Drug General Information (ID: DDIDIQNKVH)
Drug Name			Cisatracurium		Drug Info		Nifedipine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Neuromuscular Blocking Agents				Analgesics
Structure

Mechanism of Cisatracurium-Nifedipine Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Cisatracurium				Nifedipine
Mechanism		Neuromuscular blocking agent Neuronal acetylcholine receptor  Antagonist				Potentiates neuromuscular blockade
Key Mechanism Factor 1
		Factor Name		Neuronal acetylcholine receptor				Structure Sequence
		Protein Family		Ligand-gated ion channel (TC 1.A.9) family
		Protein Function		After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane.     Click to Show/Hide
Mechanism Description		Additive neuromuscular blocking effects by the combination of Cisatracurium and Nifedipine

Recommended Action
Management		Patients should be closely monitored for prolonged neuromuscular blockade. Reduced doses of muscle relaxants may be necessary. Profound neuromuscular blockade may be reversed by neostigmine or edrophonium.

References
1	Carlos R, Erill S "Therapeutic Rounds." Clin Ther 9 (1986): 22-3
2	Saitoh Y, Makita K, Tanaka H "Diltiazem and vecuronium: neuromuscular and cardiovascular effects." Can J Anaesth 44 (1997): 99
3	Sekerci S, Tulunay M "Interactions of calcium channel blockers with non-depolarising muscle relaxants in vitro." Anaesthesia 51 (1996): 140-4