Aminoglycosides apnea with

Acute neuromuscular blockade and apnea have been attributed to the aminoglycosides patients with myasthenia gravis are particularly susceptible. In humans, neuromuscular blockade generally has occurred after intrapleural or intraperitoneal instillation of large doses of an aminoglycoside, but the reaction can follow intravenous, intramuscular, and even oral administration. Neuromuscular blockade may be reversed with calcium gluconate infusion. 

Neurotoxicity (damage to the nervous system by a toxic substance) may also be seen with the administration of the aminoglycosides. Signs and symptoms of neurotoxicity include numbness, skin tingling, circum-oral (around the mouth) paresthesia, peripheral paresthesia, tremors, muscle twitching, convulsions, muscle weakness, and neuromuscular blockade (acute muscular paralysis and apnea). 

Because of dieir extreme nephrotoxicity, diese drugs are rarely if ever used except topically. Polymyxin B applied to intact or denuded skin or mucous membranes produces no systemic reactions because of its almost complete lack of absorption. Hypersensitization is uncommon with topical use. Neurological reactions include muscle weakness and apnea, paresthesias, vertigo, and slurred speech. Polymyxins are nephrotoxic, and coadministration with aminoglycosides should be avoided... 

---