Classification, mechanism and duration of action

NMBAs are further differentiated by their duration of action during anesthesia. Succinylcholine and mivacurium are common ultra-short-acting competitive NMBAs (5-10 min). An intermediate duration of action (30-45 min) is maintained with the use of atracurium, cisatracurium, rocuronium and vecuronium. A long-lasting duration of action (90-100 min) is observed with d-tubocurarine, doxacurium, metocurine, pancuronium and pipecuronium. 

Less commonly, NMBAs are classified based on their chemical nature to include namral alkaloids and their congeners (e.g. d-tubocurarine), aminosteroids (e.g. cisatracurium, vecuronium) and benzylisoquinolines (e.g. succinylcholine). This classification scheme also relates to mechanism of actions and associated effects. 

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