Mutual Potentiation of the Neuromuscular Effects of Antibiotics and Relaxants

Induction and inhibition of pinocytosis by aminoglycoside antibiotics

“…It is therefore interesting to note that netilmicin is a very effective inhibitor of neuromuscular transmission (Albiero et al, 1978). Aminopyridines, which increase Ca2+-entry into presynaptic terminals (Thesleff, 1980), and the Ca2+-ionophore, A 23187, reversed the effect of aminoglycosides on transmission (Burkett et al, 1979;Fiekers, 1983) as well as the netilmicin block of pinocytosis (Figures 3b, 4a and b). Netilmicin may therefore decrease the activity of intracellular Ca2+ at sites critical for transmitter release and for invagination of the membrane in the amoeba.…”

Neuromuscular Pharmacology

“…GMA has had limited clinical trial in the treatment of myasthenia gravis (Flacke, 1973) and in the reversal of depolarizing and non-depolarizing agents. 4-AP has been used clinically with success in the reversal of curariform neuromuscular block (Stoyanov et al, 1976), and experimentally with success in the reversal of neuromuscular block produced by polymixin B and other antibiotics (Lee, de Silva and Katz, 1978;Burkett et al, 1979). It potentiates the effects of neostigmine and pyridostigmine (Miller et al, 1979).…”

Reversal Agents

“…Antagonism of neuromuscular blockade has been reported to be more diffi cult after the administration of certain antibiotics, particularly aminoglycosides [ 11 ]. Aminoglycosides, polymyxins, and clindamycin will inhibit the prejunctional release of acetylcholine and also depress postjunctional nicotinic acetylcholine receptor sensitivity to acetylcholine.…”