Wj. Book et al., ADVERSE-EFFECTS OF DEPOLARIZING NEUROMUSCULAR BLOCKING-AGENTS - INCIDENCE, PREVENTION AND MANAGEMENT, Drug safety, 10(5), 1994, pp. 331-349
Muscle relaxants block neuromuscular transmission, acting at nicotinic
acetylcholine receptors of the neuromuscular junction. Suxamethonium
(succinylcholine) is a depolarising agent, whereas all other relaxants
in clinical use are nondepolarising. The desired neuromuscular block
results from the structural similarity of muscle relaxants to acetylch
oline, enabling the interaction with receptors at the neuromuscular ju
nction. Adverse effects of suxamethonium are generally related to its
agonist mode of action. Autonomic cardiovascular effects may result. O
ther adverse effects include anaphylactic or anaphylactoid reactions,
and histamine release. Various disease states may present specific con
siderations in the use of muscle relaxants. Although many complication
s of muscle relaxants (such as prolonged block or resistance) are easi
ly treated, others may require immediate intervention and vigorous the
rapy. Careful selection of appropriate relaxants for particular patien
ts will usually prevent the occurrence of complications.