ENFLURANE, ISOFLURANE, HALOTHANE, AMINOGLYCOSIDES AND POLYMYXINS, LITHIUM, MAGNESIUM SALTS, PROCAINAMIDE AND QUINIDINE MAY ENHANCE THE NEUROMUSCULAR BLOCKING ACTION OF SUXAMETHONIUM & MAY BE MUSCLE DAMAGE CAUSE BY SUXAMETHONIUM. THE ACTION OF SUXAMETHONIUM CAN BE MARKEDLY PROLONGED IN PATIENTS USING EYE DROPS CONTAINING ECOTHIOPATE. A LONG-ACTING ANTICHOLINESTERASE WHICH INHIBITS BOTH ACETYLCHOLINESTERASE AND PLASMA CHOLINESTERASE. FOLLOWING SYSTEMIC ABSORPTION OF ECOTHIOPATE. PLASMA CHOLINESTERASE ACTIVITY MAY RAPIDLY BE REDUCED TO 5% OR LESS OF NORMAL AND PROLONGED APNOEA AFTER ADMINISTRATION OF SUXAMETHONIUM HAS
OCCURRED. ON DISCONTINUING ECOTHIOPATE, ENZYME ACTIVITY RE-
MAINS DEPRESSED FOR I TO 2 MONTHS. EXPOSURE TO ORGANOPHOSPHORUS INSECTICIDES MAY ALSO REDUCE PLASMA CHOLINESTERASE ACTIVITY. ANTI-
CHOLINESTERASE SUCH AS NEOSTIGMINE ENHANCE THE ACTION OF
SUXAMETHONIUM. CYCLOPHOSPHAMIDE HAS BEEN REPORTED TO
PROLONG THE NEUROMUSCULAR BLOCK PRODUCED BY SUXAMETHONI-
UM. SEVERE BRADYCARDIA AND ASYSTOLE HAVE OCCURRED WHEN USED IN ANAESTHETIC REGIMENS WITH PROPOFOL AND OPIOIDS SUCH AS FENTANYL.
APROTININ
BENZODIAZEPINES
BETA BLOCKERS
CARDIAC INOTROPES
GANGLION BLOCKERS
H-2 ANTAGONISTS
LITHIUM : PROLONG PARALYSIS
LOCAL ANAESTHETICS : PROCAIN , COCAINE & CHLOROPROCAINE MAY COMPETITIVELY ENHANCE THE NEUROMUSCULAR BLOCKING ACTIVITY OF SUXAMETHONIUM.
MAGNESIUM SALTS : PROLONG PARALYSIS
MAOS : PROLONGATION OF SUXAMETHONIUM PRODUCED PARALYSIS
METOCLOPRAMIDE : DOSE RELATED PROLONGATION OF PARALYSIS
NEUROMUSCULAR BLOCKERS :
SEX HORMONES : CAUSE ONLY SLIGHT PROLONGATION OF PARALYSIS
SYMPATHOMIMETICS : PROLONGS PARALYSIS