Τόμος 17 (1999) – Τεύχος 3 – Άρθρο 2 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 17 (1999) – Issue 3 – Article 2 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

Από | | Άρθρο - Article, Αχιλλέας Μπενάκης - Achilles Benakis, Πλήρες Κείμενο στα Ελληνικά - Full Text in Greek, Σταύρος Τ. Πλέσσας - Stavros T. Plessas, Χαράλαμπος Τ. Πλέσσας - Charalambos T. Plessas

 

Τίτλος – Title

Μυοχαλαρωτικά Φάρμακα: Φυσιολογία της Νευρομυϊκής Διαβίβασης

Skeletal Muscle Relaxants: Neuromuscular Physiology
Συγγραφέας – Author

Σταύρος Τ. Πλέσσας1, Χαράλαμπος Τ. Πλέσσας2, Αχιλλέας Μπενάκης3

1 Τμήμα Νοσηλευτικής, Πανεπιστήμιο Αθηνών, Αθήνα, Ελλάς 2 Τμήμα Επιστημονικής Πληροφόρησης του ΦΑΡΜΑΚΟΝ-Τύπος, Αθήνα, Ελλάς 3 Εργαστήριο Φαρμακολογίας, Ιατρική Σχολή Πανεπιστημίου Θεσσαλίας, Λάρισσα, Ελλάς

Stavros T. Plessas1, Charalampos T. Plessas2, Achilles Benakis3

1 Department of Nursing, University of Athens, Athens, Greece 2 Pharmakon-Press Information Services, Ath­ens, Greece 3 Department of Pharmacology, Medical School, University of Thessalia, Larissa, Greece
Παραπομπή – Citation

Πλέσσας,Σ.Τ., Πλέσσας,Χ.Τ.,  Μπενάκης,Α. : Μυοχαλαρωτικά Φάρμακα: Φυσιολογία της Νευρομυϊκής Διαβίβασης , Επιθεώρηση Κλιν. Φαρμακολ. Φαρμακοκινητ. 17 : 162-176 (1999)

Plessas,S.T., Plessas,C.T., Benakis,A. : Skeletal Muscle Relaxants: Neuromuscular Physiology, Epitheorese Klin. Farmakol. Farmakokinet. 17: 162-176 (1999)
Ημερομηνία Δημοσιευσης – Publication Date
– 2000 –
Γλώσσα Πλήρους Κειμένου –
Full Text Language

Ελληνικά – Greek
Παραγγελία – Αγορά –
Order – Buy
Ηλεκτρονική Μορφή: pdf (15 €) –
Digital Type: pdf (15 €)
pharmakonpress[at]pharmakonpress[.]gr
Λέξεις κλειδιά – Keywords

Φυσιολογία νευρομυϊκής διαβίβασης, συναπτική διαβίβαση, νευρομυϊκή σύναψη, μορφολογία της σύναψης, απολήξεις κινητικού νεύρου, περισυναπτική περιοχή, ενεργή περιοχή, υποδοχείς, μετασυναπτικοί, συναπτικοί, εξωσυναπτικοί, προσυναπτικοί, νικοτινικός υποδοχέας, ακετυλοχολίνη, απελευθέρωση ακετυλοχολίνης, δίαυλοι ασβεστίου, ακετυλοχολινεστεράση, θεωρία κβάντων, μυοχαλαρωτικά φάρμακα, μη εκπολωτικά, εκπολωτικά, παρακολούθηση και έλεγχος νευρομυϊκής λειτουργίας

Physiology of neuromuscular transmission, synaptic transmission, neuromus­cular junction, morphology, motor nerve endings, perijunctional zone, active zone, recep­tors, postjunctional, junctional, extrajunctional, prejunctional, nicotinic re­ceptor, acetyl­choline, release of acetylcholine, quantal theory, calcium channels, acetyl­choli­nesterase, neuromuscular blocking agents, nondepolarising, depolarising, monitor­ing of neuromuscu­lar function
Λοιποί Όροι – Other Terms

