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This Concept Map, created with IHMC CmapTools, has information related to: need botox for my butt, Acetylcholine Mechanisms for altered acetylcholine actions Massive ACh release at the presynaptic neuron, Binds to Nicotinic receptor Bolus Dosing 1 g bolus in 30 min then infusion 0.5 g /hr, Acetylcholine Mechanisms for altered acetylcholine actions Block ACh binding to ACh-esterase (irreversible), Acetylcholine Mechanisms for altered acetylcholine actions Reversibly block nicotine receptor from acetylcholine, Acetylcholine Acetylcholine receptor modification Non-depolarizing Neuromuscular blocker: Acts by also competing with Ach and binds to the receptor but acts to close the Na+ pumps., Acetylcholine Mechanisms for altered acetylcholine actions Replace acetylcholine with similar drug resistant to acetylcholinesterase, ACh Binds to nicotinic receptor Opens sodium and potassium channels 2 Potassium ions in and 3 Sodium ions out, causing depolarization, Acetylcholine Mechanisms for altered acetylcholine actions Normal (Healthy), Incremental Dosing 1.8-3 mg IV Repeated every 5 min doubling the dose each time until Atropinization (Endpoint), Treatment Atropine (Muscarinic Receptor) Incremental Dosing, 1 g bolus in 30 min then infusion 0.5 g /hr Treats these symptoms Muscle Fasciculation Hyper-reflexia Flaccid Muscle Weakness, Treatment ???? Oximes (Nicotinic Receptor), 3.41 mL delivers 68.18 mg, Oximes (Nicotinic Receptor) Pralidoxime Binds to Nicotinic receptor, administered every 10-15 min until Atropinization (Endpoint) Followed by Maintenance via reduced doses or increasing time between doses, Bolus Dosing 2-5 mg administered every 10-15 min until Atropinization (Endpoint), Acetylcholine Mechanisms for altered acetylcholine actions Block acetylcholine release from nerve ending, Non-depolarizing Neuromuscular blocker: Acts by also competing with Ach and binds to the receptor but acts to close the Na+ pumps. Therapeutic Tubocurare, Normal (Healthy) ???? ACh Binds to nicotinic receptor, Depolarizing Neuromuscular blocker: Acts by competing with Ach and binds to the receptor, it is like an agonist and keeps the Na+ gates open so there is an influx of Na+ causing depolarization. (Persistent depolarization) Therapeutic Succinylcholine