Sux, roc, vec, cis, sugammadex, neostigmine
Depolarizing neuromuscular blocker
Acetylcholine receptor agonist at the NMJ; sustained depolarization → fasciculations → flaccid paralysis. Hydrolyzed by plasma cholinesterase.
Aminosteroid non-depolarizing muscle relaxant
Competitive antagonist at the NMJ nicotinic receptor.
Modified γ-cyclodextrin selective relaxant binding agent
Encapsulates rocuronium > vecuronium > pancuronium in 1:1 complex. No effect on cisatracurium, atracurium, sux.
Benzylisoquinolinium non-depolarizing neuromuscular blocker (intermediate duration)
Competitive antagonist at the post-synaptic nicotinic ACh receptor at the neuromuscular junction. Single cis-cis isomer of atracurium (4× more potent, lower laudanosine production).
Aminosteroid non-depolarizing neuromuscular blocker (intermediate-acting)
Competitive nicotinic ACh-receptor antagonist at the NMJ. Aminosteroid → reversible by sugammadex.
Benzylisoquinolinium non-depolarizing neuromuscular blocker (intermediate-acting)
Competitive nicotinic antagonist. Eliminated by HOFMANN elimination (spontaneous, temp/pH-dependent) + ester hydrolysis → organ-independent clearance.
Aminosteroid non-depolarizing neuromuscular blocker (long-acting)
Competitive nicotinic antagonist. Also blocks cardiac muscarinic receptors (vagolytic) → tachycardia.
Benzylisoquinolinium non-depolarizing NMB (short-acting)
Competitive nicotinic antagonist. UNIQUE among non-depolarizers: metabolized by PLASMA CHOLINESTERASE (like succinylcholine) → shortest-acting NDMR.