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Revista Cubana de Anestesiología y Reanimación

2014, Number 3

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Revista Cubana de Anestesiología y Reanimación 2014; 13 (3)

Drug interactions with the use of neuromuscular blockers

Cordero EI

Language: Spanish
References: 26
Page: 276-286
PDF size: 142.70 Kb.


ABSTRACT

Introduction: drug interaction is the capacity of a drug to alter the pharmacological effects of another one being administered simultaneously.
Objective: carry out an update of the interaction of neuromuscular blockers with frequently used drugs.
Results: neuromuscular blockers are used to relax the striated muscle, permit tracheal intubation and ventilation, and create sufficient surgical plane. Many drugs interact with them, and they frequently enhance the muscular blocking effect. The process is clinically important in the case of antibiotics, inhaled anesthetics, lithium and cyclosporin. Difficulty in blockade reversal may arise when calcium channel blockers and polymyxin are administered. Other drugs, such as phenytoin, carbamazepine and lithium, may cause resistance to these medications. There are compounds which may cause muscular relaxation due to their own action or in an additive or synergic manner. Some such interactions may be beneficial, as is the case with inhaled agents, which produce good muscular relaxation and lower the dose requirements of neuromuscular blockers. But in most cases interactions are dangerous.
Conclusions: even though modern anesthesiologists have sufficient theoretical knowledge about drug interactions, they should bear in mind those produced by neuromuscular blockers, for they may induce unpredictable neuromuscular blockade in daily practice.


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