Neuromuscular blocking activity of aminoglycoside antibiotics

Abstract

The aminoglycoside antibiotics possess neuromuscular blocking activity; the potency of those antibiotics tested appears to be as follows: gentamicin > streptomycin > amikacin > sisomicin > kanamycin = tobramycin > kanendomycin = dibekacin. The neuromuscular blockade produced by these antibiotics is not reversed by neostigmine, whereas it is reversed by by calcium. Calcium not only has the ability to restore the neuromuscular transmission but also to exert protective action against the neuromuscular blocking activity of aminoglycoside antibiotics; these antibiotics are also potentially capable of interacting with nondepolarizing muscle relaxant drugs (d-tubocurarine, pancuronium) or propranolol, a β-adrenergic receptor blocking agent. This interaction results in respitory depression and/or prolonged apnea. The authors' findings lead to the assumption that aminoglycoside antibiotics are involved in the process of acetylcholine release by nerve impulses, antagonizing calcium ions.