How is the neurotransmitter acetylcholine synthesized (created) ?

Synthesis of acetylcholine is facilitated by the enzyme, choline acetyltransferase (CAT). This enzyme combines choline with acetate derived from acetyl coenzyme A (CoA). Choline is taken up into cholinergic nerves by a high affinity transport process (sodium-choline cotransport) that is indirectly coupled to the energy stored by the Na/K pump ATPase. This transporter process is inhibited by hemicholinium-3  (HC-3). HC-3 has no immediate effect on neurotransmission, but can cause cholinergic nerve fibers eventually to run out of transmitter. In the presence of HC-3, the more rapidly cholinergic fibers are stimulated, the more rapidly they run out of ACh.