Articles  |   February 2018
ACE Question
Article Information
Education / CPD / Neuromuscular Diseases and Drugs / Articles
Articles   |   February 2018
ACE Question
ASA Monitor 02 2018, Vol.82, 42-43.
ASA Monitor 02 2018, Vol.82, 42-43.
Which of the following medications is most likely to prolong the duration of nondepolarizing neuromuscular blockade?
The duration of nondepolarizing neuromuscular blockade can be prolonged by many conditions, and several drugs are associated with prolongation of neuromuscular blockade, including antibiotics, volatile anesthetic agents, lidocaine, furosemide, lithium, and magnesium. In contrast, patients receiving phenytoin typically display resistance to nondepolarizing neuromuscular blocking agents.
Antibiotics associated with prolonged duration of neuromuscular blockade include:
The aminoglycoside category of antibiotics is most commonly associated with prolongation of neuromuscular blockade, although this is of less clinical significance with the use of neuromuscular blocking drugs that have a short or intermediate duration of action. Proposed mechanisms for prolonged neuromuscular blockade from aminoglycosides include modification of the prejunctional membrane (resulting in decreased release of acetylcholine) and stabilization of the postjunctional membrane. Competition by the antibiotic with calcium for the release of acetylcholine has also been suggested as a mechanism for prolongation of neuromuscular blockade.
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