Flashcards in Neuromuscular blocking agent reversal (13) Deck (55)
What do you call a CRNA who graduates school in last place and has the lowest passing scores on the boards????
A CRNA (bitch)!!!!!!!!!!
2 parts of the CNS
2 parts of the PNS
somatic nervous system (SNS)
Autonomic nervous system (ANS)
Which system conveys information from receptors to the CNS
which system conveys information from the CNS to the muscles and glands
what are the 2 main areas the efferent system sends information to?
the somatic nervous system (SNS)
and Autonomic nervous system (ANS)
what does the somatic nervous system (SNS) do
conveys informatin from the CNS to the skeletal muscles
what does the ANS do
conveys information from the CNS to smooth muscle
diagram of CNS and PNS
C Brain Spinal Cord
N ^ v
S Afferent Efferent
P Somatic Autonomic
N Nervous Nervous
S System System
2 parts of the ANS
Sypathetic nervous sytem
parasympathetic nervous system
ACh is stored where at the synaptic cleft
in vessicles at motor end plate
the nicotinic ACh receptor consist of how many gycoproteiin subunits to form an ion channel? what are the named?
-2 gamma (epsilon)
how many alpha glycoprotein subunits on the nicotinic receptor need to bound to for ACh to open the channel
how many alpha glycoprotein subunits on the nicotinic receptor need to bound to for NDMBs to block the channel
how many alpha glycoprotein subunits on the nicotinic receptor need to bound by Sux's to cause a block
how is reversal of NMB (neuro muscular blockade) achieved
by competitive antagonism
--competition b/t NMBA and ACh for the motoer end plate receptor at the NMJ
- whichever is the greatest wins
what is RECURARIZATION?
was a problem with long acting NMBAs whose effects outlasted the reversal agents
what is ENCAPSULATION reversal
cyclodextrin surrounds and bonds NMBA in plasma
-the concenration gradient reversed drawing NMBAs off receptors into plasma and then quickly bound
side notes about cholinesterase inhibitors
what were they derived from?
what were they used for?
precursor of what (give ex)
derived from Calabar bean
used in West africa as a poison
precursor for organphosphates
what class of drugs are reversal agents
basic way cholinesterase inhibitors work for reversals
-inhibits acethlcholinesterase (and other chilinesterases)
-so it increases the concentration of ACh at NMJ
Name 4 cholinesterase inhibitors
what is the most rapid acting cholinesterase inhibitor
which cholinesterase inhibitor binds REVERSIBLY to the negative charged enzyme site (cholinesterase enzyme)
wy is the duration of binding short with edrophonium
b/c once it binds it is liberated finds another site to bind to, and so on
why is edrophonium not recommended for deep blocks
b/c of the type of bonds it makes (reversable it's not a covalent bond)
does edrophonium require attenuation of muscarinic response to ACh accumulation?
just b/c shores may ask what is the basic chemical make up of edrophonium
simple alcohol with quaternary ammonium group
just b/c shores may ask (b/c he is jealous that jake is a fucking wizard) what is the basic chemical make up of Neostigmine
Quaternary ammonium compound