Nondepolarizing Neuromuscular Blockers

Nondepolarizing neuromuscular blockers are modeled after the original neuromuscular blocker curare, which was used by hunters in the Amazon region to paralyze their prey. Nondepolarizing neuromuscular blockers competitively block ACh at the nicotinic receptors.  At high doses, nondepolarizing neuromuscular blockers block ion channels at the motor endplate of muscles.

Class Drugs

• Cisatracurium

• Pancuronium

• Rocuronium

• Vecuronium

Class Mechanism of Action

• Competitively block ACh at the nicotinic receptors (low doses)

• Block ion channels at the motor endplate of muscles (high doses)

Class Application

• Paralysis for procedures

Class Adverse Effects

• Minimal adverse effects

Class Tested Concepts

• Small muscles such as facial muscles affected first, diaphragm and larger muscles affected last.

• Effects can be reversed at low concentrations when cholinesterase inhibitors such as neostigmine are administered.

Drug Table

Drug Name	Application	Comments	Image
Cisatracurium	Paralytic for surgical procedures		"Sister" and "Curry"
Pancuronium	Paralytic for surgical procedures		"Pan" and "Curry"
Rocuronium	Paralytic for surgical procedures		"Rock" and "Curry"
Vecuronium	Paralytic for surgical procedures		"Vet" and "Curry"