Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDIAFQ76ZJ)
  Drug Name Tubocurarine Drug Info Lincomycin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Neuromuscular Blocking Agents Antibiotics
  Structure

 Mechanism of Tubocurarine-Lincomycin Interaction (Severity Level: Moderate)
     Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Tubocurarine Lincomycin
      Mechanism Neuromuscular blocking agent
Neuronal acetylcholine receptor  Antagonist 		Neuromuscular blocking effects
Lincosamides 
      Key Mechanism Factor 1
Factor Name Neuronal acetylcholine receptor Structure Sequence
Protein Family Ligand-gated ion channel (TC 1.A.9) family
Protein Function
After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane.
    Click to Show/Hide
      Mechanism Description
  • Additive neuromuscular blocking effects by the combination of Tubocurarine and Lincomycin 

Recommended Action
      Management Patients receiving neuromuscular blockers in conjunction with lincosamide therapy should be monitored closely during and after anesthesia for development of respiratory depression, and life support should be readily available if needed. Anticholinesterases and calcium may not completely antagonize the neuromuscular blockade induced by lincosamides.

References
1 Alahdal O, Bevan DR "Clindamycin-induced neuromuscular blockade." Can J Anaesth 42 (1995): 614-7. [PMID: 7553999]
2 Avery D, Finn R "Succinylcholine-prolonged apnea associated with clindamycin and abnormal liver function tests." Dis Nerv Syst 38 (1977): 473-5. [PMID: 862507]
3 Boolj LH, Miller RD, Crul JF "Neostigmine and 4-aminopyridine antagonism of lincomycin-pancuronium neuromuscular blockade in man." Anesth Analg 57 (1978): 316-21. [PMID: 566050]
4 Canadian Pharmacists Association.
5 Cerner Multum, Inc. "Australian Product Information.".
6 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
7 de Gouw NE, Crul JF, Vandermeersch E, Mulier JP, van Egmond J, Van Aken H "Interaction of antibiotics on pipecuronium-induced neuromuscular blockade." J Clin Anesth 5 (1993): 212-5. [PMID: 8391282]
8 Fogdall RP, Miller RD "Antagonism of d-tubocurarine- and pancuronium-induced neuromuscular blockades by pyridostigmine in man." Anesthesiology 39 (1973): 504-9. [PMID: 4355635]
9 Jedeikin R, Dolgunski E, Kaplan R, Hoffman S "Prolongation of neuromuscular blocking effect of vecuronium by antibiotics." Anaesthesia 42 (1987): 858-60. [PMID: 2889390]
10 Product Information. Cleocin (clindamycin). Pharmacia and Upjohn, Kalamazoo, MI.
11 Product Information. Clindesse (clindamycin topical). Ther-Rx Corporation, Bridgeton, MO.
12 Product Information. Lincocin (lincomycin). Pharmacia and Upjohn, Kalamazoo, MI.
13 Rubbo JT, Gergis SD, Sokoll MD "Comparative neuromuscular effects of lincomycin and clindamycin." Anesth Analg 56 (1977): 329-32. [PMID: 194504]