Respiratory Paralysis After a Large Dose of Streptomycin

Fisk, G. C.

doi:10.1136/bmj.1.5225.556

Cited by 24 publications

(7 citation statements)

References 6 publications

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“…Ream (25), for example, documented an incidence of profound hypotension and acute cardiac arrest occurring immediately after the intravenous administration of kanamycin in a patient with an appendical abscess. Depression of systemic blood pressure in man has also been observed by several investigators after the administration of other chemically related antibiotics (3,9,24). Although several mechanisms (e.g., negative inotropic and chronotropic effects on the myocardium [3,18,28], autonomic ganglionic blockade [4,5,21], and respiratory depression [21,25] as well as a direct depolarizing action on the smooth muscle cell membrane.…”

Section: Discussionmentioning

confidence: 99%

“…Present findings indicate that aminoglycoside antibiotics interfere with Ca2+-linked events leading to activation of the contractile mechanism of vascular smooth muscle. These in vitro findings may partially explain the occurrence of in vivo cardiovascular depression that has occasionally been observed after the administration of chemically related antimicrobial agents.Severe hypotensive episodes have been observed occasionally in man (3,9,24,25) and repeatedly in experimental animals (3,4,18,20,21) after the administration of aminoglycoside antibiotics (neomycin-streptomycin group). Although the mechanism(s) involved in this adverse side effect has not been completely resolved, recent studies suggest that these agents may alter peripheral vascular smooth muscle contractility.…”

mentioning

confidence: 99%

“…Severe hypotensive episodes have been observed occasionally in man (3,9,24,25) and repeatedly in experimental animals (3,4,18,20,21) after the administration of aminoglycoside antibiotics (neomycin-streptomycin group). Although the mechanism(s) involved in this adverse side effect has not been completely resolved, recent studies suggest that these agents may alter peripheral vascular smooth muscle contractility.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Alteration of Contractile Function and Calcium Ion Movements in Vascular Smooth Muscle by Gentamicin and Other Aminoglycoside Antibiotics

Adams

Goodman

Weiss

1974

Antimicrob Agents Chemother

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Experiments were conducted to examine the effects of certain aminoglycoside antibiotics on contractile responses.and related calcium ion (Ca2+) movements in isolated vascular smooth muscle. Gentamicin, kanamycin, and streptomycin decreased contractile responses produced by norepinephrine, histamine, and high K+ in rabbit aortic strips. The inhibitory action of these antibiotics on mechanical function was more pronounced when the Ca2+ concentration of the bathing solution was decreased from 1.5 mM (normal Ca2+ solution) to 0.05 mM (low Ca2+ solution). The uptake of radiocalcium ("'Ca) into the isolated media-intimal layer of rabbit aortae was decreased in a maintained manner by each antibiotic. With gentamicin, the inhibitory effect on 4"Ca uptake was shown to be dependent upon the concentration of gentamicin employed and to be more evident in a 0.1 mM Ca2+ solution than in a normal Ca2+ solution. In addition, the rate of 4"Ca efflux from the rabbit aortic media-intimal layer was increased in a sustained manner by gentamicin, streptomycin, and kanamycin. Furthermore, contractile responses induced by high K+ and norepinephrine in canine carotid arterial strips were inhibited by gentamicin. Present findings indicate that aminoglycoside antibiotics interfere with Ca2+-linked events leading to activation of the contractile mechanism of vascular smooth muscle. These in vitro findings may partially explain the occurrence of in vivo cardiovascular depression that has occasionally been observed after the administration of chemically related antimicrobial agents.Severe hypotensive episodes have been observed occasionally in man (3,9,24,25) and repeatedly in experimental animals (3,4,18,20,21) after the administration of aminoglycoside antibiotics (neomycin-streptomycin group). Although the mechanism(s) involved in this adverse side effect has not been completely resolved, recent studies suggest that these agents may alter peripheral vascular smooth muscle contractility. In the constant flow-rate perfused hind-limb preparation of thf dog, Cohen et al.(3) observed that the intraarterial administration of streptomycin and kanamycin decreased hind-limb vascular resistance. Evidence of streptomycin-induced dilatation of the renal vasculature was obtained in the in situ perfused canine kidney by Wolf and Wigton (30). The pharmacologic action involved in this peripheral vasomotor effect has not been determined, but several reports have associated this group of antibiotics with alteration of calcium ion (Ca2+) function in certain mammalian organ systems.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Alteration of Contractile Function and Calcium Ion Movements in Vascular Smooth Muscle by Gentamicin and Other Aminoglycoside Antibiotics

