What is a cholinergic crisis?
You don’t need an MD to understand what happens during a cholinergic crisis.
In medical literature, a cholinergic crisis is often referred to as “cholinergic syndrome” or “cholinergic-cholinergic”.
In other words, a cholinergic crisis occurs when it comes to ‘ acetylcholine.
The excess acetylcholine has influenced the Neuromuskel intersection. The Neuromuskel intersection is between the axon of a motor neuron and a muscle fiber1.
A cholinergic crisis is often caused by a class of compounds known as inhibitors of acetylcholinesterase. Some inhibitors of acetylcholinesterase are essential medications (e.g. donepezil, dealing with dementia). Alternative insecticides organophosphates (e.g. diazinon).
Acetylcholinesterase usually breaks the neurotransmitter in the Neuromuskel-Junction1.
Fun fact: Acetylcholinesterase has a high catalytic activity. An acetylcholinesterase can affect 25000 molecules of acetylcholine per second.
Cholinergic crisis is also referred to as cholinergic and cholinergic syndrome cholinergic.
What is the Neuromuskel intersection?
The Neuromuskel junction is a chemical synapse formed by touching a motor neuron and a muscle fiber2.
A motor neuron sends a chemical signal to the muscle fiber that is contract2. Specifically, the motor neuron published ACH quia git on receptors called protein expressed in the surface muscle fibers2 alas. There are two types of ACH receptors:
Most present on the surface of muscle skeleton.
Your activation will lead to your twitching3. –
Nicotine-each is expressed in skeletal muscles of the membrane, and their activation comes into the breathing3 process.
Muscarinic acetylcholine receptors
Grant on the surface of the muscles of the inner organs.
Your activation leads to the innate modulation of contractile activite4.
Muscarinic ACh receptors are also on the surface of the glands (such as the tear glands) where they stimulate the production and secret of the FLUIDS4 body.
What causes a cholinergic crisis?
There are two main causes of the cholinergic crisis:
An overdose with a cholinesterase inhibitor
Exposure to nerve agents known as organophosphates
Cholinesterase inhibitors are a variety of medications used for a variety of conditions.
Cholinesterase inhibitors treat myasthenia gravis, an autoimmune disorder that causes skeletal muscle weakness. They also reverse a residual paralysis of the muscles after a surgical procedure5. Cholinesterase inhibitors are also used for the treatment of dementia (e.g. donepezil).
Also, some over-the-counter supplements inhibit acetylcholinesterase. For example, Huperzine A is a powerful and irreversible acetylcholinesterase inhibitor.
Organophosphates are compounds for insecticides and herbicide properties. Organophosphates for idle irreversible mental ‘ acetylcholinesterase, inhibits the metabolism of acetylcholine and causes the Mud 5 syndrome.
Classification of the cholinergic crisis
Cholinergic crisis is divided into:
As a result of excessive activation of nicotine acetylcholine receptor system
In connection with the following side effects: muscle weakness, inability to swallow and volunteers and cramps
As a result of redundant activation of the muscarinic acetylcholine receptors
Partners: blurred vision, pain in the abdomen, vomiting, nausea, diarrhea and the Secret of tears and mucus 5.
What are the types and symptoms of a cholinergic crisis?
The signs and symptoms of the cholinergic crisis result from excessive activation of the muscarinic. The acronym of Sludge describes the footprint of the symptoms:
Saliva: Due to the stimulation of saliva glands
Tearing: Due to the stimulation of the lacrimal glands
Urine: Due to the relaxation of the muscle sphincter internally of the urethra and contraction of the muscles of the body
Gastrointestinal: Due to changes in the tone of the smooth muscle of the gastrointestinal tract leads to gastrointestinal problems, including cramps
Other symptoms of a cholinergic crisis are:
The secret and excessive bronchial mucus production
Limitations of pupils
SPASMS6 of the musculoskeletal
What are the complexities of a cholinergic crisis?
If moved untreated cholinergic crisis can be fatal because the muscles are no longer the alias. In this case, as a physiological reaction protection against excess each activity6.
In particular, because of the reduced activity of nicotine cholinergic, the crisis is linked to the following deadly events6:
Insufficient airways due to the failure of the gas exchange
Reduction of muscle tones caused by paralysis or weakness, flaccid paralysis also known as
Crisis cholinergic vs. Myasthenia grave
Cholinergic crisis can often be confused with a different medical condition known as a myasthenic crisis.
The distinction between these terms is unclear because they have a similar presentation.
But distinguish cholinergic vs. myasthenic crisis is crucial since the underlying condition is different, they are exactly the opposite, and the administration of the wrong drug can fatal7.
Myasthenic crisis is a deadly form of severe myasthenia, where the muscles for breathing will be weak. If not treated, it can cause problems of breathing and ultimately the lung failure7.
While the cholinergic crisis is associated with an excessive activity, duneurotransmetteur the Myasthenic tomb, alas, is associated with the reduced ACH activity by auto-antibody “attack” of the marchandises7 of the nicotine-ACH receptor.
What Crisis cholinergic drugs?
Cholinergic crisis is used with anticholinergic drugs such as atropine, oximes like Pralidoxime and Benzodiazepinescomme diazepam.
Edrophonium inhibits the functioning of the enzyme ache and can help to differentiate a cholinergic and a myasthenic crisis7.
If the Edrophonium exacerbates paralysis, it indicates that a cholinergic crisis is currently 7. But the improvement of edrophonium after taking Edrophonium suggests Myasthenic CRISIS7.
Once the cholinergic crisis has been identified, it can be managed with anticholinergic drug atropine.
Blockade of muscarinic ACh receptors atropine normalized ach-7 excessive activity.
While atropine treats the effects of the activity of muscarinic receptors, it has no effect on acetylcholine receptors7. Thus, the key element in a cholinergic crisis, the paralysis of the muscles associated with a deadly arrest of the airways, does not improve with atropine.
Patients with a respiratory toxicity must be ventilation EC Nique, i.e. intubation to support respiration until the crisis has been resolved.
Pralidoxime is a derivative that binds acetylcholinesterase enzymes that have been deactivated by organophosphates. It is therefore not surprising that the pralidoxime is used clinically to combat the poisoning of organophosphates in conjunction with atropine and diazepam.