Nondepolarizing neuromuscular blocking drugs can be identified by the “cur” within their names. These drugs include atracurium, mivacurium, pancuronium, rocuronium, tubocurarine, and vecuronium.
These drugs are competitive antagonists with acetylcholine at the post-junctional membrane nicotinic receptors of the neuromuscular junction. This leaves fewer binding sites for acetylcholine to have neurotransmitter activity.
These drugs compete with acetylcholine for post-synaptic binding sites, serving as competitive antagonists.
These drugs are paralytic agents which are reversible. Cholinesterase inhibitors can be used for reversal of a nondepolarizing drug blockade. These medications prevent the enzyme acetylcholinesterase from breaking down acetylcholine, thereby increasing acetylcholine levels in the neuromuscular junction and reversing the effect of the anesthetic.
Cholinesterase inhibitors such as neostigmine and edrophonium may be used for reversal of a nondepolarizing drug blockade. These cholinesterase inhibitors can be used in myasthenia gravis as well, with edrophonium as a diagnostic agent and neostigmine for regular treatment.
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