Until now, the potential antiarrhythmic benefits of disopyramide have been restricted by anticholinergic side effects. These side effects have included xeros tomia (dry mouth, nose or eyes), abdominal discomfort, nausea, constipation and, most importantly, urinary hesitancy and retention. A sustained-release form of pyridostigmine, an acetyl-cholinesterase inhibitor, has been shown to a) prevent the anticholinergic side effects of disopyramide when used prophylacti cally and b) to eliminate or attenuate these symptoms if they are already present. Pyridostigmine has no measurable effect on disopyramide's antiar rhythmic properties. This represents a beneficial new drug interaction which will improve tolerance of disopyramide and increase patient compliance with disopyramide-containing regimens.
Get full access to this article
View all access options for this article.
References
1.
Koch-Weser J. : Drug therapy: Disopyramide. New Engl J Med300: 957-962, 1979.
2.
Morady F., Scheinman MM, Desai J.: Disopyramide. Ann Int Med96: 337-343, 1982.
3.
Norpace (Disopyramide phosphate), an antiarrhythmic drug. Investigational brochure, Searle Laboratories, May 1, 1977.
Mirro MJ, Manalan AS, Bailey JC, Watanabe AM: Anticholinergic effects of disopyramide and quinidine on guinea pig myocardium: Mediation by direct muscarinic receptor blockade. Circ Res47: 855-865, 1980.
6.
Guyton AC: Textbook of Medical Physiology. Philadelphia, WB Saunders & Co, 1976, pp. 149-150.
7.
Bradley WG, Adams RD: Myasthenia gravis, neuromuscular junction disorders, and episodic muscular weakness. In: Harrison's Priniciples of Internal Medicine. Tenth Edition. Chapter 372. Ed. by Peterson RG.New York, McGraw-Hill Inc , 1983, p. 2194.
8.
Teichman SL, Fisher JD, Matos JA, Kim SG: Disopyramide-pyridostigmine: Report of a beneficial drug interaction. J Cardiovasc Pharmacol (In press).
9.
Fisher JD: Role of electrophysiologic testing in the diagnosis and treatment of patients with known and suspected bradycardias and tachycardias. Prog Cardiovasc Dis24: 25-90, 1981.
