Neuromuscular blocking agent reversal (13) Flashcards Preview

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Flashcards in Neuromuscular blocking agent reversal (13) Deck (55)
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1

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

2 parts of the CNS

-brain
-spinal cord

3

2 parts of the PNS

somatic nervous system (SNS)
Autonomic nervous system (ANS)

4

Which system conveys information from receptors to the CNS

Afferent system

5

which system conveys information from the CNS to the muscles and glands

Efferent system

6

what are the 2 main areas the efferent system sends information to?

the somatic nervous system (SNS)
and Autonomic nervous system (ANS)

7

what does the somatic nervous system (SNS) do

conveys informatin from the CNS to the skeletal muscles

8

what does the ANS do

conveys information from the CNS to smooth muscle
cardiac muscle
and glands

9

diagram of CNS and PNS


C Brain Spinal Cord
N ^ v
S Afferent Efferent
V V
P Somatic Autonomic
N Nervous Nervous
S System System
V V
SNS PNS

10

2 parts of the ANS

Sypathetic nervous sytem
parasympathetic nervous system

11

ACh is stored where at the synaptic cleft

in vessicles at motor end plate

12

the nicotinic ACh receptor consist of how many gycoproteiin subunits to form an ion channel? what are the named?

5
-2 alpha
-1 beta
-1 delta
-2 gamma (epsilon)

13

how many alpha glycoprotein subunits on the nicotinic receptor need to bound to for ACh to open the channel

(both) 2

14

how many alpha glycoprotein subunits on the nicotinic receptor need to bound to for NDMBs to block the channel

1

15

how many alpha glycoprotein subunits on the nicotinic receptor need to bound by Sux's to cause a block

both (2)

16

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

17

what is RECURARIZATION?

was a problem with long acting NMBAs whose effects outlasted the reversal agents

18

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

19

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
-insecticides
-nerve gas

20

what class of drugs are reversal agents

cholinesterase inhibitors

21

basic way cholinesterase inhibitors work for reversals

competitive antagonism
-inhibits acethlcholinesterase (and other chilinesterases)
-so it increases the concentration of ACh at NMJ

22

Name 4 cholinesterase inhibitors

Edrophonium (Enlon)
Neostigmine (prostigmin)
pyridostigmine
Physostigmine (antilerium)

23

what is the most rapid acting cholinesterase inhibitor

edrophonium

24

which cholinesterase inhibitor binds REVERSIBLY to the negative charged enzyme site (cholinesterase enzyme)

edrophonium

25

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

26

why is edrophonium not recommended for deep blocks

b/c of the type of bonds it makes (reversable it's not a covalent bond)

27

does edrophonium require attenuation of muscarinic response to ACh accumulation?

yes

28

just b/c shores may ask what is the basic chemical make up of edrophonium

simple alcohol with quaternary ammonium group

29

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

30

does Neostigmine cross the BBB

No way