Neuromuscular-blocking drugs interaction with drugs used in anesthesiology

Abstract

Introduction: Drug interaction is understood as the ability of a drug for altering the pharmacological effects of another simultaneously administered.
Objective: To carry out an updated review about the drug interaction of neuromuscular-blocking drugs with others frequently used in the anesthesiological field.
Findings: The mechanisms of drug interaction are varied and are complicated in cases of modifications on the pharmacokinetical and pharmacodynamical properties of each medicine. Neuromuscular-blocking drugs (NMBs) are used to relax the striated musculature and to ensure tracheal intubation, ventilation. They produce a sufficient surgical plane in order for the surgeon to perform the surgical procedure properly. Many medications interact with NMBs and often potentiate the muscle relaxant effect. This is of clinical importance in the case of antibiotics, inhalational anesthetics, lithium and cyclosporine.
Conclusions: Modern anesthesiologists must have sufficient theoretical knowledge about different drug interactions that may occur during the perioperative period. Neuromuscular-blocking drugs can interact with others commonly used by patients or by the anesthesiologists, a reason why early diagnosis and appropriate treatment are necessary to avoid complications.