CLINICAL CASES
169
B IO C H E M IS T R Y PE A R L S
Malignant hyperthermia is most likely, given that anesthetic agents
stimulate a calcium release channel, leading to excessive Ca2+
release from the cisternae of the sarcoplasmic reticulum, in turn
causing muscle contraction, an increase in body temperature,
tachycardia, and subsequent metabolic acidosis.
Although the uncoupling proteins (UCP 1 to 5) are a physiologic
mechanism for maintaining body temperature through selective
uncoupling of electron transport from ATP synthesis, MH is a
pathologic exaggeration of this process.
The treatment of MH includes stopping the anesthesia, cooling the
patient, and administration of dantrolene, which reduces muscle
contractions by decreasing the amount of Ca2+ released from the
sarcoplasmic reticulum.
REFERENCE
Goodman AG, Gilman LS, eds. The Pharmacological Basis of Therapeutics, 10th ed.
New York: McGraw-Hill, 2001:295-303.
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