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من خلال دراستي للمادة طلعلي سؤالين حبيت أن أكتبن و أشوف إجاباتكن عنن.......

و هما كلآتي .............

السؤال الأول:


? Why we called for the Agonist is agonist and called the partial agonist is partial agonist


[b](Note: No answer becouse Agonist have Effecacy 1 and Partial Agonist less than 1)


السؤال الثاني:

When we Treate the Myastinia Grave or Myastinia Crises we give Neuostigmin or Pirridostigmin ..
How Can you diffrinciate betwen these disesess when we diagnosis ?


Thanks.....

بالنسبة للسؤال الأول:
As you have mentioned, a partial agonists cannot produce an Emax of that of a full agonist, this is due to the fact that partial agonists have less efficacies than full agonist. However, you should also know that partial agonist can act as an antagonist of a full agonist. In the presence of a full agonist, a number of receptors would be occupied by partial agonist, and as the concentration of partial agonists increases as the Emax of full agonist would decrease until it reaches that of the partial agonist.

بالنسبة للسؤال الثاني:
First we need to explain Myasthenia Gravis so that we would be able to understand Myasthenia Crisis. ( a generalized knowledge of neuromuscular junction is needed to understand the concept of myasthenia gravis.)

Myasthenia Gravis: is an acquired autoimmune disorder of neuromuscular transmission characterized by muscle weakness.
In this disease; certain antibodies attack the acetylcholine receptors (AChR), thus the receptors are either blocked or destroyed. Therefore, the end plate potentials that occur in the muscle fibers are mostly too weak to stimulate the muscle fiber.

The clinical features of this disease are a generalized weakness of muscles ( usually more pronounced at the end of the day or after exercising)- However, if the disease intense enough, the patient dies of paralysis-. Certain muscles are affected more that others and those are the muscles of the eyelids, the muscles controlling eye movement, facial and neck muscles are also highly affected.
This will lead to double vision, difficulty in chewing food and holding the head upright and a nasal quality speech.

This disease can be AMELIORATED for several hours ( it cannot be treated) by administrating neostigmine which work as an anticholinesterase ( inhibit the action of acetylcholinesterase thus inhibiting the breakdown of acetylcholine leading to increasing the action of acetylcholine).

Now Myasthenia Crisis is a life-threatening respiratory failure which in the first place is a complication of Myasthenia Gravis. Myasthenia crisis occur when weakness from myasthenia gravis becomes sever enough that it would affect respiratory muscles that it would be very difficult (if not impossible) to breath.

Treatment: as Myasthenia Crisis is a necessitate intubation for ventilatory support or airway protection, we need more radical treating method than neostigmine, therefore, Plasma exchange may be performed to treat myasthenic crisis.
In this procedure, blood plasma is removed and replaced with purified plasma free of autoantibodies. Thus the patient is able to breath normally again. In addition, this procedure temporary relief the symptoms of myasthenia gravis.

بسم الله الرحمن الرحيم


شكرا لك يا G.A.J كثيرا .................
بس يمكن ما فهمت قصدي؟...
بدي ما هي المسببات التي تخلينا نقول هذا Partial Agonist ؟

والله يا صديقي ما بعرف شو بدي إللك:
يعني سموون partial agonists لأنو هنن بحفزو )stimulate) يعني نفس شغل agonist بس كل ما بالقصة إنو partial عندو E max أقل من الE max تبع ال full agonist . بقى غير هيك ما بعرف, أنا يمكن ماني فهمان كتير عليك, بس ياريت تسامحني إذا ما قدرت ساعدك كتير.