Ganglionic Stimulants and Blocking Agents Lecture PDF Flashcards
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Nicotine drug class and mech of action
- Ganglionic stimulant
- At low doses stimulates nicotine receptors and at high doses inhibits nicotine receptors, easily absorbed and distributed across the body (and across the placenta)
Nicotine effects at low doses (such as smoking) (3)
- cardiovascular stimulation of nicotinic receptors in sympathetic ganglia causes vasoconstriction and elevated BP
- gastrointestinal stimulation of nicotinic receptors in parasympathtic ganglia results in gastric acid secretion and increased tone and motility of GI smooth muscle, can produce vomiting (tolerance develops)
- CNS stimulant, moderate doses can cause tremors, high doses can cause convulsions, activates pleasure system in brain
Of all deaths related to tobacco use, greatest number are due to…
…cardiovascular disease
Acute nicotine poisoning
Can occur in doses as low as 40mg and can be fatal, toxicity is used in insecticides, results in N/V/D, faintness, rapid pulse, and death upon respiratory paralysis
Nicotine therapeutic use (1)
-facilitate withdrawal from smoking
Nicotine chewing gum (nicorette, nicotine polacrilex) and ADR’s (3)
-gum based product that when chewed releases nicotine beginning in higher strength dosages and slowly decreased over 3 months,
- jaw muscle ache
- mouth and throat soreness,
- contraindicated in pregnancy and lactation
Nicotine inhaler (nicotrol inhaler) and ADR’s (3)
-Cigarette appearing device that thru puffing that delivers nicotine helping the psychological sensation of smoking being preserved
- dyspepsia
- throat irritation
- oral burning
Nicotine nasal spray (nicotrol NS)
Differs from gum and patches since blood levels rise rapidly following administration, more closely simulates smoking
Mecamylamine (inversine)
A ganglionic blocking agent that blocks Ach at nicotinic receptors, only used rarely in hypertension when it cannot be controlled with standard medications
