Neuromuscular blockers Flashcards
At the neuromuscular junction which neurotransmitter is used and which receptor is used?
Is this fast or slow? Why?
What is the molecular structure of the receptor?
Ach and nicotinic receptor.
Fast (ionotropic) becuase the receptor is directly associated with the Na+ ion channel.
Pentameric: contains 5 subunits which create a pore for Na+ ions.
How is Ach removed from the NMJ?
There is also a pump which uptakes choline for more synthesis.
What do neuromuscular blockers do to consciousness?
Which muscles are affected first.
They don’t affect consciousness.
How do non-depolarising blockers work?
When are they used and how?
Blocks the NMJ: competative antagonists of the ACh at motor end plate.
- Have to block 70-80% of postsynaptic receptor because of the high safety factor.
- used during surgeries and administered IV. Need artificial ventilation due to effects on the lung.
In a surgery setting, what else is used on top of a non-depolarising block?
How do you reverse the neuromuscular block?
How do depolarising blockers work?
How can you reverse them?
What is a phase 1 depolarising block?
What is a phase 2 depolarising block?
Phase 2 block: evolutionary mechanism called desensitisation ability of the cell to recognise that something has gone wrong with the depolarised state.
The protein inside of the cell (b arrestin) which pulls the receptors inside of the cell (normally will break it down and then make a new one).
Phase 2 block will occur if there is a long phase 1 block.
If you want to establish a phase 1 block then you don’t want to do it for too long because a phase 2 block is irreversible until more receptors are re-synthesised (time).
What is the depolarising blocker that we need to know about?
What is it used for?
Side effects?
Name of the south american non-depolarising blocker?
Fast vs slow onset and action for non-depolarising vs depolarising?
