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Q: Death by lethal injection: biochemistry of Pancuronium bromide and KCl ( Answered,   0 Comments )
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Subject: Death by lethal injection: biochemistry of Pancuronium bromide and KCl
Category: Reference, Education and News > Teaching and Research
Asked by: physics9000-ga
List Price: $8.00
Posted: 02 Dec 2003 17:32 PST
Expires: 01 Jan 2004 17:32 PST
Question ID: 282859
In connection with an inquiry into the death penalty by lethal
injection, I am having trouble discovering exactly how the lethal
injection kills--that is, the biochemistry of its action on the body.

There are usually two drugs--Pancuronium bromide (Pavulon) to cause
paralysis, and potassium chloride to stop the heart.

So my question is (i) what is the mechanism of Paculon that causes
paralysis, and (ii) how exactly does too much potassium chloride make
the heart stop?

Background references on lethal injection:

http://web.amnesty.org/library/Index/ENGACT500011998?open&of=ENG-TWN

http://www.smh.com.au/articles/2003/10/08/1065601914123.html?from=storyrhs

http://www.oakridger.com/stories/060303/stt_20030603003.html

http://www.iht.com/articles/112788.html

http://members.tripod.com/~gadbuddhaa/thelethalinjectiongurney.htm

http://www.fadp.org/news/NYT-20030109.htm

http://buffaloreport.com/articles/031022.brauchli.pig.html

http://drugs.mongabay.com/news/Potassium_Chloride.html

http://www.annals.org/cgi/content/full/135/10/922

http://www.ncadp.org/assets/applets/report.pdf

http://www.acluohio.org/docket/intubation_complaint.pdf
Answer  
Subject: Re: Death by lethal injection: biochemistry of Pancuronium bromide and KCl
Answered By: tutuzdad-ga on 02 Dec 2003 18:49 PST
 
Dear physics9000-ga;

Thank you for allowing me an opportunity to answer your interesting question.

In the mainstream medical world, Pancuronium bromide (Pavulon) is a
non-depolarizing neuromuscular blocking agent often used to assist in
tracheal intubations and mechanical ventilation therapy.
Non-depolarizing (meaning that transmission at the skeletal
neuromuscular junction is blocked without causing depolarization of
the motor end plate) neuromuscular blockers act by inhibiting
transmission of nerve impulses by binding with cholinergic receptor
sites, antagonizing action of acetylcholine. In layman?s terms,
Pancuronium bromide interferes with the neural transmission between
motor neurons and skeletal muscle. The end result is chemical induced
paralysis.

In medical terms, the EMS ACADEMY web site explains it this way:

?MECHANISM OF ACTIONS: Competes with acetylcholine for cholinergic
receptor sites on the post-junctional membrane. Results in paralysis
of muscle fibers served by the occupied neuromuscular junction. Does
not cause an initial depolarization wave as does succinylcholine.
Onset is 3-5 min and effect may persist for up to 60 min.?
http://www.alaskaems.org/student/academy/drug_P.htm


Potassium Chloride Potassium has a specific physiological effects of
the ion related primarily to the electrical excitability of cells.
Excessive potassium, like the lethal dosage administered in an
execution scenario, has a severe cardiac toxicity and produces
depression of the heart when an overabundance of these ions arrest the
electrical excitability of cardiac cells, causing, in effect, cardiac
arrest (sudden heart stoppage and rapid death).

Medically speaking, MEDICINENET.COM describes potassium chloride this way:

?DRUG CLASS AND MECHANISM: Potassium chloride is in the class of drugs
called potassium supplements which are used to treat low potassium
conditions (hypokalemia) or prevent them from occurring. Potassium is
the principal positive ion inside of the cells of the body and is used
in nerve conduction, muscle contraction, and normal kidney function. A
deficiency of potassium causes weakness, fatigue, heart rhythm
problems, paralysis, and kidney dysfunction.?
http://www.medicinenet.com/potassium_chloride/article.htm

A intentional large dosage of potassium chloride like the type
administered during a lethal injection type execution rapidly brings
about a predictable reaction known as ?fatal hyperkalemia?. Since the
healthy, proportionate amount of potassium in the body normally helps
to regulate the activity of all muscle tissue, and overdose
progressively slows bradycardia and ventricular fibrillation until the
heart ceases to function entirely.

Below you will find that I have carefully defined my search strategy
for you in the event that you need to search for more information. By
following the same type of searches that I did you may be able to
enhance the research I have provided even further. I hope you find
that that my research exceeds your expectations. If you have any
questions about my research please post a clarification request prior
to rating the answer. Otherwise, I welcome your rating and your final
comments and I look forward to working with you again in the near
future. Thank you for bringing your question to us.

Best regards;
Tutuzdad ? Google Answers Researcher


INFORMATION SOURCES

PANCURONIUM BROMIDE- PAVULON
http://pedspain.nursing.uiowa.edu/adjuvants/Pavultec.htm

HYPERDICTIONARY - NEUROMUSCULAR BLOCKING AGENT
http://www.hyperdictionary.com/dictionary/neuromuscular+blocking+agent

PHARMACOLOGY OF RSI
http://www.musc.edu/emergmed/RSI/rsi3.htm

MEDICAL DICTIONARY ONLINE
http://www.online-medical-dictionary.org/?q=Agents%2C+Neuromuscular+Nondepolarizing

EMS ADADEMY
http://www.alaskaems.org/student/academy/drug_P.htm

POTASSIUM CHLORIDE SOLUTION, STRONG 15% m/v INTRAMED
http://home.intekom.com/pharm/intramed/potchlor.html

WILIPEDIA - POTASSIUM CHLORIDE
http://en.wikipedia.org/wiki/Potassium_chloride

MEDICINENET.COM
http://www.medicinenet.com/potassium_chloride/article.htm

PDR HEALTH
http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/pot_0208.shtml

MEDLINEPLUS ? HYPERKALEMIA
http://www.nlm.nih.gov/medlineplus/ency/article/001179.htm


SEARCH STRATEGY


SEARCH ENGINE USED:

Google ://www.google.com


SEARCH TERMS USED:

NONDEPOLARIZING

NEUROMUSCULAR BLOCKING AGENT

"PANCURONIUM BROMIDE" PARALYSIS

PAVULON MECHANISM

"POTASSIUM CHLORIDE " MECHANISM

"POTASSIUM CHLORIDE " OVERDOSE
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