TY - CHAP M1 - Book, Section TI - Neuromuscular Blockers A1 - Sutin, Kenneth M. A2 - Hoffman, Robert S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Nelson, Lewis S. A2 - Goldfrank, Lewis R. PY - 2015 T2 - Goldfrank's Toxicologic Emergencies, 10e AB - Curare is the generic term for the resinous arrowhead poisons used to paralyze hunted animals.104 The curare alkaloids are derived from the bark of the Strychnos vine, and the most potent alkaloids, the toxiferines, are derived from Strychnos toxifera. Fortunately for the hunters who used curare, ingestion of their prey did not cause paralysis. Sir Walter Raleigh discovered the use of curare in Guyana in 1595, and he was the first person to bring curare to Europe. Curare played a pivotal role in the discovery of the mechanism of neuromuscular transmission. In 1844, Claude Bernard placed a small piece of dry curare under the skin of a live frog and observed that the frog became limp and died.7 He performed an immediate autopsy and discovered that the heart was beating. Because direct muscle stimulation produced contraction but nerve stimulation did not, Bernard concluded that curare paralyzed the motor nerves. He later observed, however, that bathing the isolated nerve did not affect neuromuscular transmission, leading him to conclude: “Curare must act on the terminal plates of motor nerves.”15 Curare was also used by Nobel Laureate physiologists Charles Sherrington, John Eccles, and Bernard Katz to further elucidate neuromuscular physiology. Its first clinical use was described in 1878 when Hunter used curare to treat patients with tetanus and seizures.104 In 1932, Raynard West used curare to reduce the muscular rigidity of hemiplegia.104 The use of curare (d-tubocurarine) in anesthesia spanned almost 60 years until it was replaced by superior agents that caused less histamine release and hypotension. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1108431709 ER -