This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by VAN NYHUIS, L. S. Articles by FOGDALL, R. P. Search for Related Content PubMed PubMed Citation Articles by VAN NYHUIS, L. S. Articles by FOGDALL, R. P.

The Interaction Between d-Tubocurarine, Pancuroniurn, Polymyxin B, and Neostigmine on Neuromuscular Function

LINDA S. VAN NYHUIS, AB^*, RONALD D. MILLER, MD, and RICHARD P. FOGDALL, MD

*Staff Research Associate, Department of Pharmacology. University of California Medical Center, San Francisco, California 94143. Associate Professor, Department of Anesthesiology/Pharmacology. University of California Medical Center, San Francisco, California 94143. Research Trainee, Department of Anesthesiology. University of California Medical Center, San Francisco, California 94143.

Abstract

The interaction between pancuronium, d-tubocurarine, polymyxin B, and neostigmine was studied in the rat diaphragm-phrenic nerve preparation. Polymyxin B (5 µg/ml) did not affect twitch tension alone but decreased the pancuronium ED, from 0.8 µg/ml to 0.32 µg/ml and the d-tubocurarine ED₃₀ from 0.25 µg/ml to 0.15 µg/ml. Keostigmine (0.2 to 10 µg/ml) antagonized pancuronium or d-tuhocurarine-induced depression of twitch tension. In contrast, neostigmine (0.001 to 0.2 µg/ml) augmented polymyxin B depression. Similarly, neostigmine (0.1 µg/ml) augmented combined polymyxin B-pancuronium or polymyxin B-d-tubocurarine depression of twitch tension. The authors conclude that polymyxin B potentiates the neuromuscular blockade from pancuronium or d-tubocurarine and that neostigmine further augments this block.