NMJ Physiology
Depolarizing Blockers
Phase I vs. Phase II Block
Nondepolarizing Blockers
Reversal Agents
100

This neurotransmitter is released from synaptic vesicles at the neuromuscular junction.

What is acetylcholine?

100

This is the only depolarizing neuromuscular blocker commonly used today.

What is succinylcholine?

100

This phase of succinylcholine block usually shows decreased twitches with little or no fade.

What is Phase I block?

100

Nondepolarizing neuromuscular blockers act as competitive antagonists at this receptor.

What is the nicotinic acetylcholine receptor?

100

Neostigmine reverses nondepolarizing blockade by inhibiting this enzyme.

What is acetylcholinesterase?

200

These ions enter the presynaptic nerve terminal and trigger acetylcholine vesicle docking and release.

What are calcium ions?

200

Succinylcholine is structurally similar to two molecules of this neurotransmitter linked together.

What is acetylcholine?

200

This train-of-four pattern is more typical of nondepolarizing blockade.

What is fade?

200

These blockers prevent acetylcholine from binding, producing this type of paralysis.

What is flaccid paralysis?

200

Sugammadex binds these drugs best, in this order.

What are rocuronium > vecuronium > pancuronium?

300

The postsynaptic nicotinic acetylcholine receptor requires this many acetylcholine molecules to open.

What are two?

300

These visible muscle twitches may occur before succinylcholine-induced paralysis.

What are fasciculations?

300

In Phase I block, neostigmine may worsen paralysis because it increases acetylcholine and slows this process.

What is succinylcholine metabolism?

300

Nondepolarizers impair acetylcholine mobilization at the presynaptic nerve terminal, explaining this TOF finding.

What is fade?

300

This reversal agent selectively binds aminosteroid neuromuscular blockers.

What is sugammadex?

400

Acetylcholine binds specifically to these subunits on the nicotinic receptor.

What are the alpha subunits?

400

Succinylcholine is metabolized in plasma by this enzyme.

What is pseudocholinesterase or butyrylcholinesterase?

400

This phase is associated with desensitization-like block and TOF fade.

What is Phase II block?

400

For nondepolarizing blockers, this relationship exists between potency and speed of onset.

What is an inverse relationship?

400

Sugammadex does not reverse succinylcholine or drugs in this class.

What are benzylisoquinoliniums?

500

This ion is repelled by the nicotinic receptor channel because of negative charges in the channel.

What is chloride?

500

A high dose or continuous exposure to succinylcholine can cause this type of block.  

What is a Phase II block?

500

The best treatment for a normal Phase I succinylcholine block is ventilation and this.

What is time?

500

Pancuronium, vecuronium, and rocuronium belong to this structural class of neuromuscular blockers.

What are aminosteroids?

500

These symptoms summarize muscarinic effects of acetylcholinesterase inhibitors. 

What are diarrhea, urination, miosis, bradycardia, bronchoconstriction, emesis, lacrimation, laxation, and salivation.

M
e
n
u