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Colistin, hydrocortisone, neomycin, and thonzonium otic and Nimbex

Determining the interaction of Colistin, hydrocortisone, neomycin, and thonzonium otic and Nimbex and the possibility of their joint administration.

Check result:

Colistin, hydrocortisone, neomycin, and thonzonium otic <> Nimbex

Relevance: 03.10.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using cisatracurium together with neomycin topical may increase the effects of cisatracurium. You should be closely monitored for prolong breathing cessation and respiratory paralysis after use of neomycin topical. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Aminoglycosides possess neuromuscular blocking activity, which may be additive with that of depolarizing and nondepolarizing muscle relaxants, potentially resulting in severe and/or prolonged respiratory depression during concomitant use. Aminoglycosides inhibit the release of acetylcholine at neuromuscular junctions by interfering with calcium influx. They also appear to decrease the sensitivity of postsynaptic membrane to acetylcholine. The interaction has been observed with various routes of aminoglycoside administration including oral, intramuscular, intravenous, intraperitoneal, esophageal, intraluminal, intradural, and beneath skin flaps. Respiratory paralysis and fatalities have been reported. Patients at increased risk include those with renal impairment and/or hypocalcemia.

MANAGEMENT: Topically applied aminoglycosides may be systemically absorbed, and significant absorption could occur in certain circumstances (e.g., application to burnt or broken skin; use of large quantities or on large areas for prolonged periods). Clinicians should be aware of the potential for interaction if neuromuscular blockers are used in patients who have been treated extensively with topical aminoglycosides. Vital signs should be closely monitored, and ventilatory support should be readily available in case of respiratory arrest. Treatment with anticholinesterases and calcium may not always be effective in reversing the neuromuscular blockade caused by these agents.

References

Giala M, Sareyiannis C, Cortsaris N, Paradelis A, Lappas DG "Possible interaction of pancuronium and tubocurarine with oral neomycin." Anaesthesia 37 (1982): 776
Warner WA, Sanders E "Neuromuscular blockade associated with gentamicin therapy." JAMA 215 (1971): 1153-4
Chapple DJ, Clark JL, Hughes R "Interaction between atracurium and drugs used in anaesthesia." Br J Anaesth 55 Suppl (1983): s17-22
Regan AG, Perumbetti PP "Pancuronium and gentamicin interaction in patients with renal failure." Anesth Analg 59 (1980): 393
Giala MM, Paradelis AG "Two cases of prolonged respiratory depression due to interaction of pancuronium with colistin and streptomycin." J Antimicrob Chemother 5 (1979): 234-5
Hasfurther DL, Bailey PL "Failure of neuromuscular blockade reversal after rocuronium in a patient who received oral neomycin." Can J Anaesth 43 (1996): 617-20
Pittinger CB, Eryasa Y, Adamson R "Antibiotic-induced paralysis." Anesth Analg 49 (1970): 487-501
Vanacker BF, Van de Walle J "The neuromuscular blocking action of vecuronium in normal patients and in patients with no renal function and interaction vecuronium- tobramycin in renal transplant patients." Acta Anaesthesiol Belg 37 (1986): 95-9
Jedeikin R, Dolgunski E, Kaplan R, Hoffman S "Prolongation of neuromuscular blocking effect of vecuronium by antibiotics." Anaesthesia 42 (1987): 858-60
Kronenfeld MA, Thomas SJ, Turndorf H "Recurrence of neuromuscular blockade after reversal of vecuronium in a patient receiving polymyxin/amikacin sternal irrigation." Anesthesiology 65 (1986): 93-4
Geha DG, Blitt CD, Moon BJ "Prolonged neuromuscular blockade with pancuronium in the presence of acute renal failure: a case report." Anesth Analg 55 (1976): 343-5
Lippmann M, Yang E, Au E, Lee C "Neuromuscular blocking effects of tobramycin, gentamicin, and cefazolin." Anesth Analg 61 (1982): 767-70
Burkett L, Bikhazi GB, Thomas KC Jr, Rosenthal DA, Wirta MG, Foldes FF "Mutual potentiation of the neuromuscular effects of antibiotics and relaxants." Anesth Analg 58 (1979): 107-15
Levanen J, Nordman R "Complete respiratory paralysis caused by a large dose of streptomycin and its treatment with calcium chloride." Ann Clin Res 7 (1975): 47-9
Dupuis JY, Martin R, Tetrault JP "Atracurium and vecuronium interaction with gentamicin and tobramycin." Can J Anaesth 36 (1989): 407-11

Colistin, hydrocortisone, neomycin, and thonzonium otic

Generic Name: colistin sulfate / hydrocortisone / neomycin / thonzonium bromide otic

Brand name: Coly-Mycin S, Cortisporin-TC, Coly Mycin S

Synonyms: Colistin, hydrocortisone, neomycin, and thonzonium (otic), Neomycin, Colistin, Hydrocortisone, and Thonzonium

What is Colistin, hydrocortisone, neomycin, and thonzonium otic?

Nimbex

Generic Name: cisatracurium

Brand name: Nimbex

Synonyms: n.a.

What is Nimbex?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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