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Autonomics-1.8
Pharmocology-Autonomics1.8/ganglionicBlockingDrugs(Nn)
| Question | Answer |
|---|---|
| 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 |
| Trimethaphan, mecamylamine, hexamethonium prototypes? | little clinical use due to adverse effects |
| Chemistry of GBD? | quarternary ammonium have poor oral absorption and poor CNS penetration |
| Trimethaphan MOA? | non-depolarizing competative antagonism for Ach receptor |
| Hexamethonium MOA? | nondepolarizing competative agent: clogging open ion channels |
| Pharmacokinetics of GBD? | GI absorption if unpredictable. If absorbed, excreted unchanged by the kindey. Given IV trimethaphan duration of effects is minutes |
| Pharmacologic action of GBD? | selectively eliminate the component of ANS that dominates the system, leading to less dominant component characteristics. |
| effects of GBD on arterioles? | usually dominant sympathetic, but effect will be vasodialation, inc peripheral blood flow, hypotension |
| effects of GBD on veins? | usually sympathetic dominant, but effects will be dilation, peripheral pooling, decrease venous return, decrease cardiac output |
| effects of GBD on heart? | usually parasympathetic dominant, but effects are tachycardia |
| effects of GBD on iris? | usually parasympatheic dominates, but effects are mydriasis (far vision) |
| effects of GBD on ciliary muscle? | usually parasympathetic dominates, but effects are cycloplegia |
| effects of GBD on GI tract? | usually parasympathetic dominates, but effects are reduced tone and motility, constipation, decreased gastric and pancreatic secretions |
| effects of GBD on Urinary bladder? | usually parasympathetic dominates, but effects are urinary retention |
| effects of GBD on salivtory glands? | usually parasympathetic dominates, but effects are xerostomia |
| effects fo GBD on sweat glands? | usually sypmathetic dominates, but effects are anhidrosis (no sweat) |
| Trimethaphan use as a GBD? | infrequent use for hypertensive emergancy dissecting aortic aneurysm (continuous IV infusion) |
| 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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lmh9p4
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