1. Curare and Related Compounds George Hsiao 2008

3. 北城醫院事件(atracurium) Mistake of Hepatitis vaccination, 2002

4. I: Neuromuscular Junction (NMJ)

5. NMJ

6. (a) Muscular site

9. (b) Motor neuron Site Motor neuron axon innervation

10. Nicotinic receptor Local events

11. Neuromuscular Junction & Neurotransmission

12. Whole Story

13. II. Muscular Nicotinic Receptor

16. Nicotinic-Nn and Nm

23. III. NMJ Blockers

28. The therapeutic uses of NMJ blocking are as follows:  To serve as an adjunct to general anesthetics during surgery, when reflex muscle movement could interfere with the surgical procedure or the delivery of gas anesthesia.  To facilitate mechanical intubation by preventing resistance to passing the endotracheal tube and in situation in which patients “fight” or resist the respirator.  To facilitate electroconvulsive therapy when intense skeletal muscle contractions as a result of electric shock could cause the patient broken bones or other injury.

29. IV. Acetylcholinesterase and its Inhibitor

36. AChE reactivator: Pralidoxime (PAM)