Tuesday - George Trachte - muscle paralytics

Question 1

Two types of ways to paralyze muscles during surgury

Answer 1

Depolarizing - Succinylcholine (depolarizes via chronic Na influx. flaccid paralysis)

competative - d-Tubocurarine, mivacurim, (block Na influx by competing for nicotinic receptors.)

Question 2

____ have no synapses outside the CNS, while ____ do.

Answer 2

somatic - no synapses

autonomic - synapses

Question 3

What do you use to treat Myasthenia Gravis?

Answer 3

Anticholinesterases, they stop the break down of Ach so that you can get more bound to the few nicotinic receptors you have left.

Question 4

What happens when a neuromuscular nicotinic receptor is activated?

Answer 4

activation results in:

Na influx
Endplate Depolarization
Muscle action potential
opening of voltage-sensitive Ca channel and Ca influx
release of more Ca from S.R.
Ca interaction with troponin c
contraction

Question 5

two drugs that prolong acetylcholine actions (anticholinesterases).

Answer 5

Pyridostigmine (think gulf war syndrome), neostigmine.

Question 6

One short acting anticholinesterase that is used in diagnosis of myasthenia gravis

Answer 6

edrophonium.

Question 7

What is a cholinergic crisis

Answer 7

Excess Ach, leading to overstimulation and decreased sensitization, usually due to AchE not working.

Question 8

Acronym for toxicity of anticholinesterases

Answer 8

SLUDGE

sweating
lacrimation
urination
diarrhea
GI distress
emesis (vomiting)

Question 9

continue on slide 26

Answer 9

ok