ENFLURANE, ISOFLURANE, HALOTHANE, AMINOGLYCOSIDES AND POLYMYXINS, LITHIUM, MAGNESIUM SALTS, PROCAINAMIDE AND QUINIDINE MAY ENHANCE THE NEUROMUSCULAR BLOCKING ACTION OF DECAMETHONIUM & MAY BE MUSCLE DAMAGE CAUSE BY DECAMETHONIUM. THE ACTION OF DECAMETHONIUM 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 DECAMETHONIUM 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 DECAMETHONIUM. CYCLOPHOSPHAMIDE HAS BEEN REPORTED TO
PROLONG THE NEUROMUSCULAR BLOCK PRODUCED BY DECAMETHONIUM. 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