Muscle relaxant drugs (11) Flashcards Preview

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Flashcards in Muscle relaxant drugs (11) Deck (58)
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1

Acetylcholine contains a positively charged quaternary ammonium group that attaches to the _________ charged _________ receptors

-negatively
-cholinergic

2

how is acetylcholine synthesized?
acetyl-Coa + choline ----????----> acetylcholine (basiaclly what is the enzyme that helps is convert)

choline acetyl transferase
see slide #4 (Muscle relaxant drugs)for the chemical structures it may help

3

how is acetylcholine metabolised
acetylcholine -------??????-----> choline + acetic acid (basically what is the enzyme that breaks acetylcholine down?)

cholinesterase
see slide #4 (Muscle relaxant drugs)for the chemical structures it may help

4

So acetylcholine is rapidy metabolized by acetylcholinesterase into _______ and _____

Acetate and Choline

5

acetylcholinesterase is also called _________ ___________ or _____ _________

specific cholinesterase or
true cholinesterase
(just incase he tries to throw a curve ball)

6

how does acetylcholine work in the neuro muscular junction (NMJ)

1st- Ach is released presynaptically and bindsto the postsynaptic nicotinic receptor
-NEXT- there are 2 alpha subunits on the nicotinic receptor
-LAST(LY)- Na+ channels open when both subunits are occupied by Ach
((((side note this will show why and where the NMBD work and why they block the Na+ channels)))))

7

(5) main structures of Muscle relaxants

--ALL are quaternary ammonium compounds ( 4 carbon atoms attached to 1 Nitrogen atom)
-ALLcontain at least 1 ammonium group
- ALL MIMIC ACh to exert relaxant properties
-the POSITIVELY charged quaternary ammonium group is electrostatically attracted to the negatively charged cholinergic receptor
-SCh (a small slender molecule) binds to (both alpha units) and activated ACh receptor

8

Look at slide 11 in the Muscle relaxant drugs ppt

to see the chemical makeup of vec and pan
mono vs bisquaternary

9

2main categories of muscle relaxants (don't over think it)

Depolarizers
non-depolarizers

10

2 examples of depolarizers (only that we really use I am not even sure if the other is still in use)

-Succinylcholine
-Decamethonium

11

6 main non-depolarizers ( to become an extra bad badass what is the 7th don't need to know for test but for knowledge)

Curare
Pancuronium
veruronium
pocuronium
atracurium
cis-atracurium
BONUS
--------Mivacurium

12

what is a special note about Curare

its the origional NDMBD

13

*******************************************
Must know the doses of the following
Cis-atracurium
Rocuronium
Pancuronium
Vecuronium

in order per potency (Pink Vagina Can-Always Rebound)
Pancuronium-0.08-0.1
Vercuronium-0.08-0.1
Cis-Atracurium- 0.15-0.2 mg/kg
Rocuronium- 0.6-1.2 mg/kg

14

Depolarizers (Sux's) resemble and mimic ______ at the Ach receptor

Acetylcholine

15

how do DMBDs work (Sux's)

-mimic ACh at teh ACh receptor
-cause sustained depolarization rendering the NMJ unable to conduct further impulses which = muscle relaxation
-fasiculations

16

Sux's (DMBDs) has how many phases

2

17

what is a phase I block of DMBDs

sustained opening of receptor channels in depolarized post junctions membrane cannot respond to further ACh

18

what is phase II block of DMBDs

desensitized repolarized post-junctional membrane remains unresponsive to ACh. (occurs after a large or repeated sux's doses)

19

when does phase II blocks occur

After large or repeated doses of sux's

20

what is the mechanis that causes phase II blocks

Unknown

21

Side effects of DMBDs (sux's)

-the sustained depolarization causes K+ to be releases from cells (remember most K+ is stored in the cell)

22

Hyperkalemia is an increased risk with Sux's administration,but this risk is increased with what type of pt's

Upregulated

23

the massive K+ release associated with DMBDs (sux's) is released from where

extra junctional receptors

24

Sux's is metabolized by what? and where?

psuedocholinesterase
in the plasma

25

plasmacholinesterase (what metabolizes sux's) is also called what

psuedocholinesterase
butyrocholinesterase

26

Sux's is metabolized rapidly into ___________ upon injection into the blood, thus only a fraction actually reaches the NMJ

Succinylmonocholine

27

what accounts for th longer duration of action of depolarizers (sux's) compared to ACh

b/c depolarizers must diffuse away from the NMJ to the plasma to be metabolized
(kinda of confusing, if you want clarification look at slide 19, basic take home message is that sux's last longer than ACh)

28

2 types of psuedocholinesterase deficiency's

1) Heterozygous atypical
2)Homozygous atypical

29

what drug would a psuedocholinesterase deficiency affect and why?

Sux's, b/c thats what metabolizes all DMBDs AKA sux's

30

2 things to know about psuedocholinesterase deficiency
Heterozygous atypical

-1 abnormal gene ( way to remember HETER 1 male 1 female)
-prolonged block 20-30 minutes after sux's administration
(side note occurs 1:50 pts)