This document discusses neuromuscular junction blockers and their therapeutic uses. It first provides background on the neuromuscular junction and how it functions. It then discusses specific neuromuscular junction blockers like curare and atracurium. Finally, it notes some of the main therapeutic uses of neuromuscular junction blockers, including as an adjunct to general anesthesia during surgery, to facilitate intubation, and to prevent injuries during electroconvulsive therapy. The document also briefly mentions acetylcholinesterase and its inhibitor pralidoxime.

1. Curare and Related Compounds George Hsiao 2008

3. 北城醫院事件(atracurium) Mistake of Hepatitis vaccination, 2002

4. I: Neuromuscular Junction (NMJ)

5. NMJ

6. (a) Muscular site

9. (b) Motor neuron Site Motor neuron axon innervation

10. Nicotinic receptor Local events

11. Neuromuscular Junction & Neurotransmission

12. Whole Story

13. II. Muscular Nicotinic Receptor

16. Nicotinic-Nn and Nm

23. III. NMJ Blockers

28. The therapeutic uses of NMJ blocking are as follows:  To serve as an adjunct to general anesthetics during surgery, when reflex muscle movement could interfere with the surgical procedure or the delivery of gas anesthesia.  To facilitate mechanical intubation by preventing resistance to passing the endotracheal tube and in situation in which patients “fight” or resist the respirator.  To facilitate electroconvulsive therapy when intense skeletal muscle contractions as a result of electric shock could cause the patient broken bones or other injury.

29. IV. Acetylcholinesterase and its Inhibitor

36. AChE reactivator: Pralidoxime (PAM)