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document
Disopyramide-pyridostigmine interaction : selective reversal of anticholinergic symptoms with preservation of antiarrhythmic effect . This double-blind , randomized , placebo crossover study was used to evaluate the effects of a cholinesterase inhibitor -- slow-release pyridostigmine ( 180 mg orally every 12 hours ) -- on the anticholinergic and antiarrhythmic properties of disopyramide . Quantitative side effects questionnaire scores were used to guide disopyramide administration in 20 men with ventricular tachycardia . Disopyramide was given to each patient both with placebo and with active pyridostigmine . The maximal administered dose for each regimen was used in conjunction with corresponding questionnaire scores to calculate an index or estimate of the maximal tolerable dose of disopyramide . Additional evaluations performed at baseline and at each maximal administered dose regimen included tear and saliva quantitation , 24 hour electrocardiogram ( ECG ) , exercise testing and programmed ventricular stimulation . Results showed that the maximal administered dose of disopyramide was greater with active pyridostigmine than with placebo : 295 +/- 75 versus 245 +/- 100 mg every 6 hours ( p less than 0.05 ) . The calculated maximal tolerable dose was substantially greater in the presence of pyridostigmine : 355 +/- 90 versus 260 +/- 115 mg every 6 hours ( p less than 0.001 ) . Maximal side effects questionnaire scores also reflected decreased anticholinergic activity in the presence of pyridostigmine compared with placebo : 101.9 +/- 2.2 versus 104.6 +/- 2.8 , respectively ( p less than 0.005 ) . Baseline tear and saliva production was significantly reduced during disopyramide therapy , but was restored toward normal by the addition of pyridostigmine . ( ABSTRACT TRUNCATED AT 250 WORDS )
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Intervention_Pharmacological
Disopyramide-pyridostigmine
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Intervention_Control
placebo
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Intervention_Pharmacological
cholinesterase inhibitor -- slow-release pyridostigmine
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Intervention_Pharmacological
disopyramide
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Intervention_Pharmacological
disopyramide
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Intervention_Pharmacological
Disopyramide
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Intervention_Control
placebo
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Intervention_Pharmacological
pyridostigmine
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Intervention_Pharmacological
disopyramide
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Intervention_Pharmacological
disopyramide
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Intervention_Pharmacological
pyridostigmine
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Intervention_Pharmacological
pyridostigmine
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Intervention_Pharmacological
pyridostigmine
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Intervention_Control
placebo
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Outcome_Physical
anticholinergic and antiarrhythmic properties
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Outcome_Other
maximal tolerable dose
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Outcome_Physical
tear and saliva quantitation , 24 hour electrocardiogram ( ECG ) , exercise testing and programmed ventricular stimulation .
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Outcome_Other
maximal tolerable dose
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Outcome_Adverse-effects
Maximal side effects questionnaire scores
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Outcome_Physical
anticholinergic activity
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Participant_Sample-size
20
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Participant_Sex
men
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Participant_Condition
ventricular tachycardia
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Participant_Condition
placebo
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Participant_Condition
active pyridostigmine .