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Enlon Plus

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Enlon Plus

Side Effects
Interactions

SIDE EFFECTS

Cardiovascular

Arrhythmias Frequency > 10%: junctional rhythm, bradycardia, tachycardia; Frequency 3-10%: first and second degree A-V block, P Wave changes, atrial premature contractions; Frequency 1-3%: third degree A-V block, ventricular premature contractions; Frequency less than 1%: 3 second R-R interval.

Of the patients who experienced any arrhythmias, 85% had the onset within two minutes, 74% no longer had any arrhythmias after 10 minutes. Arrhythmias related to increased vagal tone, bradycardia, second and third degree heart block respond to treatment with 0.2-0.4 mg of atropine I.V. (Bigeminy or ventricular ectopy may be treated with lidocaine 50 mg I.V.).

Adverse experiences reported for anticholinesterase agents such as edrophonium chloride, but not observed in the 235 patients studied with ENLON-PLUS (edrophonium chloride, USP and atropine sulfate, USP) Injection:

Cardiovascular

Nonspecific EKG changes, fall in cardiac output leading to hypotension;

Respiratory

Increased tracheobronchial secretions, laryngospasm, bronchiolar constriction and respiratory muscle paralysis;

Neurologic

Convulsions, dysarthria, dysphonia, and dysphagia;

Gastrointestinal

Nausea, vomiting, increased peristalsis, increased gastric and intestinal secretions, diarrhea, abdominal cramps;

Musculoskeletal

Weakness and fasciculations;

Miscellaneous

Increased urinary frequency, diaphoresis, increased lacrimation, pupillary constriction, diplopia, and conjunctival hyperemia.

Untoward reactions to atropine sulfate generally are dose-related. Individual tolerance varies greatly but systemic doses of 0.5 to 10 mg are likely to produce the following effects, which were not observed in the 235 patients treated with ENLON-PLUS (edrophonium chloride and atropine sulfate) :

Neurologic

Speech disturbances and restlessness with asthenia;

Dermatologic

Flushed, dry skin, formation of a scarlatiniform rash;

Miscellaneous

Dryness of the nose and mouth, thirst, blurred vision, photophobia, slight mydriasis. Atropine may produce fever through inhibition of heat loss by evaporation.

Read the Enlon Plus (edrophonium chloride and atropine sulfate) Side Effects Center for a complete guide to possible side effects

DRUG INTERACTIONS

ENLON-PLUS (edrophonium chloride, USP and atropine sulfate, USP) Injection should not be administered prior to the administration of any nondepolarizing muscle relaxants. It should be administered with caution to patients with symptoms of myasthenic weakness who are also on anticholinesterase drugs. Anticholinesterase overdosage (cholinergic crisis) symptoms may mimic underdosage (myasthenic weakness), so the use of this drug may worsen the condition of these patients (see OVERDOSAGE section for treatment).

Narcotic analgesics, except when combined with potent inhaled anesthetics, appear to potentiate the effect of edrophonium on the sinus node and conduction system, increasing both the frequency and duration of bradycardia. In patients with cardiovascular disease, given anesthesia with narcotic and nitrous oxide without a potent inhalational agent, there is increased risk for clinically significant bradycardia. In patients receiving beta-adrenergic blocking agents there is increased risk for excessive bradycardia from unopposed parasympathetic vagal tone. Such patients should receive atropine sulfate alone prior to ENLON-PLUS (edrophonium chloride and atropine sulfate) .

Compared to muscle relaxants with some vagolytic activity, muscle relaxants with no vagolytic effects, i.e. vecuronium, may be associated with a slightly higher incidence of vagotonic effects such as bradycardia and first-degree heart block when reversed with ENLON-PLUS (edrophonium chloride and atropine sulfate) .

Last reviewed on RxList: 3/4/2009
This monograph has been modified to include the generic and brand name in many instances.

Side Effects
Interactions
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