因為有同學問到 這個表格的問題 查一下 Clinical Anesthesiology 節錄下面這段 希望對大家的理解有幫助 前言 Thus, depolarizing muscle relaxants act as ACh receptor agonists, whereas nondepolarizing muscle relaxants function as competitive antagonists. This basic difference in mechanism of action explains their varying effects in certain disease states. 舉例來了: For example, conditions associated with a chronic decrease in ACh release (eg, muscle denervation injuries) stimulate a compensatory increase in the number of ACh receptors within muscle membranes. These states also promote the expression of the immature (extrajunctional) isoform of the ACh receptor, which displays low channel conductance properties and prolonged open-channel time. 重點是下面這裡 This up-regulation causes an exaggerated response to depolarizing muscle relaxants (with more receptors being depolarized), but a resistance to nondepolarizing relaxants (more receptors that must be blocked). In contrast, conditions associated with fewer ACh receptors (eg, down-regulation in myasthenia gravis) demonstrate a resistance to depolarizing relaxants and an increased sensitivity to nondepolarizing relaxants. 換句話呢 depolarizing 要 bind 上去才有用 所以receptor 越多越好 ---> up-regulation 會增加敏感度 non-depolarizing 是害人精 要霸占位置 所以當receptor越多時 他就越不站到多數的位置 敏感度就下降 相反的 如果 位置越少(down-regulation receptor ) 他就越容易 占住所有的位置 來達到阻斷 ach 傳遞神經訊息的目的 希望這樣有解答到大家的疑惑 歡迎大家 來討論一下 -- Let your beauty come alive Let your colour fill the sky --

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