Άρθρο

Article
Περίληψη – Summary

–

During the 16th century, European explorers found that the Indians along the Ama­zon and Orinoco Rivers were using an arrow poison, named curare that produced death by skeletal paralysis. Curare is one of several differ­ent resinous substances obtained from extracts of South American trees including species of chon­drodendron. The pharmacologically active ingredi­ent of curare used medically is the alkaloid d-tubocurarine. Muscle relaxation or paralysis re­sults from an interruption in the pathways for nervous impulses between the nervous system and muscle. The mechanism of neuromuscular transmission at the end plate begins with arrival of an impulse at the motor nerve terminal, influx of calcium and release of acetylcholine (ACh). The nerve synthesises ACh and stores it in small, uniformly packages called vesicles. Stimulation of the nerve causes these vesicles to migrate to the surface of the nerve, rupture and discharge ACh into the synaptic cleft separating nerve from muscle. Acetylcholine diffuses across this cleft to the nicotinic receptor located on the motor end plate. This postjunctional receptor is an ion chan­nel composed of four distinct subunits (α, β, γ, δ), in the stoichiometric ratio of 2:1:1:1 respectively. Combination of two ACh molecules with recep­tors on the two α-subunits causes opening of the channel. The resulting movements of sodium and potassium are associated with depolarisation of the end plate membrane. The magnitude of the end plate po­tential that results is directly related to the amount of ACh released. If the end plate potential is large, the muscle membrane is depo­larised to its threshold and an action potential will be propa­gated along the entire muscle fibber, causing mus­cle contraction. The released ACh is immediately removed from the end plate region by diffusion and rapid enzymatic destruction by acetylcholinesterase enzyme, which also is in the cleft. Achetylcholine is not released continuously by the prejunctional nerve ending: rather it is re­leased in packets, with each packet corre­spond­ing to the release of one synaptic vesicle. The amount of acetylcholine contained in one vesicle is called a quantum of acetylcholine.

Αναφορές – References

1. Martyn J.A.J., Standaert F.G., Miller R.D.: Neuromus­cular Physiology and Pharmacology. In: Anesthesia (Miller R.D., ed.), 5th ed., Volume 1, pp. 735-751, Churchill Liv­ingstone, New York, 2000

2. Bowman W.C.: Pharmacology of neuromuscular func­tion. Wright-Butterworth, London, 1990

3. Fletcher G.H., Steinbach J.H.: Ability of neuromuscular blocking drugs to act as partial agonists at fetal and adult mouse muscle nicotinic receptors. Mol. Pharmacol. 49: 938 (1996)

4. Martyn J.A.J., White D.A., Gronert G.A., et al.: Up-and-down regulation of skeletal muscle acetylcholine receptors. Anesthesiology 76: 822 (1992)

5. Tansey M.G., Chu G.L., Merlie J.P.: Aria/HRG regulates AChR ε subunit gene expression at the neuromuscular synapse via activation of PI3 kinase and RAS/MAPK pathway. J. Cell Biol. 134: 465 (1996)

6. Hall Z., Merlie J.R.: Synaptic structure and develop­ment: The neuromuscular junction. Cell 72: 99-121 (1993)

7. Witzeman V., Brenner H.R., Sakman B.: Neural factors regulate AChR subunit mRNAs at rat neuromuscular syn­apses. J. Cell Biol. 114: 125 (1991)

8. Berne P.M., Levy M.N.: Principles of Physiology. 4th ed., Mosby, New York, 1998

9. Standaert F.G.: Neuromuscular Physiology and Pharma­cology. In: Anesthesia (Miller R.D., ed.), 4th ed., pp. 731-754, Churchill Livingstone, New York, 1994

10. Stoelting R.K. (Ed.): Pharmacology and Physiology in Anesthetic Practice. 3rd Edition, Lippincott-Raven, Phila­delphia, 1999

11. Drachman D.B.: Myasthenia gravis. N. Engl. J. Med. 330: 1797 (1994)

12. Lukas R.J., Bencherif M.: Heterogeneity and regulation of nicotinic acetylcholine receptors. Int. Rev. Neurobiol. 34: 25 (1992)

13. Kelly R.B.: The cell biology of the nerve terminal. Neu­ron 1: 431 (1988)

14. Durant N.N., Katz R..: Suxamethonium. Br. J. Anaesth. 54: 195 (1982)

15. Van der Kloot W., Molgo J.: Quantal acetylcholine release at the vertebrate neuromuscular junction. Physiol. Rev. 74: 899-991 (1994)

16. Changeux J.-P.: Chemical signalling in the brain. Sci. Am. 269: 58-62 (1993)

17. Pedersen S.E., Cohen J.B.: d-tubocurarine binding sites are located at the α-γ, α-δ interphases of the nicotinic acetylcholine receptor. Proc. Natl. Acad. Sci. USA 87: 2785 (1990)

18. Griesmann G.E., McCornick D.J., De Aizpurua H.J., et al.: α-bungarotoxin binds to human acetylcholine receptor α-subunit peptide 185-189. J. Neurochem. 54: 1541 (1990)

19. Martyn J.A.J.: Basic and clinical pharmacology of the acetylcholine receptor: Implications for the use of neuro­muscular relaxants. Keio J. Med. 44: 1 (1995)

20. Vincent A., Newland C., Croxen R., et al.: Genes at the junction: Candidates for myasthenic syndrome. Trends Neurosci. 20: 15 (1997)

