Neuromuscular Junction - Physiology and Pharmacology
Channel: Liam Skoda
Date: 2023-11-19

This lecture aims to provide a conceptual overview of the physiology, pharmacology, toxicology and monitoring of the neuromuscular junction, with particular reference to the use of neuromuscular blocking agents in critical care environments. Slides and animations are my own work and free for reuse (suggest using 4K version). Content developed during preparation for CICM primary exam. 

Minor voiceover correction: At 01:15:50 I stated that "many" patients with myalgia develop rhabdomyolysis, I should have said "some". 

David Goodsell 2009 illustration: https://iubmb.onlinelibrary.wiley.com/doi/full/10.1002/bmb.20297
Stanford Anaesthesia Lecture Slides: https://ether.stanford.edu/ca1_new/tutorial_book.html
Open Anaesthesia: https://www.openanesthesia.org/
Deranged Physiology: https://derangedphysiology.com/main/home

Ketamine Nightmares 
Website: https://ketaminenightmares.com/
Channel: @ketaminenightmares403 

Outline:
00:01:57 Membrane potentials
00:07:14 Skeletal muscle and NMJ transmission
00:12:30 Excitation–contraction coupling
00:16:12 Motor units, twitch, summation and tetanus
00:27:26 Disorders of acetylcholine release
00:31:06 Neuromuscular blockers and myasthenia gravis
00:47:33 Acetylcholine: Central and autonomic sites of action
01:00:15 Introduction to neuromuscular blocking drugs
01:04:59 Succinylcholine and butyrylcholinesterase
01:21:24 Non–depolarising muscle relaxants and overview
01:28:37 Neuromuscular blocking drug summary table
01:29:10 Cholinesterase inhibitors
01:41:48 Antimuscarinic drugs
01:45:41 Sugammadex 
01:47:58 Peripheral nerve stimulation
01:58:07 Summary of neuromuscular monitoring
02:03:23 Conclusion