Adams

Goodman

Weiss

1974

Antimicrob Agents Chemother

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“…Hypotensive episodes, for example, have occurred during treatment with gentamicin (Warner & Sanders, 1971;Hall, McGibbon, Evans & Meadows, 1972), streptomycin (Fisk, 1961; see Pittinger, Eryasa & Adamson, 1970), kanamycin (Ream, 1963), and neomycin (Pittinger, Long & Miller, 1958). Cardiovascular collapse has also been observed subsequent to exposure to aminoglycoside antibiotics (Ream, 1963;see Pittinger et al, 1970).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Depressant Effects of Neomycin and Gentamicin in Rhesus Monkeys

Adams

1975

British J Pharmacology

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“…There is evidence that streptomycin, neomycin and amikacin reduce transmission in sympathetic gangliag-12 and that streptomycin and tobramycin may cause hypotension.' 3- 15 Some drugs used during anaesthesia cause vasodilatation by relaxing vascular smooth muscle and by impairing transmission in sympathetic ganglia. This effect may be augmented by other, similarly acting, drugs.…”

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Aminoglycoside antibiotics and sympathetic ganglionic transmission

Taylor¹,

Healy²

1979

Anaesthesia

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Several aminoglycoside antibiotics including neomycin, streptomycin and kanamycin have been shown to produce neuromuscular blockade in animals'-4 and in man.'-* The involvement of acetylcholine at the neuromuscular junction and at the synapse in autonomic ganglia suggests the possibility that those drugs which interfere with transmission at the neuromuscular junction may also alter transmission in ganglia. There is evidence that streptomycin, neomycin and amikacin reduce transmission in sympathetic gangliag-12 and that streptomycin and tobramycin may cause hypotension.' 3-15 Some drugs used during anaesthesia cause vasodilatation by relaxing vascular smooth muscle and by impairing transmission in sympathetic ganglia. This effect may be augmented by other, similarly acting, drugs. Therefore the effects of streptomycin, gentamycin, tobramycin and amikacin on transmission at sympathetic ganglia have been examined using the guineapig isolated hypogastric nerve-vas deferens preparation. MethodThe hypogastric nerve, hypogastric plexus and vas deferens of adult guinea-pigs (body weights 400-500 g) were dissected using a recognised method16 and mounted in 50 ml of Krebs solution at a constant temperature of 32°C.Oxygen 95% and carbon dioxide 5 % were bubbled through the Krebs solution. A parallel platinum wire electrode was used to stimulate the vas deferens transmurally and conventional unshielded bipolar platinum ring electrodes were used to stimulate the hypogastric nerve. A supramaximal rectangular wave stimulus was applied; this was 40 V for the hypogastric nerve and 100-120 V for transmural stimulation. Transmural and nerve stimuli were applied alternately for 20 s at 2 min intervals with a stimulus frequency of 20 Hz and a pulse width of 0.2 msec. Contractions of the vas deferens were sensed using an isotonic transducer (Scientific Research Instruments Ltd) and recorded with a pen recorder (Vitatron). The responses of the preparation were allowed to stabilise for 1 hr and then baseline recordings were made. Dose increments of the drug to be tested were added to the bath at 12-min intervals until complete blockade of the response to hypogastric nerve stimulation occurred. The concentration of drug in the bath was doubled when each increment was added. In this way a cumulative concentration-response association was established. The preparation was then washed thoroughly with Krebs solution and allowed to recover. The effect of each drug was measured on five guinea-pig preparations.

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Respiratory Paralysis After a Large Dose of Streptomycin

Cited by 24 publications

References 6 publications

Alteration of Contractile Function and Calcium Ion Movements in Vascular Smooth Muscle by Gentamicin and Other Aminoglycoside Antibiotics

Alteration of Contractile Function and Calcium Ion Movements in Vascular Smooth Muscle by Gentamicin and Other Aminoglycoside Antibiotics

Cardiovascular Depressant Effects of Neomycin and Gentamicin in Rhesus Monkeys

Aminoglycoside antibiotics and sympathetic ganglionic transmission

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