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Causes of upregualtions of NAChR
Last updated: 03/04/2015
Upregulation of Acetylcholine receptors leads to increased sensitivity to Succinylcholine and risk for hyperkalemia due to depolarization of the muscle membrane. May occur in:
1) Spinal Cord Injury
2) Stroke
3) Burns
- After immobilization, upregulation of NAChRs
- Avoid Succinylcholine – especially after 24 hours post burn and for up to 1-2 years post burn (may take months to years to return to preburn levels of NAChR)
- Resistance to nondepolarizing NMBDs and increased sensitivity to succinylcholine
4) Prolonged immobility
5) Prolonged exposure to neuromuscular blockers
- Typically seen in ICUs to facilitate mechanical ventilation, tetanus, status epilepticus, reduction in oxygen consumption
6) Multiple Sclerosis
- Demyelination of the CNS
- Attention autonomic dysfunction
7) Guillain Barre’ syndrome
- Demyelination and axonal degeneration produce functional denervation of muscle and upregulation of NAchRs at the postsynaptic membrane
- Pay attention to autonomic dysfunction
- Maintain adequate preload, temperature control, postural changes, blood loss
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