This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Anesthesia, Subject name: Pharmacology
Neostigmine antagonizes non depolarising blockade by all of the following mechanism except 
Select and explain. 
A. Decreasing the breakdown of acetyl choline at the motor end plate, B. Preventing the K+efflux, C. Increasing the release of acetyl choline at the motor end plate, D. Depolarization at the motor end plate
A: Decreasing the breakdown of acetyl choline at the motor end plate
Answer: A: Decreasing the breakdown of acetyl choline at the motor end plate 
Explanation: Refer Katzung 10/e p 436 Neostigmine is an anti cholinerasterase. It inhibits the breakdown of ACh at the mother end plate This results in increased activity of ACh that causes depolarization of motor end plate by opening Na+channels . It posseses some direct agonistic activating on NM receptors resulting in depolarization