Neuromuscular blockade nicotinic cholinergic receptors

The effects of curare develop rapidly after it enters the body. Victims develop rapid weakness of voluntary muscles followed by paralysis, respiratory failure, and death. The cause is a blockade of nicotinic cholinergic receptors at the neuromuscular junctions in skeletal muscle. Unlike botulinum toxin, release of acetylcholine by the cholinergic nerve terminals is not affected. When curare is present, however, the acetylcholine that is released cannot bind to the receptors because they are reversibly occupied by the curare. As a consequence, nerve-muscle communication fails and paralysis ensues. 

Neuromuscular blockade is a rare side-effect of the aminoglycosides, related to blockade of acetylcholine at the nicotinic cholinergic receptor. This is most often seen as respiratory depression and apnea when anesthetic agents are administered... 

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