NMJ & Muscle Relaxants! Flashcards

1
Q

Where are ach receptors found on the nmj

A

ach (nicotinic) receptors are located at the mouths of the junctional folds

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2
Q

what doe junctional folds do at the nmj

A

increase the surface area

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3
Q

what does ca entry to the pre synaptic nerve terminal do

A

ca enters via n channels and then ca neutralizes negatively charged membrane which stims fusion and release of NT

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4
Q

Where are a2 receptors located and what is the function of them

A

located through CNS (mostly pre synaptically) to modulate the release of NT by slowing down deporalization of axon terminal

-used in CNS to decrease central activity

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5
Q

How much ach does each vesical contain

A

10 000 molecules of ach

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6
Q

what does ach stim do

A

open up the channels in the endplate to ca,an, k (of only 2 or 3 vesicles hit then a MEPP develops)

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7
Q

How many vessicles for a normal endplate potential of 10-15mmV

A

200

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8
Q

What is tatanic contraction

A

no sig reduction in intracellular ca contration so a sustained release results

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9
Q

How does lidocaine work

A

interferes with sodium channels on the nerve fibres, interfering w the entry of sodium ions preventing firing

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10
Q

What does ethanol do at low and high doeses

A

at low concentration: may enhance fusion of vesicles

at high concentration: will inhibit the release of ach

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11
Q

what ddoes black widow spider venom do

A

causes a dramatic and almost complete release of each vesicles from the nerve endings

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12
Q

what does botox do

A

blocks ach release from vessicles

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13
Q

what do nicotinic antagonists do and what are the 2 classes

A

block nicotinic channels

  1. non depolarizing competative blockers
  2. depolarizing blockers
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14
Q

what are 3 examples of non depolarizing competitive blockers

A
  • D-Tubocurarine
  • Pancuronoim + rocurononium
  • Atracurium
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15
Q

how do u reverse the effcts of non depolarizing competitive blockers

A

raise ach conc

-Neostigmine + edrophonium used (achesterase blocers)

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16
Q

what is a depolarizing blocker and ex

A

tire out ach receptors

Succinycholine- rapid onset of action and very short duration of action, rapid hydrolysis by plasma cholinesterase

17
Q

Can depolarizing blockers be revearsed

A

no becuase this would just sum the effects

18
Q

what is curare and what does it do

A

binds to ach receptors and is a non depolarizing competitive inhibitor

19
Q

how to overcome the effects of curarre

A

switch to tetnus (more ach release- out competes it)

20
Q

how does neostigmine reverse curarre effects

A

neostigmine will inhibit achestelcholinesterase (more each avail)

21
Q

what does succinycholine do to tetnus, single twitch

A

depolarizing blocker so after initiall increase in strength will not be able to contract as forcefully

22
Q

can succynlcholine be reversed by neostigmine

A

no they will be synergistic and cause a further reduction

23
Q

what is baclofen used for and what are its effects pre and post synaptically

A

Baclofen- anti spastic agent that is a selective agonist of GABA (b) receptors pre and post

at pre- inhibits ca influx + NT release
at post- Increases K influx causing hyerpolarization

24
Q

what is tizanidine and what is it used ffor

A

anti spasticity agent- a2 adrenergic receptor agonsit exerting effects pre and post synaptically

25
what is myasthenia gravis
autoimmune disease in which antibodies to nicotinc receptors are produced (smaller mm affected first)
26
what are the two tests for myasthenia gravis
Tubocurarine- non depolarizing blocker at NJM-> if sensitive to this then probable disease Edrophphonian- inhibits achetlecholinesterase= if pts feels better disease is probable
27
What is parkinsons disease due to
a dopamine/ ach imbalance resulting in excessive ach release
28
what did illegal mepridine synthesis cause
MPTP- destroys dopaminergic fibres creating a type of parkinsons disease
29
what are the drugs used for therapy of parkinsons (3)
L dopa- dopamine precurseer Dopamine receptor agonist anticholinergic muscarinic blocker
30
what is huningtons disease
loss of GABAergic and cholinergic neurons- causes hyperkinesia
31
what are the drug therapies for huningtons
-barbituates/benzodiazepines | baclofen (anti spastic)