Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDID12RQWA)
  Drug Name Succinylcholine Drug Info Galantamine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Analgesics Parasympathomimetics
  Structure

 Mechanism of Succinylcholine-Galantamine Interaction (Severity Level: Moderate)
     Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Succinylcholine Galantamine
      Mechanism Neuromuscular blocking agent
Acetylcholinesterase  Substrate 		Neuromuscular blocking effects
Acetylcholinesterase  Inhibitor
      Key Mechanism Factor 1
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.
    Click to Show/Hide
      Mechanism Description
  • Additive neuromuscular blocking effects by the combination of Succinylcholine and Galantamine 

Recommended Action
      Management It may be appropriate to discontinue acetylcholinesterase inhibitor therapy for a few days before the procedure depending on the needs of the patient. Otherwise, the patient should be monitored closely for increased pharmacologic effects of succinylcholine. Peripheral nerve stimulators are recommended for accurate assessment of neuromuscular blockade in patients who have been taking pyridostigmine.

References
1 Freeman SE, Dawson RM "Tacrine: a pharmacological review." Prog Neurobiol 36 (1991): 257-77. [PMID: 1714613]
2 Heath ML "Donepezil and succinylcholine." Anaesthesia 58 (2003): 202. [PMID: 12562439]
3 Keeler JR "Interactions between nerve agent pretreatment and drugs commonly used in combat anesthesia." Mil Med 155 (1990): 527-33. [PMID: 2126852]
4 Product Information. Aricept (donepezil). Pfizer US Pharmaceuticals, New York, NY.
5 Product Information. Reminyl (galantamine) Janssen Pharmaceuticals, Titusville, NJ.