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Neuro
Week 3b - NMJ Blocking Agents (nicotinic antagonist)
12
Accounting
Pre-School
03/07/2013

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Cards

Term
What is the major, stereotypical neuromuscular blocking agent (NMBA)?
Definition
-Tubocurarnine
-It is long acting
Term
What is a short acting NMBA?
Definition
-Mivacurium
Term
What kind of receptor is at the neuromuscular junction?
Definition
-Nicotinic II receptor (type I is for the first neuron junction for sensory, autonomics, and everything but NMJs in general)
Term
What two types of NMBA are there?
Definition
-Nondepolarizing and depolarizing
-The nondepolarizing antagonize the NAch receptor
-Depolarizing blockers just keep the end plate depolarized
Term
What are some nondepolarizing agents (6)?
Definition
1. **Tubocurarine
2. Metocurine
3. Atracurium
4. Gallamine
5. Pancuronium
6. Vecuronium

-Tubocurarine is also a ganglionic blocker (of Nic I)
-Blocks sympathetic nervous system
Term
Depolarizing agents (2)?
Definition
1. **Succinylcholine
2. Decamethonium

-Neither have much ganglion blocking effect (Nic I)
-Can result in hyperkalemia
Term
What blocks both muscular and ganglion nicotinic receptor? What is it's action? What are it's side effects?
Definition
-TUBOCURARINE TUBOCURARINE TUBOCURARINE!!!!

-It *competitively inhibits at **nicotinic receptors

-Can cause *hypotension, bronchospasm, edema, and histamine release
Term
What are the effects of the SNS? What if they are inhibited?
Definition
-Constricts blood vessels; hypotension
-Speeds heart; bradycardia
-Dilates pupil; miosis (constricted)
-Activates sweat glands; anhydrous
-Decreases peristalsis; diarrhea

-These are all symptoms you could expect when inadvertently blocking off sympathetic outflow (at the ganglia)
Term
What is the action of succinylcholine? What do we use it for? Toxicity?
Definition
-It is an **agonist at nicotinic receptors; stimulates at first, but then you get prolonged *flaccid paralysis

-Use it for the initial placement of a tracheal tube
-Only last about five mins
-Can cause arrhythmias, hyperkalemia, and *malignant hyperthermia (in genetically susceptible)
Term
What if tubocurarine and succinylcholine are used together?
Definition
-They have an antagonistic effect
Term
Give three antispasmodic drugs and actions?
Definition
1. Baclofen; GABAb agonist (inhibitory)
2. Diazepam; Enhances CNS GABA action
3. Botox; Prevents ACh release
Term
How do we treat MG (2)?
Definition
1. Pyridostigmine
2. Neostigmine

-Both inhibit AChEsterase
-Overdose may cause *cholinergic crisis (too much causes a depolarizing block)
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