Local Anaesthetics Flashcards

1
Q

Describe pain transmission along axons

A

Pain causes stretch in neurons which leads to AP firing in nociceptors
Na+ moves in
K+ starts to move
Depolarises sequentially

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2
Q

Why cant the AP move back in the direct it comes from?

A

It leaves a hyperpolarisation behind it

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3
Q

What are the nodes of ranvier?

A

Spaces between myelin sheaths where Na+ receptors are located at high density

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4
Q

What is saltatory conduction?

A

APs jumping between nodes of ranvier instead of smooth flow

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5
Q

How are APs recorded using current clamp methods?

A

Electrode goes in the cell and ground

Different between these is the AP

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6
Q

Which channels are open at rest to establish the resting membrane potential?

A

K+

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7
Q

Why does the Na+ influx occur first?

A

Because the K+ channels respond more slowly to voltage

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8
Q

Outline the structure of the VGNC

A

24 membrane spanning domains forming a main alpha subunit
With 4 voltage sensors in the 4th TMD
Re-entrant pore loop

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9
Q

How do ions pass through the VGNC?

A

Arrive with a hydration shell which they lose when they travel through the channel
They then get re-hydrated on the other side

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10
Q

Explain how a VGNC opens

A

Positive amino acids means the transmembrane regions attract to the inside of the membrane
The depol of the cell reduces the attraction making space for Na+

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11
Q

What is the H gate?

A

The inactivation particle

This is positively charged nd binds to the channel in the same manner as Na to inactivate it

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12
Q

What are the three main configurations of an ion channel?

A

Open and active
Open and inactive
Closed and not active

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13
Q

What are the diff types of VGNC?

A

Na(v) 1.1 - 1.9

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14
Q

Are LAs lipophilic or hydrophilic?

A

Amphipathic

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15
Q

What is the basic explanation of LA action?

A

Binds to Na channels when inactive
So sodium cant
So the channel can’t be activated

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16
Q

Which mutations are found in inherited erythromelalgia?

A

N395K (Sheets et al 2007)

L858H

17
Q

Which conditions are caused by NaV1.7 mutations?

A

Inherited erythromelalgia
Paroxysmal extreme pain disorder
Congenital insensitivity to pain

18
Q

Where are NaV1.7’s mostly expressed?

19
Q

What is seen in NaV1.7 KO mice?

A

Increased mech and thermal thresholds

Reduced inflam responses

20
Q

Are NaV1.7 mutations in increased pain loss of function or gain of function?

A

Gain
L858H and N395K show more AP firing in the DRG

Waxman 2007

21
Q

Why is the grasshopper mouse cool af?

A

Mutation in the NaV 1.8 channel which means it cannot be recruited by NaV1.7 to propagate pain signals further

22
Q

How should bark scorpion venom normally work?

A

It should bind to the NaV1.7 channel

This is then activated and recruits NaV1.8 to propagate the signal

23
Q

Which key structure is present in all local anaesthetics?

A

Aromatic ring adding to lipid solubility

Intermediate chain which joins this to the amina

24
Q

Which part of the LA attracts protons?

A

The intermediate chain between the aromatic ring and the amine

25
What is the ester portion of the LA metabolised by?
Psuedocholinesterase in plasma and liver
26
What is the amide portion of the LA metabolised by?
P450s
27
What happens to the amide once is accepts the proton?
Becomes more positively charged Becomes water soluble Cant cross the cell membrane
28
Infected tissue is more alkaline than healthy tissue | T/F
F | Infected tissue has a lower pH and is more acidic than healthy tissue
29
Why do LAs not work as well in infected tissue?
Lower pH means more charged LAs which cant cross the membrane as well
30
Which fibres are most easily blocked by LAs?
Small, myelinated
31
What may charge lidocaine derivatives target?
TRPV1 | Binshtok et al 2007
32
Why would charged lidocaine derivatives be preferable to lidocaine?
More selective so as to not cause motor control and numbness
33
What compound may assist QX-314 entry into cells? Why do we think this?
Capsaicin Because Capsaicin appears to enhance the entry of FM1-43 dye which is a similar size and charge to QX-314
34
Why must QX-314 act via TRPV1 channels
Enhanced by capsaicin Doesn't work on motor neurons (no TRVP1) Cap + QX-314 greatly increased mechanical pain threshold vs either of them alone Binshtok et al 2007
35
What is SVmab1?
Antibody selective to NaV1.7
36
Is SVmab1 an effective anaesthetic?
Reduces inflammatory pain in the presence of formalin without affecting motor/balance
37
How is SVmab1 different from other antibodies?
Can be given IV without it being degraded