Pharmocology-Autonomics1.8/ganglionicBlockingDrugs(Nn)
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| GBD mechanisms? | interfere w Ach release, prolong depolarization, interfere with postsynaptic action by blocking ion channel or nicotinic receptor. CANNOT select for PANS or SANS
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| Trimethaphan, mecamylamine, hexamethonium prototypes? | little clinical use due to adverse effects
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| Chemistry of GBD? | quarternary ammonium have poor oral absorption and poor CNS penetration
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| Trimethaphan MOA? | non-depolarizing competative antagonism for Ach receptor
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| Hexamethonium MOA? | nondepolarizing competative agent: clogging open ion channels
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| Pharmacokinetics of GBD? | GI absorption if unpredictable. If absorbed, excreted unchanged by the kindey. Given IV trimethaphan duration of effects is minutes
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| Pharmacologic action of GBD? | selectively eliminate the component of ANS that dominates the system, leading to less dominant component characteristics.
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| effects of GBD on arterioles? | usually dominant sympathetic, but effect will be vasodialation, inc peripheral blood flow, hypotension
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| effects of GBD on veins? | usually sympathetic dominant, but effects will be dilation, peripheral pooling, decrease venous return, decrease cardiac output
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| effects of GBD on heart? | usually parasympathetic dominant, but effects are tachycardia
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| effects of GBD on iris? | usually parasympatheic dominates, but effects are mydriasis (far vision)
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| effects of GBD on ciliary muscle? | usually parasympathetic dominates, but effects are cycloplegia
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| effects of GBD on GI tract? | usually parasympathetic dominates, but effects are reduced tone and motility, constipation, decreased gastric and pancreatic secretions
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| effects of GBD on Urinary bladder? | usually parasympathetic dominates, but effects are urinary retention
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| effects of GBD on salivtory glands? | usually parasympathetic dominates, but effects are xerostomia
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| effects fo GBD on sweat glands? | usually sypmathetic dominates, but effects are anhidrosis (no sweat)
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| Trimethaphan use as a GBD? | infrequent use for hypertensive emergancy dissecting aortic aneurysm (continuous IV infusion)
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| Trimethaphan (Arfonad) and Mecamylamine (Inversine) as a GBD? | Used in the past as antihypertensives. Were the first available, but now many side effects
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