Count to 10 - Anaesthetic Primary Podcast EP16 – NMJ & Suxamethonium | MiniPod | CT10
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Aug 21, 2023 Explore the Neuromuscular Junction physiology and Suxamethonium pharmacology in this episode. Learn about acetylcholine, action potential pathway, ACH receptors, and Sux pharmaceutics. Dive into past SAQs focusing on Sux adverse effects and review opening viva stems. A detailed look at succinylcholine metabolism, pharmacokinetics, and potential risks associated with its administration. Understand the impact of drugs on neuromuscular junction physiology for effective management.
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High-Fidelity Neuromuscular Transmission
- The neuromuscular junction is a chemical bridge with pre- and post-junctional components and a 20 nm synaptic cleft.
- High-fidelity transmission relies on abundant ACh release and folded motor endplate structure to ensure muscle activation.
Acetylcholine Synthesis And Clearance
- Acetylcholine is synthesized from choline and acetyl-CoA via choline acetyltransferase and broken down by acetylcholinesterases into choline and acetate.
- ACh is quaternary, limiting blood-brain penetration and necessitating local synaptic metabolism.
Vesicular Release Produces Miniature Potentials
- One action potential releases ~200 vesicles, each holding ~10,000 ACh molecules, producing miniature endplate potentials.
- Summation of these miniature potentials triggers muscle action potentials and contraction via T-tubules and SR calcium release.