Ms - Trachte Muscle Paralytics

Front 1

Somatic nervous system has one nerve coming off CNS which releases ___ which interacts with the _______ receptor causing muscle contraction.

Back 1

Ach
Nicotinic

Front 2

What type of receptor is a nicotinic receptor?
It is activated by Ach of what?

Back 2

Ion channel

Nicotine

Front 3

Nicotinic receptor is blocked by what unique chemical?

Back 3

alpha-bungarotoxin from krait or cobra venom

Front 4

Something that blocks Ach release will prevent what?
muscle depolarization
contraction
or both

Back 4

BOTH

Front 5

Something that blocks nicotinic receptors will prevent
muscle depolarization
contraction
or both

Back 5

BOTH

Front 6

Something that blocks calcium-induced calcium release will block
muscle depolarization
contraction
or both

Back 6

Contraction only!

Front 7

What do you use to treat myasthenia gravis?
mechanism?

Back 7

Anicholinesterases

Increase Ach concentration in the vicinity of the nicotinic receptor

Front 8

Neostigmine
Physostigmine
Pyridostigmine
All are what type of drugs?

Back 8

Anticholinesterases

Front 9

Neostigmine stimulates ____ receptors. It also increases _____ concentration at _____ receptors to treat abdominal distension

Back 9

nicotinic
acetylcholine
muscarinic

Front 10

Physostigmine is an __________ used for poisoning with ______ like Atropine

Back 10

anticholinesterase
anticholinergics

REVERSES PARALYSIS

Front 11

Pyridostigmine is an _______ can be used prophylactically to prevent actions of what?

Back 11

anitcholinesterase

nerve gases (SOMAN)

Front 12

Curare is an ________ to Ach. takes more Ach to get equal contraction.

Back 12

Antagonist - takes up receptors so you need more Ach to produce response

Neostigmine will potentiate the action of Ach

Front 13

Edrophonium is used for what?

Increases strength in a _____ crisis and decreases strength in a _____ crisis

Back 13

Used to diagnose myasthenia gravis (vs cholinergic crisis)

myasthenic
cholinergic

Front 14

Nicotinic receptor has a unique property in that excessive stimulation ______ organ to further stimulation (principal behind a cholinergic crisis)

Back 14

desensitizes

Front 15

What are the toxicities of anticholinesterases?

Back 15

SLUDGE
salivation
lacrimation
urination
diarrhea
GI distress
emesis
(also miosis... smaller muscles affected by parasymps)

Front 16

what do thse drugs have in common?
tubocurarine
mivacurium
succinylcholine

What is their major action?

Back 16

Neuromuscular blockers
or
Nicotinic receptor antagonists

To paralyze skeletal muscle; hypotension; decrease GI motility; depolarizing agents release K+

Front 17

Tubocurarine and Mivacurium are both ______ _____
What is the depolarizing agent?

Back 17

competitive blockers

succinylcholine

Front 18

d-tubocurarine is what kind of drug?
Blocks _____ muscles first

Back 18

competitive agent (nicotinic receptor antagonist)

smaller (jaw>eyes>limbs>diaphragm)

Front 19

Which areas are most sensitive when using depolarizing agents (such as _________)?

Back 19

chest and abdomen

succinylcholine

Front 20

Nicotinic receptor antagonist drug rxns:
ether, halogenated anesthetics, streptomycin, tetracycline all do what?

Anticholinesterases do what?

NE and E?

Back 20

Enhance competitive block

antagonize competitive blocker, but potentiate a depolarizing blocker

Slight ability to reverse competitive blockade (due to beta 2 receptor on muscle)

Front 21

Malignant _______ caused by halothane and succinylcholine. Treatment is ______ which inhibits Ca2+ release from sarcoplasmic reticulum by blocking the Ryanodine receptor

Back 21

Hypothermia
Dantrolene

Front 22

what kind of drug is Tubocurarine?
quaternary ammonium ion structures - some _____ blockade

Back 22

Competitive inhibitor
ganglionic

Front 23

Succinylcholine has a ____ term of action because of ____ metabolism. Has some muscarinic and ganglionic nicotinic agonist properties - can _____ bronchioles
Releases _______
Can produce malignant hyperthermia - treat with calcium antagonist ______
Used for tracheal intubation to prevent aspiration.
Avoid in ____ pts

Back 23

short
rapid
constrict
histamine
dantrolene
burn

Front 24

If you see a graph with a depolarizing and holding steady at a certain level it is what drug's action?

Back 24

Succinylcholine - depolarizing agent

Doesn't repolarize so muscle cant respond to additional signals

Front 25

If you see a graph with a normal muscle depolarization, what drug would the patient have?

Back 25

Neostigmine - perhaps they had myasthenia gravis

Front 26

If you saw a graph with a bottom straight line, maybe a tiny peak where it should be depolarizing - what drug is the patient on?

Back 26

Tubocurarine - it's a nicotinic blocker so there is no membrane depolarization
Also Botulinum toxin A

Front 27

What would the graph of an action potential look like for a patient on Dantrolene

Back 27

the same - dantrolene won't interfere with electircal activity

Front 28

Can be injected into region of spastic muscle, prevent Ach release by cleaving SNAP25 proteins needed for Ach exocytosis

Back 28

Botulinum toxin

lasts about 3 mos

Front 29

Sympathetic nerves release ____ to activate ______ receptors on sweat gland - Key temp regulating mechanism

Back 29

Ach
muscarinic

Front 30

Anticholinesterases (Physostigmine, neostigmine, Pyridostigmine, malathion) - _____ sweating
Antimuscarinics (Atropine, scopolamine) - ______ sweating
Botulinum toxin - _______ sweating
Muscarinic agonists (Pilocarpine, Betahnecol) - ______ sweating

Back 30

promote (increase Ach)
prevent (block receptor)
reduce (excessive... 6 mos)
promote (more receptors for Ach)

Front 31

_____ sweat glands for normal temperature regulation
_____ sweat glands for "nervous" sweating (palms, axillary region)

Back 31

Eccrine

Apocrine

Front 32

Apocrine sweat glands innervated by sympathetics, contain __ receptors. ______ agents prevent this type of sweating. ______ promote it.

Back 32

Alpha1
Antiadregnergic
Proadrenergic