Non-depolarizing NMJ blockers: classification

Tubocurarine

Benzylisoquinolines

Atracurium

Benzylisoquinolines

Mivacurium

Benzylisoquinolines

Rocuronium

Amino-steroids

Vecuronium

Amino-steroids

Pancuronium

Amino-steroids

Gantacurium

Mixed onium chlorofumarates

How many molecules of tubocurarine needed to block nACH in the NMJ? 

1

Effect of AChEIs on the effect of tubocurarine 

Reversal (these drugs are competitive antagonists–able to displace the agonist)

Effect of AChEIs on the effect of SuCh: 

Potentiation (bc it prolongs the duration of action of SuCh)

Is it safe to eat meat of an animal paralyzed by tubocurarine?

Yes (positive charge– won’t cross the membrane)

cisatracurium

Benzylisoquinolines

Which nondepolarizing NMJ blockers can be metabolized through both Hoffman elimination and ester hydrolysis?

Cisatracurium and Atracurium

Which nondepolarizing NMJ blocker has the highest risk of seizures as a result of laudanosine?

Atracurium

What chelating agent reduces duration of action of rocuronium/vecuronium (antidote to toxicity)?

Sugammadex

Why are most neuromuscular blockers administered via IV?

Most are charged and would not cross the membrane to the blood otherwise