JAMES W. JEFFERSON, M.D., F.A.C.P.
To the editor: In their review "Pancuronium Bromide" (Ann Intern Med 88:64-68, 1978), Roizen and Feeley did not mention the interaction of this drug with lithium. In 1974, Borden, Clarke, and Katz (1) described prolonged neuromuscular blockade in a patient taking lithium carbonate who was given pancuronium bromide preoperatively.
This interaction has since been confirmed experimentally in dogs in which lithium significantly prolonged pancuronium-induced neuromuscular blockade and the time required for neostigmine to reverse the blockade (2, 3). Similar findings have been reported with succinylcholine (2-4).
These observations suggest that neuromuscular blocking agents should be used with caution in patients
JEFFERSON JW. Lithium-Pancuronium Interaction. Ann Intern Med. ;88:577. doi: 10.7326/0003-4819-88-4-577_1
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Published: Ann Intern Med. 1978;88(4):577.
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