title: Unrecognized drug-drug interactions: a cause of intraoperative cardiac arrest?
abstract: Many physicians overlook, or are unaware of, most drug-drug interactions. In our patient, the local anesthetic used for an axillary block may have been the precipitating drug in a cascade of drug-drug interactions that resulted in a cardiac arrest. The combination of multiple preoperative drug-drug interactions prevented the return of a stable native cardiac rhythm for almost 24 h. The mechanisms of interactions of these frequently used drugs are described, and the reader is guided to sources that identify and simplify the understanding of potentially dangerous drug-drug interactions.
authors.affiliation: Department of Anesthesiology, University of Maryland, Baltimore, USA. sandson.marcucci@comcast.net
authors.forename: Catherine
authors.initials: C
authors.lastname: Marcucci
authors.forename: Neil B
authors.initials: NB
authors.lastname: Sandson
authors.forename: Eric M
authors.initials: EM
authors.lastname: Thorn
authors.forename: Denis L
authors.initials: DL
authors.lastname: Bourke
mesh_terms: D004347:Drug Interactions / Q000235:genetics / Q000502:physiology*; D006323:Heart Arrest / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged