What are the major features of nondepolarizing neuromuscular blockers?
Competitive antagonist (70% for effect, 90% for full)
Rocuronium- most popular
Cistacurium- Hoffman elimination (good for medically compromised)
Onium = aminosteriod
Explain how the depolarizing neuromuscular blocker works.
Rapidly stimulates and leaves Na channel inactive to prevent repolarization and is not broken down by Achesterase (plasma cholinesterase must break down)
Phase 1 block for short 5 minute duration (except with plasma cholinesterase defficincies)
Could lead to bradycardia and Hyperkalemia and malignant hyperthermia
Why can succinylcholine lead to malignant hyperthermia?
Variation in RYANODINE receptor in the sarcoplasmic reticulum can result in uncontrolled Ca2+ rls and a hypermetabolic response when triggered by succinylcholine and some volatile inhaled anesthetics like sevofluorane
Therapeutic uses of NMBs?
Surgery, intubation, tetnus (non), join, bone maniupulation, electroconvulsant (dep) and laryngospasm (dep)
Describe other agents that affect NMJ.
GABA (valium, lioresal)
Alpha 2 agonist (zanaflex)
Ach rls blocker (botox)
Raised lesion > .5 cm wit water, no pus
Plug of sebaceous and dead skin in opening of hair follicle
Closed = whitehead
Inanimate disease carrying object
What is the most common skin cancer dentists observe?
Basal cell carcinoma
Change in skin color
Flat not palpated
Papule and nodule
Elevated small, no depth
Nodule= papule w depth/elevation
Pustule = pus-filled papule
Fluid-filled lesions less than .5 cm (sun blisters)
Blood plasma leaks
Allergic degranulation of mast cells
Wheals=circumscribed rounded, slightly elevated lesions of hives
What are the different types of muscle fibers?
Type I: slow, mitochondria/lipid rich (acid)
Type II: fast, glycogen (alkaline)
What types of stains used to observe mitochondria in muscles?
OXIDATIVE found in inner mitochondrial membrane
1. NADH (more mit, darker)
2. SDH (complex II)
Gmori will have purple spots if ragged red
What types of stains are used to discover neuropathic muscle problems?
1. NSE non-specific esterase: shows NMJ, dark = not well innervated