Snapshot A 46-year-old woman is undergoing an elective roux-en-y gastric bypass procedure to manage her obesity. The anesthesiology resident begins to induce anesthesia in the patient, which involved providing succinylcholine. After administration of this depolarizing agent, she developed fasciculations that eventually ceased. Introduction Neuromuscular blockade clinical use an agent used to provide muscle relaxation and diminish reflexes login to view 1 more bullet mechanism of action impairs cholinergic transmission at the neuromuscular junction login to view 5 more bullets Non-depolarizing neuromuscular blockers medications atracurium, mivacurium, pancuronium, rocuronium, tubocurarine, and vecuronium mechanism of action competes with acetylcholine for binding of nicotinic receptors on the motor-end plate login to view 4 more bullets Depolarizing neuromuscular blockers medication succinylcholine mechanism of action binds to nicotinic receptors; however, they are more resistant to acetylcholinesterases than acetylcholine login to view 10 more bullets adverse effects malignant hyperthermia hyperkalemia login to view 2 more bullets