Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

1.2K
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
1.2K
Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action01:17

Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action

3.4K
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
3.4K
Neuromuscular Junction And Blockade01:29

Neuromuscular Junction And Blockade

5.8K
The site of chemical communication between a motor neuron and a muscle fiber is called the neuromuscular junction (NMJ). The end of the motor neuron at the NMJ divides into a cluster of synaptic end bulbs. The cytoplasm of these bulbs consists of synaptic vesicles enclosing acetylcholine molecules, the principal neurotransmitter released at the NMJ. The region opposite the synaptic bulb that ends in the muscle fiber is called the motor end plate, which has acetylcholine receptors. Within the...
5.8K
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics01:11

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics

908
All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
908
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

3.4K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
3.4K
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

1.1K
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
1.1K

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Route of Allergen Immunotherapy: A Global Look Into Physicians' Motivations.

Allergy·2026
Same author

Drug-induced anaphylaxis in pregnant women: a call for correct labeling antibiotic allergies.

Current opinion in allergy and clinical immunology·2026
Same author

Anaphylaxis and Epinephrine Use in Pregnancy.

The journal of allergy and clinical immunology. In practice·2026
Same author

Association Between Domestic Mold Detection and Clinical Outcomes in House Dust Mite Allergic Patients.

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology·2026
Same author

Allergic rhinitis activity and efficacy of 300 IR house dust mite sublingual immunotherapy tablet in pediatrics.

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology·2026
Same author

Management and Immunotherapy for Fungal Allergy: Clinical Practice and Unmet Needs.

Clinical reviews in allergy & immunology·2026

Related Experiment Video

Updated: Mar 20, 2026

Author Spotlight: Translational Applications of Stimulated SFEMG in Rodent Models
04:30

Author Spotlight: Translational Applications of Stimulated SFEMG in Rodent Models

Published on: March 8, 2024

1.8K

[Allergy to neuromuscular blocking agents].

Anca-Mirela Chiriac1, Pascal Demoly1

  • 1Centre hospitalier universitaire de Montpellier, hôpital Arnaud-de-Villeneuve, département de pneumologie et addictologie, unité exploration des allergies, 34295 Montpellier, France; Sorbonne universités, UPMC Paris 06, UMR_S 1136, institut Pierre-Louis d'épidémiologie et de santé publique, équipe EPAR, 75013 Paris, France.

Presse Medicale (Paris, France : 1983)
|May 29, 2016
PubMed
Summary

Allergy to neuromuscular blocking agents (NMBAs) is a major cause of perioperative anaphylaxis. Allergy testing is crucial to identify specific triggers and prevent fatal re-exposure, guiding safe anesthetic choices.

More Related Videos

Subcutaneous Administration of Muscarinic Antagonists and Triple-Immunostaining of the Levator Auris Longus Muscle in Mice
07:09

Subcutaneous Administration of Muscarinic Antagonists and Triple-Immunostaining of the Levator Auris Longus Muscle in Mice

Published on: September 8, 2011

14.1K
Basophil Activation Test for Allergy Diagnosis
07:22

Basophil Activation Test for Allergy Diagnosis

Published on: May 31, 2021

9.8K

Related Experiment Videos

Last Updated: Mar 20, 2026

Author Spotlight: Translational Applications of Stimulated SFEMG in Rodent Models
04:30

Author Spotlight: Translational Applications of Stimulated SFEMG in Rodent Models

Published on: March 8, 2024

1.8K
Subcutaneous Administration of Muscarinic Antagonists and Triple-Immunostaining of the Levator Auris Longus Muscle in Mice
07:09

Subcutaneous Administration of Muscarinic Antagonists and Triple-Immunostaining of the Levator Auris Longus Muscle in Mice

Published on: September 8, 2011

14.1K
Basophil Activation Test for Allergy Diagnosis
07:22

Basophil Activation Test for Allergy Diagnosis

Published on: May 31, 2021

9.8K

Area of Science:

  • Anesthesiology
  • Clinical Immunology
  • Pharmacology

Background:

  • Allergy to neuromuscular blocking agents (NMBAs) is a leading cause of perioperative anaphylaxis globally.
  • Suxamethonium and rocuronium are the most common NMBA culprits.
  • Accurate diagnosis is vital to prevent recurrent, potentially fatal anaphylactic reactions.

Purpose of the Study:

  • To emphasize the critical need for allergy work-up in suspected NMBA hypersensitivity.
  • To highlight the importance of assessing cross-reactivity in confirmed NMBA allergy cases.
  • To introduce the investigation of the cross-sensitization hypothesis for NMBA allergy.

Main Methods:

  • Clinical history review for compatible anaphylaxis events.
  • Diagnostic allergy testing to confirm or exclude NMBA hypersensitivity.
  • Cross-reactivity assessment in patients with confirmed NMBA allergy.

Main Results:

  • Delayed diagnosis or omission of allergy work-up poses a significant risk of fatal re-exposure.
  • Mandatory cross-reactivity assessment is required for patients with confirmed NMBA allergy.
  • The cross-sensitization hypothesis in NMBA allergy is under investigation.

Conclusions:

  • Comprehensive allergy evaluation is essential for patients experiencing perioperative anaphylaxis potentially linked to NMBAs.
  • Understanding cross-reactivity patterns is critical for patient safety and management.
  • Further research into cross-sensitization may lead to improved preventive strategies for NMBA allergies.