Pharmacology of Neuromuscular Transmission

Question 1

The Action potential generated is propagated along the ______ and down the ______ tubules.

Answer 1

Sarcolemma, T

Question 2

In AP Propagation, Ca 2+ ions bind to _____, which changes the shape and removes the blocking action of ______, leaving the actin active sites exposed.

Answer 2

Troponin, Tropomyosin

Question 3

In contraction, ____ cross bridges alternately attach to actin and detach, pulling the actin filaments towards the centre of the _____.

Answer 3

Myosin, Sarcomere

Question 4

How many subunits make up the Nicotinic receptors

Answer 4

5

Question 5

List the 5 subunits of the nicotinic receptors

Answer 5

2 alpha, 3 non alpha subunits,

Question 6

List the subunits that make up the ganglionic nicotinic receptor

Answer 6

2 alpha, 3 beta

Question 7

True or false, prolonged opening of nicotinic Na+ channels, prolongs inactivation of the immediate surrounding Na+ ion channels.

Answer 7

True

Question 8

What two drugs interfere with the non-depolarising postsynaptic action of ACh

Answer 8

Pancuronium, Mivacurium

Question 9

True or false, Pancuronium is a competitive agonist of nicotinic receptors

Answer 9

False, Antagonist

Question 10

True or False, Mivacurium binds to and prevents the action of ACh, this decreasing AP development

Answer 10

True

Question 11

What drug interferes with the Depolarizing postsynaptic action of ACh

Answer 11

Succinylcholine (suxamethonium)

Question 12

True or false succinylcholine is an antagonist of nicotinic receptors

Answer 12

False, it is an agonist

Question 13

True or false, Acetylcholinesterase can metabolise succinylcholine

Answer 13

False, it can’t

Question 14

True or False, Succinylcholine causes persistent depolarisation of the nicotinic sodium channels

Answer 14

True

Question 15

True or False, Succinylcholine causes a blockade of voltage-gated sodium channel

Answer 15

True

Question 16

What are some clinical applications of Drugs that induces skeletal muscle paralysis

Answer 16

DURING ENDOTRACHEAL INTUBATION
DURING ORTHOPEDIC MANIPULATION
TO ALLEVIATE THE PERIPHERAL SYMPTOMS OF CONVULSION
TO PROVIDE CONTROLLED VENTILATION (OBSTRUCTIVE
AIRWAY DISEASE)

Question 17

List the drugs that are short acting in inducing paralysis (5-15mins)

Answer 17

SUCCINYLCHOLINE, MIVACURIUM

Question 18

List the drug that is long lasting in inducing paralysis (30-120 mins)

Answer 18

Pancuronium

Question 19

What is the time taken for the onset of paralysis inducing drugs

Answer 19

<5 mins

Question 20

True or false Succinylcholine is a very polar agent

Answer 20

True

Question 21

True or false, Mivacurim has charged N groups and is similar to Each

Answer 21

True

Question 22

What is the normal route of administration for Paralysis inducing drugs

Answer 22

IV or IM

Question 23

What is the removal site for Succinylcholine and Mivacurium

Answer 23

Psuedocholinesterase

Question 24

What is the removal site for Pancuronium

Answer 24

Renal

Question 25

What drug produces the adverse drug reaction: M2 MUSCARINIC RECEPTOR BLOCKADE

Answer 25

Pancuronium

Question 26

What drug produces the adverse drug reaction: HISTAMINE RELEASE

Answer 26

Mivacurium, Succinylcholine

Question 27

What drug produces the adverse drug reaction: MALIGNANT HYPERTHERMIA

Answer 27

Succinylcholine

Question 28

What drug produces the adverse drug reaction: INCREASE IOP

Answer 28

Succinylcholine

Question 29

What drug produces the adverse drug reaction: POST-OPERATIVE PAIN

Answer 29

Succinylcholine

Question 30

What drug produces the adverse drug reaction: Increase K+ release-HYPERKALEMIA

Answer 30

Succinylcholine

Question 31

True or false, succinylcholine is well absorbed orally

Answer 31

False

Question 32

What is the effect of administering anticholinesterase during succinylcholine paralysis

Answer 32

Deepened Paralysis

Question 33

In a patient given mivacurium, what is the likely effect of administering anticholinesterase

Answer 33

Reversal of paralysis

Question 34

True or false, relevant effects of mivacuriumcan be reversed by anticholinesterase

Answer 34

True

Question 35

True or False, the muscle recant succinylcholine blocks the action of acetylcholine on muscarinic receptors

Answer 35

False

Question 36

True or False, Muscarinic receptors are so named because they are more sensitive to muscarine than to nicotine.

Answer 36

True

Question 37

Where are muscarinic receptors found

Answer 37

brain, heart and smooth muscle

Question 38

What are the three neurotoxins that prevent neuronal Na+ action

Answer 38

Saxitoxin, Tetrodotoxin (puffer fish) , Ciguatoxin