Acetylcholine neurotransmission as a drug target

This chapter begs for relevance by recalling Section M2 (ii) of the 2023 CICM Primary Syllabus, which expects the exam candidates to "outline the mechanisms by which drugs may affect neurotransmission and noradrenaline effect at the sympathetic nerve terminal". Surely, one may say, if noradrenaline should be treated this way, then why not acetylcholine? The answer is probably completely pragmatic (perhaps there's not enough space in the syllabus, or in any specific exam, for blueprinting of this item to allow a regular reappearance in the papers). Or it may be that there is some difficulty in determining exactly where this should fit, as acetylcholine is also used at the neuromuscular junction. These mechanisms will all be the same in any cholinergic synapse, be it neuromuscular or parasympathetic, and some may say that the inclusion of this acetylcholine chapter in the autonomic section is some kind of wastefully excessive duplication. This, of course, would be entirely on brand for both CICM and for Deranged Physiology. But the authors' time is finite. As such, the reader is left with a link to the acetylcholine neurotransmission section from another chapter, and this humongous diagram.

acetylcholine metabolism release and storage