Adverse effects of drugs on the respiratory muscles

Over 100 drugs can impair muscle function by (1) inhibiting neural drive, (2) causing peripheral neuropathy, (3) blocking neuromuscular junctions, (4) precipitating myasthenia gravis, or (5) producing myopathy. The best-known and most serious effects of drugs on respiratory muscle are sedative-associated respiratory failure, muscle relaxant-associated respiratory muscle paralysis, vaccine-associated Guillain-Barre syndrome, and antibiotic-associated potentiation of neuromuscular blockade. There are a number of other drug-induced neuropathies and myopathies, many of which can effect respiratory muscles, particularly the diaphragm. This article reviews what is known about the effects of drugs on respiratory myoneural function and what can be inferred from studies on other striated muscles.