Aminoglycosides with neuromuscular blocking

Toxic effects, which depends on dose and duration of treatment, mainly manifest as ototoxicity. Aminoglycosides also may cause nephrotoxicity and are reversible if they are withdrawn. They are known to cause neuromuscular blockade hence, care is necessary when used along with neuromuscular-blocking agents. Other reactions include allergy and cross-reactivity infections, as well as... 

Clindamycin, either alone or in combination with neuromuscular blocking drugs or aminoglycosides, has been associated with neuromuscular blockade. 

Neuromuscular blockers + Drugs with neuromuscular blocking effects (e.g. Aminoglycosides) Increased neuromuscular blocloid delayed recovery, prolonged apnoea... 

Theoretically, the neuromuscular blocking effects of botulinum toxin can be increased by other drugs with neuromuscular blocking effects, such as the aminoglycosides and muscle relaxants, but no such interactions have been reported. 

Drugs that may interact with capreomycin include aminoglycosides and nondepolarizing neuromuscular blocking agents. 

Clinically important, potentially hazardous interactions with aminoglycosides, non-depolarizing neuromuscular blocking agents... 

Aminoglycoside antibiotics produce neuromuscular blockade by inhibiting ACh release from the preganglionic terminal (through competition with Ca ) and to a lesser extent by noncompetitively blocking the receptor. Tetracyclines also can produce neuromuscular blockade, possibly by chelation of Ca. Additional antibiotics that have neuromuscular blocking action, through both presynaptic... 

The aminoglycoside antibacterials possess neuromuscular blocking activity. Appropriate measures should be taken to accommodate the increased neuromuscular blockade and the prolonged and potentially fatal respiratory depression that can occur if these antibacterials are used with conventional neuromuscular blocking drugs. 

Animal studies indicate that low and otherwise safe doses of lidocaine given with other drugs having neuromuscular blocking activity (e.g. polymyxin B, aminoglycosides) may possibly be additive with conventional neuromuscular blockers and so some caution may be warranted. ... 

Not fully understood. Trimetaphan can inhibit plasma cholinesterase to some extent, which would reduce the metabolism of the suxamethonium and thereby prolong its activity. Studies in and case reports also indicate that trimetaphan has direct neuromuscular blocking activity. Its effects are at least additive with the neuromuscular blocking effects of the aminoglycosides. ... 

The concomitant use of antibiotics, including the polymyxins, tetracyclines and the aminoglycosides with the non-depolarizing neuromuscular blocking agents has occasionally resulted in prolonged muscular... 

Neuromuscular paralysis This side effect most often results after direct intraperitoneal or intrapleural application of large doses of aminoglycosides. The mechanism responsible is a decrease in both the release of acetylcholine from prejunctional nerve endings and the sensitivity of the postsynaptic site. Patients with myasthenia gravis are particularly at risk. Prompt administration of calcium gluconate or neostigmine can reverse the block. 

Neuromuscular blockade Though rare, a curare-like block may occur at high doses of aminoglycosides and may result in respiratory paralysis. It is usually reversible by treatment with calcium and neostigmine, but ventilatory support may be required. 

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