Topic overview

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The main classification includes peripheral neuromuscular blockers, centrally acting spasmolytics, direct-acting agents, and miscellaneous toxins or modifiers. Peripheral blockers include non-depolarizing drugs—divided into aminosteroid and benzylisoquinolinium classes—and the depolarizing agent succinylcholine. Centrally acting options include several agents used in spasticity management; dexmedetomidine may also be grouped with spasmolytics in ICU sedation contexts. Dantrolene is a direct-acting relaxant, while botulinum toxins reduce presynaptic acetylcholine release and are used for chemical denervation. Gabapentinoids may have antispasticity properties, and aminoglycosides or magnesium can modify neuromuscular blockade. The appropriate group depends on the intended use, such as surgical paralysis, spasticity management, airway facilitation, or focal injection.