Neostigmine is used to reverse non-depolarizing neuromuscular blockade. Its mechanism of action involves:

• A Direct activation of nicotinic acetylcholine receptors at the motor end plate
• B Inhibition of acetylcholinesterase increasing acetylcholine concentration at the neuromuscular junction ✓
• C Inhibition of plasma cholinesterase leading to reduced metabolism of muscle relaxants
• D Encapsulation of the muscle relaxant molecule forming an inactive complex

Explanation

Neostigmine is an acetylcholinesterase inhibitor that increases acetylcholine at the neuromuscular junction, which then competes with the non-depolarizing relaxant for receptor binding. It does not directly activate receptors. Sugammadex encapsulates rocuronium/vecuronium. Plasma cholinesterase inhibition would affect succinylcholine and mivacurium metabolism, not reversal.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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