Antibiotic-induced Paralysis of the Mouse Phrenic Nerve–Hemidiaphragm Preparation, and Reversibility by Calcium and by Neostigmine

The Action of Polymyxin B at the Frog Neuromuscular Junction

“…amplitude in the presence of magnesium (Balnave & Gage, 1977). Such an action is explained by the accumulation of calcium in the nerve terminal which overcomes the magnesium-induced (Lee et al, 1977;Singh et al, 1978). In vivo, 4-aminopyridine has been shown to reverse polymyxin B-induced block of the indirectly stimulated tibialis anterior muscle of the cat (Lee, de Silva & Katz, 1978 (Magleby & Stevens, 1972).…”

“…Polymyxin B is amongst the most potent of the antibiotics in producing neuromuscular block and has been shown to depress the twitch responses of the indirectly stimulated mouse diaphragm in the same dose range as (+ )tubocurarine (Singh, Harvey & Marshall, 1978).…”

“…but not by neostigmine both in vitro (Singh et al, 1978) and in vivo (Lee, Chen & Nagel, 1977); however. the mechanism of action has still not been fully elucidated.…”

Failure of neuromuscular blockade reversal after rocuronium in a patient who received oral neomycin

“…4 They showed that this was not due to a calcium binding effect, and believed that calcium must interact or compete with neomycin at some step in the pre-junctional process which leads to transmitter release. The administration of calcium to reverse neomycin induced neuromuscular block has been quantified by Singh et al 9 Neomycin also decreases the sensitivity of the post-junctional membrane to the depolarizing actions of Ach, though this is thought to be a less important effect.5 Our patient received a bowel preparation, which included neomycin, on two consecutive days, and this may explain why she was particularly susceptible to prolonged neuromuscular blockade. Adams et all~ demonstrated that previous exposure to neomycin potentiated the neuromuscular blocking effect of another subsequent dose of the same antibiotic, even when the residual effects of the previous dose were undetectable by indirect muscle stimulation.…”

The Effect of Gentamicin on the Action of Atracurium in Adult Patients

“…A neuromuscular blockage can occur by antibiotics even if they were used alone without muscle relaxants [3]. The mechanisms of the neuromuscular blockage occurred by these antibiotics are by postjunctional effect or by causing a prejunctional effect [2,[4][5][6].…”