Drug General Information (ID: DDIUEP35T4)
Drug Name			Amphotericin B (cholesteryl sulfate)		Drug Info		Rapacuronium		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antifungal Agents				Neuromuscular Blocking Agents
Structure

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

Recommended Action
Management		To decrease or prevent this interaction, magnesium and potassium levels should be monitored, and the patient's body stores of potassium and magnesium should be replenished even before the expected fall in serum potassium occurs.

References
1	Cushard WG, Kohanim M, Lantis LR "Blastomycosis of bone." J Bone Joint Surg Am 51A (1969): 704-12. [PMID: 5819086]
2	Miller R, Bates J "Amphotericin B toxicity." Ann Intern Med 71 (1969): 1089-95. [PMID: 5361408]
3	Product Information. Amphotec (amphotericin B cholesteryl sulfate). Sequus Pharmaceuticals Inc, Menlo Park, CA.