4. Ganglionic stimulants
Agents that mimic neural transmission by
stimulation of the nicotinic receptors on
postganglionic autonomic neurons
e.g-Nicotine, lobeline, verenicline
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)
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.
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.
17. 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
18. Indication of ganglion blocker
Malignant hypertension.
Neurosurgery to control hypotension.
Orthopedic surgery to control hypotension.
Autonomic hyper reflexia.
19. Side effects
Cardiovascular: Orthostatic hypotension with or without reflex
tachycardia
ENT/glands: xerostomia, dry eyes, blurred vision, reduced bronchial
secretion, hypohidrosis
GIT: gastroparesis, constipation, urinary retention
Sexual dysfunction: failure of erection and ejaculation
in overdose risk of peripheral circulatory collapse (shock) and paralytic
ileus