What is the mechanism by which onabotulinumtoxinA (BOTOX) decreases muscle activation?
A. Blocks the binding of acetylcholine (ACh) to the motor end plate.
B. Inhibits the binding of myosin to active sites on actin.
C. Blocks the release of Ca+2 from the sarcoplasmic reticulum.
D. Inhibits the release of ACh from the presynaptic terminal.
E. None of the above occurs.
ANS: D
Rationale: Botox decreases muscle activation by inhibiting the release of ACh from the presynaptic terminal. With decreased transmitter release from the alpha motor neuron, the muscle membrane does not get the signal to initiate muscle contraction.
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