TY - CHAP M1 - Book, Section TI - Neuromuscular Blockers A1 - Guo, Caitlin J. A1 - Sutin, Kenneth M. A2 - Nelson, Lewis S. A2 - Howland, Mary Ann A2 - Lewin, Neal A. A2 - Smith, Silas W. A2 - Goldfrank, Lewis R. A2 - Hoffman, Robert S. PY - 2019 T2 - Goldfrank's Toxicologic Emergencies, 11e AB - Curare is the generic term for the resinous arrowhead poisons used to paralyze hunted animals.116 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.8 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.”18 Curare was 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.116 In 1932, Raynard West used curare to reduce the muscular rigidity of hemiplegia.116 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1163014026 ER -