id	author	title	date	pages	extension	mime	words	sentence	flesch	summary	cache	txt
anesthj-53	Reeve, DNP, CRNA, Jenna	Polypeptide Antibiotic Potentiation of Neuromuscular Blocking Agent Postoperatively: A Case Report	2016	5	.pdf	application/pdf	3340	183	40	Furthermore, it is important to recognize that polymyxin can not only potentiate the neuromuscular blockade produced by an NMBA but also cause some degree of neuromuscular blockade when administered alone.1-2,5-7,9-10,12 Lindesmith et al9 in 1968 discussed cases in which patients experienced symptoms of neuromuscular toxicity due to polypeptide antibiotics without being given any NMBA or other potentially neurotoxic antibiotics. The polypeptide antibiotics were administered intramuscularly to most of the patients.9 Also, to prevent possible complications, polypeptide antibiotics and certain NMBAs should be used cautiously in patients with altered renal function or myasthenia gravis.8 These patient populations are at higher risk for neurotoxicity and nephrotoxicity after polypeptide antibiotic administration.8 Reversal of neuromuscular blockade caused by antibiotics is difficult, and attempts to reverse with calcium chloride and cholinesterases have not proven effective.1,3-4,6-12 Although neostigmine is an acetylcholinesterase inhibitor, it can actually augment the neuromuscular blockade enhanced by polypeptide antibiotics.6 Subclinical doses of acetylcholinesterase inhibitors may inadequately antagonize neuromuscular blockade and actually enhance the blockade at standard reversal dosages.1,3,6,7	cache/anesthj-53.pdf	txt/anesthj-53.txt