Final answer:
Cholinesterase inhibitors potentiate the effects of NMBs by inactivating the enzyme acetylcholinesterase, leading to the accumulation of acetylcholine and increased muscle contractions. Such inhibitors are used in medications for Alzheimer's and myasthenia gravis, but can also be found in nerve gasses.
Step-by-step explanation:
Cholinesterase inhibitors affect neuromuscular blocking agents (NMBs) by potentiating their effects. This occurs because cholinesterase inhibitors prevent the breakdown of acetylcholine by inactivating the enzyme acetylcholinesterase. As a result, acetylcholine accumulates at the synapse, which can lead to increased muscle contractions and difficulty in achieving muscle relaxation when NMBs are used. Common cholinesterase inhibitors include drugs such as physostigmine, neostigmine, and pyridostigmine, which are used to treat diseases like Alzheimer's and myasthenia gravis.
Similarly, nerve gasses like sarin and soman target acetylcholinesterase, leading to an accumulation of acetylcholine and subsequent overstimulation of the nerves, which can cause severe symptoms or even be fatal. The overall effect of cholinesterase inhibitors, whether used as medication or encountered as toxic agents, is to increase the levels of acetylcholine at the synapse, affecting nerve transmission and muscle movement.