Drug General Information (ID: DDIE6YJNVL)
Drug Name			Cisatracurium		Drug Info		Clindamycin (topical)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Neuromuscular Blocking Agents				Antibiotics
Structure

Mechanism of Cisatracurium-Clindamycin (topical) Interaction (Severity Level: Moderate)
Additive neuromuscular blocking effects Click to Show/Hide Mechanism Graph
Drug Name		Cisatracurium				Clindamycin (topical)
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 Cisatracurium and Clindamycin (topical)

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	Cerner Multum, Inc. "Australian Product Information.".
2	Jedeikin R, Dolgunski E, Kaplan R, Hoffman S "Prolongation of neuromuscular blocking effect of vecuronium by antibiotics." Anaesthesia 42 (1987): 858-60. [PMID: 2889390]
3	Product Information. Clindesse (clindamycin topical). Ther-Rx Corporation, Bridgeton, MO.