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Skin/MSk > Exam 5 muscle paralytics > Flashcards

Exam 5 muscle paralytics Flashcards

1
Q

What neurotransmitter does the somatic nervous system use?

A

acetylcholine

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2
Q

What kind of receptor does the somatic nervous system use?

A

nicotinic

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3
Q

Where is the cell body of somatic nerves located?

A

ventral horn of the spinal cord

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4
Q

What kind of channel is the nicotinic receptor?

A

an ion channel (typically sodium)

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5
Q

What activates nicotinic receptors?

A

nicotine and acetylcholine

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6
Q

What does activation of nicotinic receptors result in?

A

Na influx, Depolarization, muscle action potential, opening of voltage-sensitive Ca2+ channel, release of calcium from sarcoplasmic reticulum, contraction

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7
Q

Explain what nerve activation leads to?

A

Acetylcholine release > nicotinic receptor activation > muscle endplate depolarization > muscle action potential > calcium influx (from calcium channel) > calcium-induced calcium release (from SR) > calcium interacts with troponin > myosin-actin interaction (muscle contraction)

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8
Q

What prolongs acetylcholine action?

A

anticholinesterases (neostigmine, pyridostigmine, edrophonium)

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9
Q

What are anticholinesterases used for?

A

treatment of mysthenia gravis

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10
Q

What is the action of neostigmine, pyridostigmine, and edrophonium?

A

anti cholinesterases

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11
Q

What drug blocks acetylcholine release? What will this result in?

A

Botulinum toxin; prevents muscle depolarization and contraction

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12
Q

What drugs block nicotinic receptors?

A

Mivacurium, tubocurarine (both competitive), succinylcholine (depolarizes)

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13
Q

What blocks calcium-induced calcium release?

A

dantrolene

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14
Q

What is useful in malignant hyperthermia? Why?

A

Dantrolene; will block contraction but not depolarization

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15
Q

How does neostigmine, pyridostigmine and soman work?

A

indirectly stimulates nicotinic receptors by blocking Ach-ase action

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16
Q

What is used to diagnose myasthenia graves? How does it work?

A

Edrophonium, reversible anticholinesterases

17
Q

What drug is used to treat potential nerve gas attacks?

A

soman

18
Q

What are the classic signs of anti cholinesterase toxicity?

A

SLUDGE (sweating, lacrimation, urination, diarrhea, GI disress, emesis)

19
Q

How does tubocurarine and mivacurium work?

A

competitive blocker of the nueromuscular jxn- not allowing sodium influx, depolarization and contraction

20
Q

How does succinylcholine work?

A

depolarizes end plate of muscle- chronic influx of Na+ causes depolarization and cannot repolarize itself

21
Q

What can block competitive neuromuscular blockers (tubocurarine)?

A

neostigmine, epinephrine and norepi have a slight ability to decrease the competitive blockade

22
Q

Where are competitive neuromuscular blockers (tubocurarine) most likely to act?

A

Jaw, eyes, limbs, diaphragm

23
Q

Where are neuromuscular depolarizing agents (succinylcholine) most likely to act?

A

chest and abdomen

24
Q

What can the toxic effects of succinylcholine be? How do you treat it?

A

Malignant hyperthermia, dantroline

25
Q

True/false: Mivacurium is long acting?

A

False; it’s short acting

26
Q

What should you avoid giving to burn patients?

A

Succinylcholine (burned muscle increases concentration of nicotinic receptors, which will result in excessive potassium release in response to stimulation)

27
Q

What is the exact molecular action of botulinum toxin A?

A

prevents acetylcholine release by cleaving proteins necessary for acetylcholine exocytosis (blocks docking of vesicles)

28
Q

What can you use to potentiate contraction for myasthenia gravis?

A

anticholinesterases: Neostigmine, pyridostimine, edrophonium

29
Q

What drug prevents contraction and malignant hyperthermia?

A

dantroline (calcium chelator)

30
Q

What drugs paralyze the patient by being nicotinic receptor antagonists?

A

Competitive: tubocurarine, mivacurium, Depolarizing: succinylcholine

31
Q

What can you use to paralyze patients muscles by preventing acetylcholine release?

A

botulinum toxin

32
Q

How does succinylcholine act?

A

Depolarizes by causing constant Na+ influx into cell

33
Q

What potentiates the action of succinylcholine?

A

Anticholinesterases- increase the amount of acetylcholine in the junction, thereby also increasing the amount of Na+ that influxes into the cell

34
Q

T/F: treatment of burn patients with succinylcholine is perfectly safe for intubation

A

FALSE. Will prop open nicotnic receptors which will lead to potassium leaking outside of the cell, increasing extracellular concentrations

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