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Nursing Knowledge
Neuromuscular blockers are a class of medications that block the transmission of nerve impulses to skeletal muscles, resulting in temporary paralysis.
Neuromuscular blockers prevent acetylcholine from activating the nicotinic M receptors post-synaptically at the skeletal neuromuscular junction.
They paralyze all skeletal muscles, including those used for breathing (the diaphragm). Mechanical ventilation is required.
They do not affect the CNS. The client is completely paralyzed, but fully conscious. Sedatives should always be given before NMBs.
| Competitive neuromuscular blockers (antagonists) | Depolarizing neuromuscular blockers (agonists) | |
| Onset of paralysis | Rapid | Rapid |
| Peak | Peak effects persist 20–45 minutes and then decline. | Peaks after 1 minute, fades after 4–10 minutes |
| Recovery | Complete recovery in 1 hour | Ultrashort-acting |
| Used for longer procedures? | Yes | No |
| Reversed by | Acetylcholine | Acetylcholine inhibitors |
Competitive:
Depolarizing:
Competitive:
Depolarizing:
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