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Does once‐daily dosing of aminoglycosides affect neuromuscular function?
Author(s) -
Wong J.,
Brown G.
Publication year - 1996
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.1996.tb00039.x
Subject(s) - dosing , aminoglycoside , gentamicin , neuromuscular blockade , medicine , anesthesia , ventilation (architecture) , pharmacology , antibiotics , biology , mechanical engineering , engineering , microbiology and biotechnology
Summary Objective: Aminoglycosides have been reported to produce a curare‐like neuromuscular blockade in animals at serum concentrations higher than those obtained with traditional dosing (1–2 mg/kg every 8 h) in humans. Aminoglycoside‐induced neuromuscular blockade is rarely, if ever, seen in humans with traditional dosing. The recent adoption of once‐daily dosing of aminoglycosides has raised concerns about increased potential for this adverse effect because higher serum concentrations are produced. The objective of this study was to determine if once‐daily dosing of aminoglycosides inhibits respiratory muscle function. Method: Nine mechanically ventilated ICU patients on once‐daily dosing of gentamicin 6 mg/ kg/day were assessed for respiratory muscle strength by measuring maximum inspiratory pressure (MIP). MIP is a measurement of the maximal negative pressure generated by repeated inhalations against an occluded airway over 20 s. This was measured within 1 hour before (MIP pre ) and within 1 hour after each aminoglycoside dose (MIP post ). Results: Mean values for MIP pre and MIP post were −26.7 cm H 2 O and − 26.5 cm H 2 O, respectively. The mean difference between MIP pre and MIP post was − 0.2 cm H 2 O, which was not statistically significant ( P >0.05). Conclusion: The effect of gentamicin (6 mg/kg/day) on respiratory muscle function was not statistically, nor clinically significant, and weaning from mechanical ventilation does not seem to be inhibited by once‐daily dosing of aminoglycosides as detectable by measurement of MIP.