Amiodarone Interaction with Lidocaine

Siegmund, Joachim B.; Wilson, John H.; Imhoff, Thomas

doi:10.1097/00005344-199304000-00001

Cited by 19 publications

(7 citation statements)

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“…However, in contrast, lignocaine N-deethylation was delayed. Since, we presume that these patients had normal hepatic blood flow, it is likely that this observation can be explained by competition between the anticonvulsant agents and lignocaine for CYP3A4, as seen in patients treated with erythromycin and amiodarone [8,28,29]. Nine out of 12 epileptic patients were treated with carbamazepine and epoxidation of this compound is mediated by CYP3A4 [35].…”

Section: Patients With Kidney Diseasementioning

confidence: 94%

“…However, like lignocaine, many other drugs (e.g. erythromycin, steroids, cyclosporine A, nifedipine, midazolam, phenobarbitone and carbamazepine) are metabolized by CYPA3 enzymes [27], and interactions may occur [28,29]. Consequently, concurrent use of these drugs may lead to erroneous conclusions when using MEGX as a measure of liver function.…”

Section: Patients With Kidney Diseasementioning

confidence: 99%

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CYP3A4 and CYP2A6 activities marked by the metabolism of lignocaine and coumarin in patients with liver and kidney diseases and epileptic patients.

Rautio

Bäckström

et al. 1995

Brit J Clinical Pharma

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1. The in vitro hepatic metabolism of lignocaine to monoethylglycinexylide (MEGX) is mediated by CYP3A4 and that of coumarin to 7‐hydroxycoumarin (7OHC) by CYP2A6. We investigated the usefulness of monitoring serum MEGX concentrations (after 1 mg kg‐1 lignocaine i.v.) and urinary 7OHC excretion (after 5 mg coumarin p.o.) to reflect liver function in patients with liver (n = 36), kidney (n = 12) and epileptic (n = 12) disease and in control subjects (n = 20). The extent of liver disease was assessed using measurements of serum aminoterminal propeptide (PIIINP) and Child‐Pugh grades. 2. Serum concentrations of MEGX were decreased in severe (4.6 +/‐ 3.0 s.d. ng ml‐ 1), moderate (19.1 +/‐ 11.6 s.d. ng ml‐1) and mild (32.8 +/‐ 14.2 s.d ng ml‐1) liver disease as compared with controls (53.4 +/‐ 15.8 s.d ng ml‐1). The excretion of 7OHC over 2 h was decreased in severe (18.0 +/‐ 10.3 s.d % of dose) and moderate (34.2 +/‐ 15.6 s.d %), but not in mild (49.7 +/‐ 19.0 s.d %) liver disease as compared with that in controls (56.2 +/‐ 11.6%). 3. In epileptic patients the urinary recovery of 7OHC was increased (2 h value 69.5 +/‐ 13.2 s.d %) suggesting enzyme induction. In contrast, serum MEGX concentration were low (40.0 +/‐ 14.1 s.d ng ml‐1), possibly due to competition for CYP3A4 between lignocaine and antiepileptic drugs. 4. In patients with kidney disease serum MEGX concentration (56.5 +/‐ 26.1 s.d ng ml‐1) was similar to that in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Patients With Kidney Diseasementioning

confidence: 94%

Section: Patients With Kidney Diseasementioning

confidence: 99%

CYP3A4 and CYP2A6 activities marked by the metabolism of lignocaine and coumarin in patients with liver and kidney diseases and epileptic patients.

Rautio

Bäckström

et al. 1995

Brit J Clinical Pharma

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“…14,16 Amiodarone and N-desethylamiodarone competitively inhibit lidocaine metabolism, 116 potentiating seizures when used concomitantly. 117 Lastly, patients taking amiodarone are advised not to drink grapefruit juice because it uses and can inactivate the CYP3A enzyme system, dramatically decreasing the metabolism of amiodarone. 118,119 SUMMARY Amiodarone can be used to treat supraventricular and ventricular arrhythmias in children.…”

Section: Drug Interactionsmentioning

confidence: 99%

Amiodarone for the Emergency Care of Children

Lane

Nguyen²,

Niemann³

et al. 2010

Pediatric Emergency Care

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Amiodarone is a class 3 antiarrhythmic agent used for a broad range of arrhythmias including adenosine-resistant supraventricular tachycardia, junctional ectopic tachycardia, and ventricular tachycardia. Compared with adults, there are few data on its use in children with arrhythmias resistant to conventional therapy. National and international guidelines for cardiopulmonary resuscitation and emergency cardiovascular care recommend its use for a variety of arrhythmias based on case reports, cohort studies, and extrapolation from adult data. This article will review the historical development, chemical properties, metabolism, indications and contraindications, and adverse effects of amiodarone in infants and children. After completing this CME activity, the reader should be able to utilize amiodarone in the pediatric population for arrhythmias and identify complications associated with its use.

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“…Some of them are not uncommon in our daily practice and others are seldom observed. So, amiodarone may significantly increase midazolam duration 43 and lidocaine toxicity 44 , even promoting seizures. Both situations seem to involve liver metabolic changes induced by amiodarone.…”

Section: Preoperative Considerationsmentioning

confidence: 99%

Manuseio peri-operatório do paciente em uso de amiodarona

Ramos

Filho

Pereira

et al. 2004

Rev. Bras. Anestesiol.

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Amiodarone, although normally safe and effective, may present adverse effects, especially on cardiovascular system, during anesthetic-surgical procedures. This is possibly due to interactions between this drug and anesthetic agents mainly related to general anesthesia. There are reports on severe, treatment - resistant bradycardias as well as on different degrees of atrioventricular block (AVB). Patients should be carefully monitored, especially during major procedures, and vasoactive drugs (isoproterenol) and temporary artificial pacemaker, should be available because they may be critical during the adverse effects treatment.

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Amiodarone Interaction with Lidocaine

Cited by 19 publications

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CYP3A4 and CYP2A6 activities marked by the metabolism of lignocaine and coumarin in patients with liver and kidney diseases and epileptic patients.

CYP3A4 and CYP2A6 activities marked by the metabolism of lignocaine and coumarin in patients with liver and kidney diseases and epileptic patients.

Amiodarone for the Emergency Care of Children

Manuseio peri-operatório do paciente em uso de amiodarona

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