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cholinergic crisis

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aspiringmd1015

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so in a patient with cholinergic crisis, the ach which is increased, it only effects the NMJ nicotinic receptors? or does it affect the entire bodies nicotinic receptors?
 

IH8ColdWeath3r

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so in a patient with cholinergic crisis, the ach which is increased, it only effects the NMJ nicotinic receptors? or does it affect the entire bodies nicotinic receptors?

Entire body. That's why you see a myriad of symptoms, the "DUMBBLSS" symptoms that are due to activation of the parasympathetic NS

D-diarrhea (parasympathetic activity increases gastric motility and gastric secretion)
U-Urination (contract the trigone/bladder muscles + relax the sphincter)
M-Miosis - due to contraction of the pupillary (constrictor) sphincter muscle
B-Bradycardia (parasympathetic action on the M2 receptors of the heart)
B-Bronchoconstriction (M3)
L-Lacrimation
S-Salivation
S-Sweating
 

IH8ColdWeath3r

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right, so does that also affect the sympathetic nervous system? as the SANS also uses nicotinic receptors at their ganglia

I don't think so, but I am not sure. I understand what you are saying (since ACh acts at all autonomic ganglia) shouldn't a cholinergic crisis lead to a sympathetic NS response. Maybe someone else can chime in
 

CodeRedDew

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Entire body. That's why you see a myriad of symptoms, the "DUMBBLSS" symptoms that are due to activation of the parasympathetic NS

D-diarrhea (parasympathetic activity increases gastric motility and gastric secretion)
U-Urination (contract the trigone/bladder muscles + relax the sphincter)
M-Miosis - due to contraction of the pupillary (constrictor) sphincter muscle
B-Bradycardia (parasympathetic action on the M2 receptors of the heart)
B-Bronchoconstriction (M3)
L-Lacrimation
S-Salivation
S-Sweating

You answered your own question. Sweating is a sympathetic response accomplished via ACh acting on muscarinic receptors. It's one of the only post-ganglionic neurons within the SANS that utilizes ACh as a neurotransmitter.
 

thehundredthone

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It does, but all ganglia get desensitised soon after the initial hyperactivity. Thus all that remains active is the set of postganglionic Ach receptors which are mostly parasympathetic, and thus you see signs of parasympathetic overactivity.

 
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aspiringmd1015

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hmm i see, so i guess my next question is, the muscruanic PANS receptors are less sensitive to overstimulation and they resist desensitization?
 

Robotman

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Entire body. That's why you see a myriad of symptoms, the "DUMBBLSS" symptoms that are due to activation of the parasympathetic NS

D-diarrhea (parasympathetic activity increases gastric motility and gastric secretion)
U-Urination (contract the trigone/bladder muscles + relax the sphincter)
M-Miosis - due to contraction of the pupillary (constrictor) sphincter muscle
B-Bradycardia (parasympathetic action on the M2 receptors of the heart)
B-Bronchoconstriction (M3)
L-Lacrimation
S-Salivation
S-Sweating

You forgot E- Excitation of muscles and CNS (seizures, confusion)
 

aspiringmd1015

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would love to read all those articles, but due to time constraints(step 1) i cant go through all of them. Thanks for the help though, much appreciated.
 
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