Prolonged succinylcholine-induced paralysis in organophosphate insecticide poisoning." Ann Emerg Med, 16, p. 215-7
- (2010) "Product Information. DuoDote (atropine-pralidoxime)." Meridian Medical Technologies Inc
atropine pralidoxime
Applies to: ATNAA (atropine / pralidoxime) and ATNAA (atropine / pralidoxime)
Pralidoxime and other drugs within the family of compounds called oximes, such as obidoxime, may potentiate the pharmacologic effects of atropine. Signs of atropinization such as flushing, mydriasis, tachycardia, and dry mouth and nose may occur earlier than expected during coadministration with pralidoxime relative to administration of atropine alone, particularly if the total dose of atropine has been large and the administration of pralidoxime was delayed. Clinicians should be aware of the potential interaction and monitor patients as appropriate. Pralidoxime may be used in conjunction with atropine in the treatment of organophosphate insecticide poisoning and nerve agent poisoning in terrorism or chemical warfare.
References (1)
- (2010) "Product Information. DuoDote (atropine-pralidoxime)." Meridian Medical Technologies Inc
Drug and food interactions
atropine food
Applies to: ATNAA (atropine / pralidoxime)
GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.
MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.
References (1)
- Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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