Ganglion Stimulants & Blockers

Question 1

Examples of GB

Answer 1

Tetraethylammonium
Mecamylamine
Hexamethonium
Trimetaphan

Question 2

PK of ganglion blockers

Answer 2

Unpredictable because of ionized nature and depressed gastric emptying.

Once you know their quaternary ammonium structure, you know the ADME

Question 3

One possible adverse risk of GB PK

Answer 3

Frank paralytic ileus

Question 4

Mild adverse effects of GB

Answer 4

• Visual disturbance
• Dry mouth
• Urinary hesitancy
• Decreased potency
• Moderate constipation
• Occasional diarrhea
• Nausea
• Syncope
• Heartburn

Question 5

Severe GB ADR

Answer 5

Marked hypotension
Syncope
Cyclopegia
Constipation
Urinary retention
Paralytic ileus

Question 6

Ganglion stimulants examples

Answer 6

Nicotine
Lobeline
TMA - tetramethylammonium

Question 7

Difference between TMA and nicotine

Answer 7

No dominant blocking action after initial stimulation
More potent
More selective

Question 8

What makes McN-A-343 unique?

Answer 8

Has primary action at muscarinic M1 receptors in ganglion. Its effects aren’t obscured by stimulation of other neuroeffector sites.