21. Deneris E.S., Connolly J., Rogers S.W.: Pharmacol­ogical and functional diversity of neuronal nicotinic acetyl­choline receptors. Trends Pharmacol. Sci. 12: 34 (1991)

22. Galzi J.L., Changeux J.P.: Neuronal nicotinic recep­tors: Molecular organization and regulation. Neuropharma­cology 34: 563 (1995)

23. Coggan J.S., Paysan J., Conroy W.G., et al.: Direct recording of nicotinic responses in presynaptic nerve ter­minals. J. Neurosci. 17: 5798 (1997)

24. Schopfer C.: Μυοχαλαρωτικά φάρμακα. Επιθ. Κλιν. Φαρμακολ. Φαρμακοκινητ. 7: 131-156 (1989)

25. Ceccarelli B., Hurlbut W.P.: Vesicle hypothesis of the release of quanta of acetylcholine. Physiol. Rev. 60: 396 (1980)

26. Uchitel O.D., Protti D.A., Sanchez V., et al.: P-type voltage dependent calcium channel mediates presynaptic calcium influx and transmitter release in mammalian syn­apses. Proc. Natl. Acad. Sci. USA 89: 3310 (1992)

27. Llinas R., Sugimori M., Silver R.B.: Microdomains of high calcium concentration in a presynaptic terminal. Sci­ence 256: 677 (1992)

28. Valtorta F., Jahn R., Fesce R., et al.: Synaptophysin (p38) at the frog neuromuscular junction: Its incorporation into the axolemma and recycling after intense quantal secretion. J. Cell Biol. 107: 2717 (1988)

29. Taylor P., Schumacher M., MacPhee-Quingley K., et al.: The structure of acetylcholinesterase: Relationship to its function and cellular disposition. Trends Neurosci. 10: 93 (1987)

30. Sakmann B.: Elementary steps in synaptic transmis­sion revealed by currents through single ion channels. Science 256: 50-512 (1992)

31. Taylor P.: Agents acting at the neuromuscular junction and autonomic ganglia. In: Goodman and Gilman’s The Pharmacological Basis of Therapeutics (Hardman J.G., Limbird L.E., ed.), 9th Ed., pp. 177-197, McGraw-Hill, New York, 1996

32. Savarese J.J., Caldwell J.E., Lien C.A., Miller R.D.: Pharmacology of muscle relaxants and their antagonists. In: Anesthesia (Miller R.D., ed.), Volume 1, 5th ed., pp. 412-490, Churchill Livingstone, New York, 2000

33. McCaughey W., Mirakhur R.K.: Drugs in anaesthetic practice and analgesia. In: Avery’s Drug Treatment (Speight T.M., Holford N.H.G., eds), 4th Ed., pp. 451-514, Adis International, Sydney, 1997

34. Feldman S.A., Fauvel N.: Onset of neuromuscular block. In: Applied Neuromuscular Pharmacology (B.J. Pollard, ed.), pp. 69-84, Oxford University Press, Oxford, 1994

35. Elliot J.M., Bion J.F.: The use of neuromuscular blocking drugs in intensive care practice. Acta Anaesthe­siol. Scand. 39(Suppl. 106): 70-80 (1995)

Online ISSN 1011-6575

Άρθρα Δημοσιευμένα σε αυτό το Περιοδικό Καταχωρούνται στα:
• Chemical Abstracts

• Elsevier’s Bibliographic Databases: Scopus, EMBASE, EMBiology, Elsevier BIOBASE
SCImago Journal and Country Rank Factor

Articles published in this Journal are Indexed or Abstracted in:
• Chemical Abstracts
• Elsevier’s Bibliographic Databases: Scopus, EMBASE, EMBiology, Elsevier BIOBASE
SCImago Journal and Country Rank Factor

Άρθρα Δημοσιευμένα στην Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση
Articles Published in Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

Συντακτικη Επιτροπή-Editorial Board

ΕΤΗΣΙΑ ΣΥΝΔΡΟΜΗ – ANNUAL SUBSCRIPTION
Γλώσσα Πλήρους Κειμένου –
Full Text Language
Ελληνικά – Greek
Παραγγελία – Αγορά –
Order – Buy
Ηλεκτρονική Μορφή: pdf (70 €) –
Digital Type: pdf (70 €)
pharmakonpress[at]pharmakonpress[.]gr
Έντυπη Μορφή (70 € + έξοδα αποστολής)
Printed Type (70 € + shipping)
pharmakonpress[at]pharmakonpress[.]gr

 

Προσθέστε στους σελιδοδείκτες το μόνιμο σύνδεσμο.

Τα σχόλια είναι απενεργοποιημένα.