<unk>  is a disorder that can be considered a gene–environment interaction. In most people with<unk>  susceptibility, they have few or no symptoms unless they are exposed to a triggering agent. The most common triggering agents are volatile anesthetic gases, such as halothane, sevoflurane, desflurane, isoflurane, enflurane or the depolarizing muscle relaxants suxamethonium and decamethonium used primarily in general anesthesia. In rare cases, the biological stresses of physical exercise or heat may be the trigger. In fact,<unk>  susceptibility <unk> S), predisposed by mutations in the skeletal muscle calcium release channel (RYR1), is one of the most severe heat-related illnesses. The<unk> S-associated heat susceptibilities predominantly affect children and metabolically active young adults, often leading to life- threatening hypermetabolic responses to heat. Other anesthetic drugs do not trigger<unk> . Some examples of drugs that don't cause<unk>  include local anesthetics (lidocaine, bupivacaine, mepivacaine), opiates (morphine, fentanyl), ketamine, barbiturates, nitrous oxide, propofol, etomidate, and benzodiazepines. The nondepolarizing muscle relaxants pancuronium, cisatracurium, atracurium, mivacurium, vecuronium and rocuronium also do not cause<unk> . There is mounting evidence that some individuals with<unk>  susceptibility may develop<unk>  with exercise and/or on exposure to hot environments. Genetics<unk> 's inheritance is autosomal dominant with variable penetrance. The defect is typically located on the long arm of chromosome 19 (19q13.2) involving the ryanodine receptor. More than 25 different mutations in this gene are linked with<unk> . These mutations tend to cluster in one of three domains within the protein, designated<unk> 1-3.<unk> 1 and<unk> 2 are located in the N-terminus of the protein, which interacts with L-type calcium channels and .<unk> 3 is located in the transmembrane forming C-terminus. This region is important for allowing passage through the protein following opening. Chromosome 7q and chromosome 17 have also been implicated. It has also been postulated that<unk>  and central core disease may be allelic and thus can be co-inherited.
Malignant hyperthermia
Sepsis
Hypothermia
Serotonin syndrome
Hyperthermia
Neuroleptic malignant syndrome
Nitrogen narcosis
Anaphylaxis