The Nicotinic

Acetylcholine Receptor
(nAChR)

Amanda Rossman RN, BSN, SRNA

York College of Pennsylvania/Wellspan Health
Nurse Anesthesia program

Overview
Receptor composition
Structure of the receptor
How the receptor is activated
What activates the receptor
How the ion channel opens

Types and functions of the receptor

Why this receptor is important to the practice
of anesthesia

Locations:
Peripheral Nervous System
Central Nervous System

Types:

Muscle-type
Neuronal-type
Non-neuronal type

Functions

Dependent upon location and

composition

http://www.jbc.org/content/283/32.cover-expansion

SUBUNITS

SUBTYPES

Rossman, 2011

1-10
1-4

http://www.jyi.org/research/re.php?id=88

1. Extracellular domain
- Binding sites

2. Transmembrane domain
- Channel gate

3. Intracellular domain
- Regulates expression

Zouridakis et al., 2009

2.

1.
3.
http://www.medicine.mcgill.ca/mjm/issues/v05n02/v05p090/v05p090fgr2.htm

Rossman, 2011

http://www.biochem.arizona.edu/classes/bioc462/462a/NOTES/LIPIDS/transport.html

http://physiwiki.wetpaint.com/page/Autonomic+Nervous+System

http://www.frca.co.uk/article.aspx?articleid=100618#

Kalamida et al., 2007

http://www.cnsforum.com/imagebank/item/Rcpt_sys_ACH_dist/default.aspx

Selective to calcium
Increases intracellular
calcium by:
Direct influx
VOCC
Release from intracellular

stores

http://www.bath.ac.uk/bio-sci/research/profiles/wonnacott-s.html

Location
Endocrine
Endothelial
Epithelial
Immune

Composition
Hetero/Homomeric
All 17 subunit

subtypes

http://www.hindawi.com/journals/mi/2010/642462/fig1/

MEMORY

MUSCLE CONTRACTION

General anesthetics
Non-competitive

antagonist

Inhibits calcium
permeability of the cell

Local anesthetics
Non-depolarizing
muscle relaxants
Depolarizing
muscle relaxants
Inhalational agents

http://www.medicine.mcgill.ca/mjm/issues/v05n02/v05p090/v05p090fgr2.htm

Rossman, 2011

Diseases

Depolarizing muscle
relaxants
Nondepolarizing
muscle relaxants

Upregulated
Receptors

Downregulated
Receptors

Upper/Lower motor
neuron lesions, burns,
immobilization,
denervation injuries

Myasthenia Gravis,
congenital myasthenic
syndromes

Located widely throughout the body and is

involved in numerous bodily functions.
Muscle, neuronal, and non-neuronal types

This is the target of many anesthetics that we

will use.
Muscle contraction and memory

Understanding of this receptor will

help us to appropriately reach the
anesthetic goals for our patient.

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