Abstract
The term ‘neuromuscular blocking drug’ might logically be regarded as applying to all drugs that interrupt transmission at neuroeffector junctions in any type of muscle (smooth, cardiac, skeletal). In fact, however, common usage restricts the term to drugs acting at junctions in skeletal muscle, and a further restriction confines the term to those drugs that block transmission by combining with acetylcholine receptors on the chemosensitive area of the muscle fibre membrane — i.e. the nicotinic cholinoceptors of the motor endplate. It is in this sense that the term is used in this chapter. Drugs and toxins are known that interrupt neuromuscular transmission by an action on the nerve endings through which acetylcholine synthesis, storage or release is impaired. Important examples are hemicholinium-3, which inhibits acetylcholine synthesis, and the exotoxin of Clostridium botulinum, which interferes with the transmitter release process (for reviews, see Macintosh and Collier, 1976; Bowman, 1980). The compound 2-(4-phenylpiperidino) cyclohexanol (AH 5183) is an example of a substance that impairs transmission probably by interfering with the loading of acetylcholine into its storage vesicles (Marshall, 1970; Anderson et al., 1983). Although of great theoretical interest, and possibly toxicological interest (for example, in the case of C. botulinum toxin), these compounds have no clinical uses; nor do they act selectively at the neuromuscular junction. For these reasons they are not referred to further in this chapter, which is concerned almost exclusively with drugs that selectively block neuromuscular transmission by an action on postjunctional cholinoceptors.
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Bowman, W.C. (1986). Mechanisms of Action of Neuromuscular Blocking Drugs. In: Woodruff, G.N. (eds) Mechanisms of Drug Action. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-08026-7_2
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