Pharmacokinetic Aspects of the Onset of Action of Neuromuscular Blocking Agents

In order to understand the factors governing the onset of neuromuscular block, it is important to know the processes following administration of a neuromuscular blocking agent (NMBA), eventually resulting in neuromuscular block. With respect to the processes involved in the time course of neuromuscular block, four steps can be discerned: Distribution and elimination of the NMBA, i. e., pharmacokinetics; Transport of the NMBA from the blood to the receptor site; Binding of the NMBA to the cholinoceptor; Processes initiated by the binding of the NMBA to the cholinoceptor, eventually resulting in neuromuscular bloc…