Causes of upregualtions of NAChR

Physiology - Neurologic

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

  4. After immobilization, upregulation of NAChRs

  5. 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)

  6. Resistance to nondepolarizing NMBDs and increased sensitivity to succinylcholine

  7. Prolonged immobility

  8. Prolonged exposure to neuromuscular blockers

  9. Typically seen in ICUs to facilitate mechanical ventilation, tetanus, status epilepticus, reduction in oxygen consumption

  10. Multiple Sclerosis

  11. Demyelination of the CNS

  12. Attention autonomic dysfunction

  13. Guillain Barre’ syndrome

  14. Demyelination and axonal degeneration produce functional denervation of muscle and upregulation of NAchRs at the postsynaptic membrane

  15. Pay attention to autonomic dysfunction

  16. Maintain adequate preload, temperature control, postural changes, blood loss


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