Synaptic transmission can be affected by several factors: 1. Synaptic fatigue can occur due to exhaustion of neurotransmitters from continuous stimulation of presynaptic neurons. 2. Synaptic delay is the minimum time required for transmission across the synapse, about 0.5 milliseconds. 3. Alkalosis increases neuronal excitability while acidosis depresses activity. Ion concentrations like calcium and magnesium also influence transmission. Hypoxia and many drugs can impact neuronal excitability and synaptic function. Anesthetics generally decrease synaptic transmission.