Drug General Information (ID: DDIDLHRT28)
Drug Name			Rocuronium		Drug Info		Hydroflumethiazide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Neuromuscular Blocking Agents				Diuretics
Structure

Mechanism of Rocuronium-Hydroflumethiazide Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Rocuronium				Hydroflumethiazide
Mechanism		Neuromuscular blocking agent Neuronal acetylcholine receptor  Antagonist				Neuromuscular blocking effects Hypokalemia
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 Rocuronium and Hydroflumethiazide

Recommended Action
Management		Close monitoring for prolonged neuromuscular blockade, potassium replacement when indicated, and neuromuscular blocker dose adjustment is recommended.

References
1	Agencia Espaola de Medicamentos y Productos Sanitarios Healthcare "Centro de informacion online de medicamentos de la AEMPS - CIMA."
2	Miller RD, Roderick LL "Diuretic-induced hypokalemia, pancuronium neuromuscular blockade and its antagonism by neostigmine." Br J Anaesth 50 (1978): 541-4
3	Product Information. HydroDIURIL (hydrochlorothiazide). Merck &amp Co, Inc, West Point, PA.