Muscle nAChR agonist
Muscle-type nicotinic acetylcholine receptor agonist
- Persistent activation → depolarizing block → flaccid paralysis
- Skeletal muscle contraction
- Rapid-sequence intubation paralysis
- Depolarization releases potassium → hyperkalemia risk
- Malignant-hyperthermia trigger
- Initial fasciculations → postoperative myalgia
Drugs with this mechanism (2)
- Acetylcholine — Endogenous neurotransmitter at muscarinic and nicotinic receptors.
- Succinylcholine — The only depolarizing neuromuscular blocker; fastest onset, malignant hyperthermia risk.
Self-check
- Why does persistent muscle nicotinic activation produce paralysis?
Depolarizing block. - Why can a depolarizing neuromuscular blocker cause hyperkalemia?
Depolarization releases potassium.
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