wk2- nmj, ache-i, MS modifying Flashcards
What is the mechanism of action of succinylcholine?
Succinylcholine is a depolarizing neuromuscular blocker; it acts as a strong ACh receptor agonist at nicotinic receptors, causing sustained depolarization and preventing further muscle contraction.
What are the clinical uses of succinylcholine?
Used for rapid muscle paralysis in intubation and short surgical procedures; ideal for rapid sequence intubation due to quick onset and short duration.
What are the adverse effects of succinylcholine?
Hyperkalemia (especially in burn or trauma patients)
Malignant hyperthermia (when used with halothane)
Bradycardia or arrhythmias
Post-op myalgia
fasciculations
increased intracranial/ occular/ intragastric pressure
What is the mechanism of action of rocuronium?
Rocuronium is a nondepolarizing neuromuscular blocker that competes with ACh for nicotinic receptors at the neuromuscular junction, preventing depolarization.
Often reversed with reversal agent.
What is rocuronium used for?
Used for muscle relaxation during surgery or mechanical ventilation; longer onset and duration than succinylcholine.
What is the mechanism of action of dantrolene?
Dantrolene inhibits ryanodine receptors (RyR1) in skeletal muscle, preventing Ca²⁺ release from the sarcoplasmic reticulum, thus reducing muscle contraction.
What are the clinical uses of dantrolene?
malignant hyperthermia
What is the moa of pyridostigmine?
Acetylcholinesterase inhibitor- increasing ach in synapse
adverse effect of pyridostigmine
diarrhea, sweating, nausea, cramps, hypersalvation- autononic hyper activity
Clinical use of pyridostigmine
Myasthenia Gravis- ach increase overcome antibodies for nm receptors
MOA- glatiramer acetate
**Disrupsts Tcell response: **
Synthetic polymer mimicking myelin basic protein (MBP).
Acts as a decoy antigen, modulating immune response:
Induces Th2 anti-inflammatory T cells Suppresses Th1 pro-inflammatory T cells
Clinical Use- glatiramer acetate
MS disease modifying txt. Relapsing-remitting MS (RRMS)
adverse effects of glatiramer acetate
Injection site reactions (most common)
Transient systemic symptoms after injection:
Flushing, chest pain, palpitations, anxiety (mimic MI but are benign)
No major systemic immunosuppression
MOA of teriflunomide
pyrimidine synthesis inhibitor
clinicl use teriflunomide
ms- disease modifying txt. recurring MS- syptom management
what are the adverse effects of teriflunomide
Hepatotoxicity (monitor LFTs)
Teratogenicity (Category X)
Alopecia, diarrhea, hypertension
Long half-life; may require accelerated elimination protocol (cholestyramine) if pregnancy desired
Dimethyl Fumarate
MOA?
Activates Nrf2 pathway, promoting antioxidant response
Reduces oxidative stress and modulates immune system
clincal use- dimethyl fumarate
Relapsing-remitting MS
adverse effects dimethylfumarate
flushing, Gi symptoms
What is the mechanism of action of fingolimod?
Fingolimod is a sphingosine-1-phosphate (S1P) receptor modulator that sequesters lymphocytes in lymph nodes, preventing their migration into the CNS.
What is fingolimod used to treat?
Relapsing forms of multiple sclerosis (MS).
What are the major adverse effects of fingolimod?
A: Bradycardia (especially after first dose), macular edema, infections, and elevated liver enzymes.
What is the mechanism of action of cladribine?
A: A purine analog that inhibits DNA synthesis and repair, leading to lymphocyte depletion.
What is cladribine used for?
A: Hairy cell leukemia and relapsing forms of multiple sclerosis.
