Neuromuscular blocking agents

Neuromuscular blocking agents

Can be nondepolarising (act by competing with acetylcholine for binding to nicotinicM receptors  muscle relaxation; eg tubocurarine, doxacurium) or depolarising (bind to nicotinicM receptors  end plate depolarisation  remains bound  prevents repolarisation; eg succinylcholine).

Also can be short acting (eg succinylcholine, mivacurium), intermediate acting (eg atracurium) or long acting (eg doxacurium).

Used to produce relaxation of skeletal muscle

Clinical uses:
• muscle relaxants during surgery
• facilitation of mechanical ventilation
• during electroconvulsive therapy

Adverse effects:
• respiratory depression

Succinylcholine:
• depolarising neuromuscular blocker
• short acting
• indicated fro malignant hyperthermia

Botulinum toxin:
• potent toxin that causes botulism
• therapeutically used in the management of long standing muscle spasm