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42 Cards in this Set
- Front
- Back
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Sch binds to and activates
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cholinergic receptors
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is pancuronium an aminosteroid or benzilisoquinolium?
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aminosteroid. benzo=curium
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causes of change in systemic blood pressure and heart rate?
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lack of specificity for NMJ; bind to cardiac muscarinic and autonomic ganglia nicitinic
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Are benzilisoquinoliniums or aminosteroids more likely to produces hisimine release?
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benzilisoquinoliniums due to tertiary amine
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what enzyme synthesizes acetylcholine?
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choline acetylase
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what enzyme is responsible for rapid hydrolysis of acetylcholine?where is it located?
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acetylcholinesterase, close to cholinergic receptors.
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are non depolarizing blocking drugs competitive or noncomp?
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comp.
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Is Sch hydrolyzed by acetylcholineesterase?
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no, so channels remain open longer, causing fasiculations.
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sTorF: since sch is 2 molecules of ach only one mol of ach is required for binding?
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T
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onset/duration of sch
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onset 30-60 sec; duration: 3-5 min
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onset time of roc?
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30-60 sec
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What is duration to return to >equal 25% control twitch height for roc, vec, cis?
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20-30min
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onset/duration for pan?
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3-5 min; 60-90 min.
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name 3 types of nicotinic cholinergic receptors.
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2 are postsynaptic (junctional and extrajunctional) 1 is presynaptic
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Ach is part of which nervous system-central or peripheral?
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none
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under certain conditions this type of receptor causes rapid proliferation..why sch contraindicated in cer. states
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extrajunctional
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which channels do presynaptic block?
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Na
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which type of receptors block high frequency stimulation?
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prejunctional
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which type of recceptors block release of ach?
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prejunctional
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what recovers first; adductor pollis or diaphragm?
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diaphragm
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can phase 1 and phase 2 block of sch be reversed with an anticholinesterase drug?
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no; only phase 2
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what happens if admin anticholinesterase in phase 1 block of sux?
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enhances blockade
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how is sux hydrolisized?
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plasma cholinesterase/(psuedocholinesterase)
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where is plasmacholinesterase synthesized? role in nmbd?
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synthesized in liver; hydrolysis on sux due to plasmacholinesterase
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brief duration of sux primarily due to
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plasmacholinesterase
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how does liver disease affect use of sux?
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produces plasma cholinesterase, which hydrolysizes it; must be sever to reduce it/prolong it
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how does obese pts affect sux?
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may have increased plasmacholinesterase so need a larger dose
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what is the normal dibucaine number for plasmacholinesterase?
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normal 80; abnormal 20
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does dibucaine number represent quality or quantity of cholinesterase activity?
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quality
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does liver disease affect dibucaine number?
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no. will still be normal (80)..only qualitative
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name the adverse side effects of sux/contraindications
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cardiac dyshrythm, inc.gastric pressure, icp, intraoccular,hyperkalemia,incr. skel muscle contraction
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describe the cardiac arrythmias which may happen with sux
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bradycardia, junctional rhythm, sinus arrest
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a pt with unrecognized muscualr dystrophy may experience what with sux?
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hyperkalemia
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pt with unhealed 3rd degree burns may experience what with sux?
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hyperkalemia
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denervation leading to severe muscle trauma may lead to what with sux?
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hyperkalemia
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sux binds to
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subunit of nicotinic receptor
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why do we give high doses of sux?
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acholinesterase breaks it down right away
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when is sux prolonged?
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severe liver disease,women at term,reglan, ab dibucaine number/not 40, anticholinesterases,myasthen.
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cardiac dysrhythmias ass. with sux
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brady, tachy, low bp
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cause of brady with sux
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mimics ach at muscarinic receptors
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cause of inc. heart rate bp with sux
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mimics ach at autonomic nervous system ganglia
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pts with hyperkalemia.
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burn, trauma, tr-t6, duchennes
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