Question:
A person was given a muscle relaxant that competitively blocks nicotinic receptors. Which of the following drugs is used for reversal of muscle relaxation after surgery?
A person was given a muscle relaxant that competitively blocks nicotinic receptors. Which of the following drugs is used for reversal of muscle relaxation after surgery?
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Boost acetylcholine to push the competitive blocker off the receptor: pick the anticholinesterase that stays peripheral.
Updated On: Jun 23, 2026
- Neostigmine
- Carbachol
- Succinylcholine
- Physostigmine
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The Correct Option is A
Solution and Explanation
Step 1: A competitive (non-depolarising) neuromuscular blocker occupies the nicotinic receptor at the motor end plate and keeps acetylcholine out.
Step 2: To reverse it, raise the local acetylcholine concentration so it can outcompete the blocker. Neostigmine is the classic anticholinesterase used to antagonise non-depolarising blockade after surgery. Option A is correct.
Step 3: Why the others are wrong: physostigmine is a tertiary-amine anticholinesterase that crosses into the CNS and is not used for neuromuscular reversal; carbachol is a direct cholinergic agonist used in ophthalmology, not for reversal; succinylcholine is itself a depolarising blocker that would add to paralysis. Neostigmine is usually given with glycopyrrolate or atropine to block its muscarinic effects.
Ref: anaesthesia pharmacology on neuromuscular reversal (Hindawi case review).
Step 2: To reverse it, raise the local acetylcholine concentration so it can outcompete the blocker. Neostigmine is the classic anticholinesterase used to antagonise non-depolarising blockade after surgery. Option A is correct.
Step 3: Why the others are wrong: physostigmine is a tertiary-amine anticholinesterase that crosses into the CNS and is not used for neuromuscular reversal; carbachol is a direct cholinergic agonist used in ophthalmology, not for reversal; succinylcholine is itself a depolarising blocker that would add to paralysis. Neostigmine is usually given with glycopyrrolate or atropine to block its muscarinic effects.
Ref: anaesthesia pharmacology on neuromuscular reversal (Hindawi case review).
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