Neuromuscular Pharmacotherapeutics - Mehdi
Cisatracurium
non-depolarizing neuromuscular blocker; used to produce myorelaxation (paralysis) adjunct to surgical anesthesia
Choline
once ACh is cleaved by AChE, this is recycled via uptake by a Na+/_____ cotransporter
ACh Receptor
upon binding to ACh, generates an end-plate potential by antiporting sodium out and potassium into the post-synapse
Tensilon Test
used to diagnose MG and to differentiate between myasthenic crisis and cholinergic crisis
Spasticity
velocity-dependent increase in resistance to passive movement; continuous clonic contraction produced by uninhibited stretch reflexes; sign of UMN lesion
Kinesin
motor protein involved in anterograde transport of ACh vesicles to the cell membrane (+ end)
Neostigmine
AChE inhibitor used to reverse paralysis post-surgery
V-type (H+ ATPase)
ATP-dependent importer of H+ into the ACh vesicle
3,4-Diaminopyradine
VGKC blocker used to treat LEMS
Hemicholinium
a drug that inhibits the uptake of choline from the synapse
Succinylcholine
agonist for AChR used as a depolarizing Nm blocker; overstimulation results in flaccid paralysis; adverse SE of anaphylaxis & malignant hyperthermia
Tetanus (Toxin)
an exotoxin that inhibits the release of mediators of the inhibitory neurons in the spinal cord; clinical f eatures include marked hyperextension of the back
P/Q-type (VGCC)
calcium channel that increases calcium contration in the presynaptic knob
Guanidine HCL
cholinergic agonist used to treat LEMS
Infantile Botulism
classic presentation of this condition is a floppy, constipated baby
ACh/H+ Antiporter
cotransporter if the ACh vesicle that takes in ACh and removes H+
Botulinum (Toxin)
degrades SNAP-25 & Syntaxin to prevent ACh release into the synapse
LEMS (Lambert Eaton Myasthenic Syndrome)
disease caused by an antibody against VGCC; decreasing ability of the presynaptic knob to intake calcium for ACh release; presents with difficulty walking; autonomic dysfunction present (dry mouth, constipation, erectile dysfunction)
Myasthenia Gravis
disease caused by antibody against nicotinic muscle ACh recetors; painless muscle weakness; starts as ptosis and increases with continued activity; rapid restoration with rest
Choline Acetyl Transferase
enzyme that catalyzes synthesis of acetylcholine
Halothane
general anesthetic that may cause malignant hyperthermia in patients with RyR mutation
Vesamicol
inhibitor of vesicle ACh/H+ antiporter in cholinergic nerve endings: prevents storage of ACh; no clinical applications
Opisthotonos
marked hyperextension of the back caused by the tetanus toxin
Infection
principal adverse effect of immunosuppressant drugs
Edrophonium
short-acting anticholinesterase inhibitor used to diagnose myasthenia gravis
Ice Pack Test
test used to help diagnose MG; lowering temparature at eyelids produces improvement in myasthenic muscle function and resolves temporarily resolves ptosis
IVIG (Intravenous Immunoglobulin)
treatment for MG; probably works through Fc receptor modulation and anti-idiotype interactions
Plasmapheresis
treatment for MG; removal of autoantibodies and immune complexes in patients whome autoimmune disease is resitant to other therapies
Thymectomy
treatment for MG; removal of the thymus gland
LES (EMG)
typical marked increase toward normal amplitude with rapid repetitive stimulation (20/sec)
MG (EMG)
typical pattern of decrement in the first four responses followed by slight increment at stimulation rate of 4/sec
