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Coupled movement of a sodium ion and ligand QX-222 in the closed cardiac sodium channel (2)

When the outer pore is blocked by tetrodotoxin (TTX), the sodium ion is trapped in the central cavity and prevents binding of QX-222. QX-222, a lidocaine derivative, is a sodium channel blocker. (Source: Tikhonov DB, Zhorov BS. Predicting structural details of the sodium channel pore basing on animal toxin studies. Front Pharmacol 2018;9:880. See also: Bruhova I, Tikhonov DB, Zhorov BS. Access and binding of local anesthetics in the closed sodium channel. Mol Pharmacol 2008;74[4]:1033-45. Creative Commons Attribution [CC BY] license.)