Clindamycin enhances a nondepolarizing neuromuscular blockade.
Neuromuscular blockades induced by clindamycin alone and with d-tubocurarine or pancuronium were examined in the in-vitro guinea pig lumbrical muscle-nerve preparation. Clindamycin, 80-240 mug/ml, initially increased twitch tension. With higher concentrations (180-240 mug/ml) twitch tension subsequently decreased. With 15 to 20 per cent depression of twitch tension by clindamycin, neostigmine (5-20 ng/ml) or calcium (81 mug/ml) slightly but not completely antagonized the blockade. Clindamycin, 40 mug/ml, a dose that did not depress twitch tension, potentiated d-tubocurarine- or pancuronium-induced neuromuscular bloackade. Plasma concentrations of clindamycin of 10-40 mug/ml were recommended for treating serious infections. The authors conclude that the administration of clindamycin may augment nondepolarizing blockade in man, and antagonism by neostigmine and calcium may be incomplete.
D000759:Adjuvants, Anesthesia; D000818:Animals; D002118:Calcium / Q000494:pharmacology; D002981:Clindamycin / Q000008:administration & dosage / Q000494:pharmacology*; D006168:Guinea Pigs; D066298:In Vitro Techniques; D009388:Neostigmine / Q000494:pharmacology; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D009469:Neuromuscular Junction / Q000187:drug effects; D010197:Pancuronium / Q000494:pharmacology; D014403:Tubocurarine / Q000494:pharmacology
D000759:Adjuvants, Anesthesia; D009466:Neuromuscular Blocking Agents; D009388:Neostigmine; D002981:Clindamycin; D010197:Pancuronium; D002118:Calcium; D014403:Tubocurarine