Pharmacology of Neuromuscular Transmission Flashcards
The Action potential generated is propagated along the ______ and down the ______ tubules.
Sarcolemma, T
In AP Propagation, Ca 2+ ions bind to _____, which changes the shape and removes the blocking action of ______, leaving the actin active sites exposed.
Troponin, Tropomyosin
In contraction, ____ cross bridges alternately attach to actin and detach, pulling the actin filaments towards the centre of the _____.
Myosin, Sarcomere
How many subunits make up the Nicotinic receptors
5
List the 5 subunits of the nicotinic receptors
2 alpha, 3 non alpha subunits,
List the subunits that make up the ganglionic nicotinic receptor
2 alpha, 3 beta
True or false, prolonged opening of nicotinic Na+ channels, prolongs inactivation of the immediate surrounding Na+ ion channels.
True
What two drugs interfere with the non-depolarising postsynaptic action of ACh
Pancuronium, Mivacurium
True or false, Pancuronium is a competitive agonist of nicotinic receptors
False, Antagonist
True or False, Mivacurium binds to and prevents the action of ACh, this decreasing AP development
True
What drug interferes with the Depolarizing postsynaptic action of ACh
Succinylcholine (suxamethonium)
True or false succinylcholine is an antagonist of nicotinic receptors
False, it is an agonist
True or false, Acetylcholinesterase can metabolise succinylcholine
False, it can’t
True or False, Succinylcholine causes persistent depolarisation of the nicotinic sodium channels
True
True or False, Succinylcholine causes a blockade of voltage-gated sodium channel
True
What are some clinical applications of Drugs that induces skeletal muscle paralysis
DURING ENDOTRACHEAL INTUBATION
DURING ORTHOPEDIC MANIPULATION
TO ALLEVIATE THE PERIPHERAL SYMPTOMS OF CONVULSION
TO PROVIDE CONTROLLED VENTILATION (OBSTRUCTIVE
AIRWAY DISEASE)
List the drugs that are short acting in inducing paralysis (5-15mins)
SUCCINYLCHOLINE, MIVACURIUM
List the drug that is long lasting in inducing paralysis (30-120 mins)
Pancuronium
What is the time taken for the onset of paralysis inducing drugs
<5 mins
True or false Succinylcholine is a very polar agent
True
True or false, Mivacurim has charged N groups and is similar to Each
True
What is the normal route of administration for Paralysis inducing drugs
IV or IM
What is the removal site for Succinylcholine and Mivacurium
Psuedocholinesterase
What is the removal site for Pancuronium
Renal
What drug produces the adverse drug reaction: M2 MUSCARINIC RECEPTOR BLOCKADE
Pancuronium
What drug produces the adverse drug reaction: HISTAMINE RELEASE
Mivacurium, Succinylcholine
What drug produces the adverse drug reaction: MALIGNANT HYPERTHERMIA
Succinylcholine
What drug produces the adverse drug reaction: INCREASE IOP
Succinylcholine
What drug produces the adverse drug reaction: POST-OPERATIVE PAIN
Succinylcholine
What drug produces the adverse drug reaction: Increase K+ release-HYPERKALEMIA
Succinylcholine
True or false, succinylcholine is well absorbed orally
False
What is the effect of administering anticholinesterase during succinylcholine paralysis
Deepened Paralysis
In a patient given mivacurium, what is the likely effect of administering anticholinesterase
Reversal of paralysis
True or false, relevant effects of mivacuriumcan be reversed by anticholinesterase
True
True or False, the muscle recant succinylcholine blocks the action of acetylcholine on muscarinic receptors
False
True or False, Muscarinic receptors are so named because they are more sensitive to muscarine than to nicotine.
True
Where are muscarinic receptors found
brain, heart and smooth muscle
What are the three neurotoxins that prevent neuronal Na+ action
Saxitoxin, Tetrodotoxin (puffer fish) , Ciguatoxin
