Pharmacodynamic interaction between pantoprazole and vecuronium at neuromuscular junction

Abstract

1 The effect of pantoprazole on vecuronium-induced neuromuscular blockade in in vivo has not been clearly defined. In this study, we demonstrate that chronic administration, but not acute administration, of pantoprazole alters the pattern of vecuronium-induced neuromuscular blockade. 2 This study was designed to evaluate the effect of acute and chronic administration of pantoprazole on vecuronium-induced neuromuscular blockade using the rat in vivo sciatic nerve-stimulated gastrocnemius preparation. 3 Vecuronium was administered as a slow intravenous infusion (29.41 μg kg(-1) min(-1)) until the gastrocnemius twitch response to sciatic nerve stimulation was completely abolished. The effect of acute (single dose, i.v.) and chronic administration (per oral for 21 days) of pantoprazole (3.64 mg kg(-1)) on vecuronium-induced blockade was assessed by comparing ED50 values, time required for 50% block, ED95 values, block duration and percentage of recovery with respect to control. 4 Acute administration of pantoprazole had no significant effect on any parameter of vecuronium-induced neuromuscular blockade. Chronic administration of pantoprazole significantly reduced vecuronium ED50 value, time for 50% block, ED95 value and percentage recovery from blockade compared with the control group (P<0.05). Reduction in the duration of vecuronium-induced blockade was not significantly affected by chronic treatment with pantoprazole compared with control. 5 On chronic administration, pantoprazole may produce earlier block, quick relaxation and reduces the recovery of vecuronium without affecting its duration of action.

Neuromuscular blocking effect of fluoxetine and its interaction with rocuronium

“…The potency of rocuronium was increased by 2.7-fold in the presence of 20 lM of fluoxetine. It suggests that earlier intubating conditions with rocuronium can be achieved in the patients taking fluoxetine (Vadgama et al, 2011). Left shifting of the DRC and TOF ratio of rocuronium confirms the increased potency of rocuronium in the presence of fluoxetine.…”

Inhibition of Effects of Acetylcholine at Neuromuscular Junction by Omeprazole

“…Proton pump inhibitors lessen the lower esophageal contractions 10 . Neuromuscular transmission is impeded by proton pump inhibitors.Lansoprazole when used as a component of premedication before anesthesia enhances the neuromuscular block produced by vecuronium in humans 11 . Omeprazole potentiates the paralysis produced by atracurium and succinylcholine in rodents 11 .It was therefore pertinent to determine the activity of Omeprazole at NMJ and its interaction with NMJ blockers like Pancuronium.…”