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1. GANGLION STIMULANTS
BLOCKING AGENTS
PROF. DR. S. MOSHIN TURAB

2. GANGLION
A ganglion is a
nerve cell cluster or
a group of nerve
cell bodies located
in the autonomic
nervous system and
sensory system

3.  GANGLION STIMULANTS

4. GANGLIONIC STIMULANTS


Agents that mimic neural transmission by
stimulation of the nicotinic receptors on
postganglionic autonomic neurons
e.g-Nicotine, lobeline, verenicline

5. GANGLION STIMULANTS






Selective nicotinic
agonists
Nicotine(small dose)
Lobeline
Dimethyl phenyl
Tetramethyl
ammonium(TMA)
Varenicline
•




Non
Selective/Muscarinic
agonists
Acetylcholine
Carbachol
Pilocarpine
Anticholiester

6. MECHANISM OF GANGLION
STIMULANTS

7. Actions




Activation of nicotinic
receptors on the plasma
membrane of the cells of
the adrenal medulla
Exocytotic release of E and NE
• Stimulation of nicotinic
receptors at NMJ
Contraction of skeletal muscle
ACTIONS

8. Treatment of smoking cessation/quiting
tobacco chewing





Majority of smokers ( tobacco chewers) wish to
quit smoking/chewing, but fail to do so because
of nicotine dependence
Measure to help smokers quit is counseling and
motivation
The goals of pharmacotherapy are
To reduce the craving foe the satisfying (reward)
effects of nicotine
To suppress the physical withdrawal symptoms
of nicotine

9. 



The drugs currently utilized for the above goals
are
Nicotine replacement (nicotinic chewing gum)
Partial agonists of α4β2 NRs (Varenicline)
Antidepressants (Bupropion)

10. GANGLION BLOCKERS

11. DEFINITION
A ganglionic blocker (ganglioplegic) is a type of
medication that inhibits transmission between
preganglionic and postganglionic neurons in the
Autonomic Nervous System, often by acting as a
nicotinic receptor antagonist.

12. Muscarinic receptor subtypes in airways. M1 are localized to
parasympathetic ganglia. M2 on postganglionic cholinergic nerve terminals
inhibit the release of Ach. M3 that constrict airway smooth muscle.

13. CLASSIFICATION

15. EFFECTS OF BLOCKING AGENT
Ganglionic blockers block both the parasympathetic nervous system
and sympathetic nervous system, the effect of these drugs depends
upon the dominant tone in the organ system.

16. Mechanism of action

17. Mechanism of action

18. Antihypertensive use
The competitive ganglion blockers were used in the 1950s for hypertension and
peptic ulcer but have been totally replaced now because they produce a number of
intolerable side effects

19. Indication of ganglion blocker
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


Malignant hypertension.
Neurosurgery to control hypotension.
Orthopedic surgery to control hypotension.
Autonomic hyper reflexia.

20. Side effects




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Cardiovascular:
Cardiovascular: Orthostatic hypotension with or
without reflex tachycardia
ENT/glands
ENT/glands: xerostomia, dry eyes, blurred vision,
reduced bronchial secretion, hypohidrosis
GIT:
GIT: gastroparesis, constipation, urinary
retention
Sexual dysfunction
Sexual dysfunction: failure of erection and
ejaculation
in overdose risk of peripheral circulatory
collapse (shock) and paralytic ileus

21. THANKS