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Neuromuscular-blocking drugs, or Neuromuscular blocking agents (NMBAs), block transmission at the neuromuscular junction, [1] causing paralysis of the affected skeletal muscles. This is accomplished via their action on the post-synaptic acetylcholine (Nm) receptors.
Depolarizing neuromuscular blockers: Depolarizing agents act as agonists for acetylcholine receptors. Succinylcholine is currently the only depolarizing neuromuscular blocking drug that has been placed in ongoing clinical use. Its pharmacological structure resembles two acetylcholine molecules combined through acetate methyl groups. [11]
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A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics.
Anticholinergics (anticholinergic agents) are substances that block the action of the acetylcholine (ACh) neurotransmitter at synapses in the central and peripheral nervous system. [ 1 ] [ 2 ] These agents inhibit the parasympathetic nervous system by selectively blocking the binding of ACh to its receptor in nerve cells .
Actions on the neuromuscular junction may result in prolonged muscle contraction. [22] The effects of neostigmine on postoperative nausea and vomiting are controversial and there is not a clear linkage in clinical practice, however, there is good evidence to support the reduction in risk when anticholinergic agents are administered. [23]
Antinicotinic agents are classified into ganglionic blockers and neuromuscular blockers. Ganglionic blockers are of little clinical use as they act at all autonomic ganglions. [1] [2] They act by: Interfering acetylcholine release; Prolonged depolarization (depolarisation block), i.e. stimulation then block stimulation
Pancuronium, the first aminosteroid neuromuscular blocking agent to be introduced. Aminosteroids are a group of steroids with a similar structure based on an amino - substituted steroid nucleus. [ 1 ] [ 2 ] They are neuromuscular blocking agents , acting as competitive antagonists of the nicotinic acetylcholine receptor (nAChR), and block the ...