Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDIBQ382PH)
  Drug Name Succinylcholine Drug Info Cyclophosphamide Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Analgesics Antineoplastics
  Structure

 Mechanism of Succinylcholine-Cyclophosphamide Interaction (Severity Level: Moderate)
     Antagonize the effect of cholinergic agents Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Succinylcholine Cyclophosphamide
      Mechanism Anticholinergic effects
Muscarinic acetylcholine receptor  Antagonist 		Cholinergic effects
Acetylcholinesterase  Inhibitor
      Key Mechanism Factor 1
Factor Name Muscarinic acetylcholine receptor M Structure Sequence
Protein Family G-protein coupled receptor 1 family
Protein Function
The muscarinic acetylcholine receptor mediates various cellular responses, including inhibition of adenylate cyclase, breakdown of phosphoinositides and modulation of potassium channels through the action of G proteins. Primary transducing effect is Pi turnover.
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      Key Mechanism Factor 2
Factor Name Acetylcholinesterase
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Structure Sequence
MRPPQCLLHTPSLASPLLLLLLWLLGGGVGAEGREDAELLVTVRGGRLRGIRLKTPGGPVSAFLGIPFAEPPMGPRRFLPPEPKQPWSGVVDATTFQSVCYQYVDTLYPGFEGTEMWNPNRELSEDCLYLNVWTPYPRPTSPTPVLVWIYGGGFYSGASSLDVYDGRFLVQAERTVLVSMNYRVGAFGFLALPGSREAPGNVGLLDQRLALQWVQENVAAFGGDPTSVTLFGESAGAASVGMHLLSPPSRGLFHRAVLQSGAPNGPWATVGMGEARRRATQLAHLVGCPPGGTGGNDTELVACLRTRPAQVLVNHEWHVLPQESVFRFSFVPVVDGDFLSDTPEALINAGDFHGLQVLVGVVKDEGSYFLVYGAPGFSKDNESLISRAEFLAGVRVGVPQVSDLAAEAVVLHYTDWLHPEDPARLREALSDVVGDHNVVCPVAQLAGRLAAQGARVYAYVFEHRASTLSWPLWMGVPHGYEIEFIFGIPLDPSRNYTAEEKIFAQRLMRYWANFARTGDPNEPRDPKAPQWPPYTAGAQQYVSLDLRPLEVRRGLRAQACAFWNRFLPKLLSATDTLDEAERQWKAEFHRWSSYMVHWKNQFDHYSKQDRCSDL
Gene Name ACHE
Uniprot ID ACES_HUMAN
KEGG Pathway hsa:43
Protein Family Type-B carboxylesterase/lipase family
Protein Function
Hydrolyzes rapidly the acetylcholine neurotransmitter released into the synaptic cleft allowing to terminate the signal transduction at the neuromuscular junction. Role in neuronal apoptosis.
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      Mechanism Description
  • Antagonize the effect of Cyclophosphamide when combined with Succinylcholine 

Recommended Action
      Management Succinylcholine should probably be avoided in patients with low cholinesterase levels. Other patients should be closely monitored for excessive and prolonged neuromuscular blockade and ventilatory support should be available.

References
1 Dillman JB "Safe use of succinylcholine during repeated anesthetics in a patient treated with cyclophosphamide." Anesth Analg 66 (1987): 351-3. [PMID: 3565800]
2 Product Information. Anectine (succinylcholine). Glaxo Wellcome, Research Triangle Park, NC.
3 Walker IR, Zapf PW, Mackay IR "Cyclophosphamide, cholinesterase and anaesthesia." Aust N Z J Med 2 (1972): 247-51. [PMID: 4508246]
4 Zsigmond EK, Robins G "The effect of a series of anti-cancer drugs on plasma cholinesterase activity." Can Anaesth Soc J 19 (1972): 75-82. [PMID: 4257896]