Which drug produces transient muscle fasciculations followed by muscle paralysis that is not reversed by neostigmine?
- rocuronium
- hyoscyamine
- cisatracurium
- succinylcholine
- pancuronium
The answer is D: succinylcholine.
Succinylcholine is the only depolarizing neuromuscular blocking agent that produces persistent depolarization of the motor end plate, thereby causing transient muscle fasciculations followed by paralysis. Cholinesterase inhibitors, acting to increase acetylcholine levels, do not counteract the muscle paralysis produced by succinylcholine and can actually increase the degree of paralysis by prolonging muscle depolarization.
Succinylcholine is the only depolarizing neuromuscular blocking agent that produces persistent depolarization of the motor end plate, thereby causing transient muscle fasciculations followed by paralysis. Cholinesterase inhibitors, acting to increase acetylcholine levels, do not counteract the muscle paralysis produced by succinylcholine and can actually increase the degree of paralysis by prolonging muscle depolarization.
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