Neuromuscular junction aminoglycosides

The principal arninoglycoside toxicides are neuromuscular paralysis, ototoxicity, and nephrotoxicity. Neuromuscular paralysis is a relatively rare complication resulting from high aminoglycoside concentrations at the neuromuscular junctions following, for example, rapid bolus intravenous injection or peritoneal instillation, rather than the normal intravenous infusion. The mechanism apparentiy involves an inhibition of both the presynaptic release of acetylcholine and the acetylcholine postsynaptic receptors (51). 

Administration of the aminoglycosides with the cephalosporins may increase the risks of nephrotoxicity. When the aminoglycosides are administered with loop diuretics there is an increased risk of ototoxicity (irreversible hearing loss). There is an increased risk of neuromuscular blockage (paralysis of the respiratory muscles) if the aminoglycosides are given shortly after general anesthetics (neuromuscular junction blockers). 

Neuromuscular blockade Neurotoxicity can occur. Aminoglycosides may aggravate muscle weakness because of a potential curare-like effect on the neuromuscular junction. 

C) Aminoglycosides cause a neuromuscular block by displacing Ca" + from the neuromuscular junction. 

C. Aminoglycosides can cause neuromuscular junction blockade by the mechanism of displacing Ca+" from the neuromuscular junction and thus leading to the Ca" " -dependent prejunctional release of acetylcholine. This is of chnical significance only in patients with myasthenia gravis, hypocalcemia, and hypermagnesemia. 

The aminoglycoside, amikacin. The aminoglycosides can inhibit Ca++ uptake which is required for the release of acetylcholine at the neuromuscular junction, and can cause neuromuscular blockade. This is rare at usual doses of the drug, but patients with myasthenia gravis are particularly susceptible. 

Paradelis AG, Crassaris LG, Karachalios DN, Triantapl llidis CJ. Aminoglycoside antibiotics interaction with trimethaphan at the neuromuscular junctions. Drugs Clin Res (1987)... 

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