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NDMB Alpha Subunit Blockade — FRCA Primary MCQ

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HardPharmacology - NeuromuscularNDMB Alpha Subunit BlockadeFRCA Primary

Which description best explains the neuromuscular block produced by rocuronium at the adult motor end plate?

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Correct answer: BCompetitive antagonism at nicotinic acetylcholine receptors prevents channel opening

The best answer is “Competitive antagonism at nicotinic acetylcholine receptors prevents channel opening”. Rocuronium is a non-depolarising neuromuscular blocker: it competitively antagonises acetylcholine at the postsynaptic nicotinic receptor and prevents the channel opening required for end-plate depolarisation. This differs from suxamethonium’s initial depolarising action and from presynaptic mechanisms that reduce acetylcholine release.

Reference: Royal College of Anaesthetists, Primary FRCA Syllabus 2021: https://www.rcoa.ac.uk/sites/default/files/documents/2026-01/Primary-FRCA-Syllabus.pdf