NM Pharmacology

Question 1

nAChR Subs (3)

Answer 1

Neuronal: alpha and beta
Muscle: fetal - a/b/g/d. Adult - a/b/e/d

Question 2

ACh Binding Protein

Answer 2

Buffers amount of ACh in synapse bc looks like outside of AChR but is soluble

Question 3

Sequence of Muscle Blockade

Answer 3

Fast twitch first - tips of extremities
Limbs/neck/trunk
Intercostals/diaphragm - respiratory failure. Helpful that that’s last

Question 4

Side Effects from Competitive Blockers like DTC (d-tubocurarine) (2)

Answer 4

No CNS effects bc don’t cross BBB

Hypotension due to ganglionic blockade and histamine release

Question 5

Succinylcholine (what it is, 2 phases, important point about treatment, and complication)

Answer 5

Looks like 2 ACh, can’t by hydrolyzed so continuously activate R
Phase I (depolarizing) - R activation and depol, then fasciculations, then flaccid paralysis
Phase II (desensitizing) - membrane repolarizes, but doesn’t respond to nerve stimulation bc Rs are desensitized (or channel blocked)
Don’t treat w/ neostigmine bc problem is not lack of ACh
Malignant Hypothermia can occur

Question 6

Edrophonium

Answer 6

Short duration, reversible inhibitor of AChE

Question 7

Carbamate Esters

Answer 7

Like neostigmine, covalent very slowly reversible inhibitors of AChE

Question 8

Organophosphates

Answer 8

Like malathion and sarin, covalent irreversible inhibitors of AChE

Question 9

2-PAM

Answer 9

Treats OP toxicity as long as administered before “aging”

Question 10

How to Test Neostigmine Dose for MG

Answer 10

Give edrophonium. If strength increases, not enough. If it weakens, too much

Question 11

Physostigmine

Answer 11

Treatment for atropine intoxication, AChE inhibitor that crosses BBB unlike neostig