Drug General Information (ID: DDIX3E2U51)
Drug Name			Doxacurium		Drug Info		Lithium carbonate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Antimanic Agents
Structure

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

Recommended Action
Management		Caution is advised if neuromuscular blocking agents are used in patients who have been treated with lithium. Patients should be monitored closely for development of respiratory depression, and life support should be readily available if needed.

References
1	Hill GE, Wong KC, Hodges MR "Potentiation of succinylcholine neuromuscular blockade by lithium carbonate." Anesthesiology 44 (1976): 439-42. [PMID: 1267214]
2	Martin BA, Kramer PM "Clinical significance of the interaction between lithium and a neuromuscular blocker." Am J Psychiatry 139 (1982): 1326-8. [PMID: 6812439]
3	Product Information. Eskalith (lithium). SmithKline Beecham, Philadelphia, PA.