Nurses Helping Nurses
allnurses Network: Central | Jobs | Books | Newsletter
allnurses: A Nursing Community for Nurses
Home General News Blogs Articles Students Region Specialty Degrees F.A.Q.
Certified Registered Nurse Anesthetist (CRNA) /

Twitch fade with NDNMB



Did You Know?
allnurses is the largest community for nurses on the web. We now have over 388,837 members! Join today to network with other nurses, laugh, share, and much more.

Oct 23, 2003 06:35 PM

Twitch fade with NDNMB

Updated Oct 24, 2003 at 08:35 AM by g8rlimey

Just wondering if any of you knowledgeable folks out there can give me simple explanation for this one:

Presence of fade w/ NDNMB during tetany/TOF vs absence of fade w/ DNMB (Phase I) during tetany/TOF.
The only good explanations I have found for this action are as follows:
1. Fade is present during tetany/TOF w/ NDNMB b/c of the depletion of Ach at presynapse.
2. Fade is present during tetany/TOF w/ NDNMB b/c of presynapse receptor inhibition of Ach release--much like the presynaptic alpha-receptor inhibition of NE release at the sympathetic terminal?
3. Fade is absent in the DNMB during tetany/TOF b/c of the inhibition of repolarization produced by sux.

Does this sound reasonable?

My other question is this---if there are available receptors at both inhibited nicotinic cholinergic post-junctional receptors, why can't sux have fade like panc or roc?

I would really like to understand the physiology behind these differences, so any help would be appreciated.

THX---Sam

---Post edited for clarification


Share

Search Tags
None
Top

 
Advertisement
Sponsored Links
 
Reply
3 Comments
No. 1
Old Oct 23, 2003, 09:30 PM

Any takers?
Top
 
No. 2
from Athlein
Old Oct 24, 2003, 02:50 AM

Sam,

I'm not following your line of thinking, but...

Barash has a good explanation of the neuromuscular pharmacology phenomenon going forward from page 387 in 3rd edition. Did you look there?
Top
 
No. 3
from g8rlimey
Old Oct 24, 2003, 09:02 AM

Athlein:

Thx for the reference. I understand now. For those of you lurking on this question, the answer is as follows:

Barash, Cullen, and Stoelting, Clinical Anesthesia, 2nd edition, pp. 483-487

“The blocking effect of succinlycholine at the NMJ is probably due to desensitization. Prolonged exposure to an agonist leads to a state characterized by a lack of responsiveness of the receptors.

Nondepolarizing NMB drugs bind to the postsynaptic receptor in a competitive fashion. An excess of Ach can tilt the balance in favor of neuromuscular transmission. There are good reasons to believe that Ach release is maintained during high frequency stimulation under physiologic conditions through presynaptic Ach receptors that regulate transmitter release. These positive feedback receptors are blocked by small doses of nondepolarizing relaxants.”
Top
 
Reply




Thread Tools


Who's Online
294 members
2,394 guests
2,688

4

James Woods, Actor Sues Hospital, Warwick, RI

1

16 fired for HIPAA Violations

6

Four Lehigh Valley Health Network nurses accused of...

48

lawsuit - But don't most RN's work through breaks/lunch...

0

Patient Evaluation of Retail Clinic Care

7

The hard to reach on-call doctor, and its effects on...

12

Woman charged with passing off prescription drug as...

28

Man in "Vegetative State" was conscious for 23...

2

Interesting article on ThedaCare's Collaborative Care Model

14

Possible breakthrough regarding MS






Currently Reading This Page: 1 (0 members & 1 guests)

Interested in the hottest topics of the week? Subscribe to the Nurse-zine Newsletter.
Enter email address: