Neuromuscular Pharmacology

Question 1

What is a good mnemonic for remembering the non-depolarizing neuromuscular blockers?

Answer 1

They all have “-cur-“ in them, because they are related to curare! (panCURonium, ronCURonium, veCURonium)

Question 2

What specific V-SNARE is clipped by botulinum toxin?

Answer 2

Synaptobrevin

Question 3

Why does botulinum lead to flaccid paralysis while tetanus toxin leads to spastic paralysis?

Answer 3

Botulinum targets the NMJ presynaptic neurons, while tetanus targets inhibitory GABA channels.

Question 4

How does black widow toxin exert its effect?

Answer 4

It perforates the presynaptic membrane, thus leading to excessive calcium entry and inappropriate acetylcholine release. Ultimately this leads to depolarization blockade – resulting in respiratory paralysis similar to botulism toxicity.

Question 5

What toxin blocks voltage-sensitive sodium channels?

Answer 5

Tetrodotoxin

Question 6

Lamotrigine blocks ___________.

Answer 6

voltage-sensitive calcium channels

Question 7

What does dantrolene block? In what circumstance is it used?

Answer 7

It blocks voltage-sensitive calcium channels – which get stuck open in malignant hyperthermia

Question 8

Describe the three drugs that make up the lethal-injection cocktail.

Answer 8

Midazolam –general anesthetic to make the person unconscious
Pancuronium –paralyze the respiratory muscles
Potassium chloride – stop the heart

Question 9

Edrophonium, neostigmine, pyridostigmine, and physostigmine can reverse what toxicity?

Answer 9

Overdose with non-depolarizing neuromuscular junction blockers (such as pancuronium or curare)