Neurotoxins, cholinergic system NMJ, NMJ blocking agents, reversal of competitive NMJ blockers, uses of NMJ blockers, pharmacokinetic considerations, half-times, concerns, contraindications

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Colorado State University
Biomedical Science
BMS 450
Douglas Ishii

11 MarchHistoryAmazon basin natives arrows poisoned by extract from vine C tomentosum caused a curious flaccid paralysis API dtubocurareBaron Alexander von Humboldt Prussian explorerFrancois Magendie physiologistClaude Bernard first lectures in western pharmacology College de France founded 1530Electrical stimulation of muscle caused muscle contractionElectrical stimulation of nerve caused action potentialStimulation of nerve did not cause muscle contractionDiscovery of neuromuscular junction NMJPreceded concept of synapseHandout Chemical structuresCompetitive nondepolarizing agentsReversible binds to closed states of AChRIonic generally devoid of CNS effects edibledtubocarine chloride historical not much usedDepolarizing agents essentially noncompetitiveSuccinylcholine chloride aka suxamethoniumBinds open state of AChROnly depolarizing agent in use30 sec onset initial fasciculation then paralysis3 min halflife rapid tracheal intubation in trauma
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