Ganglionic Stimulants and Blocking Agents Lecture PDF

Question 1

Nicotine drug class and mech of action

Answer 1

• 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)

Question 2

Nicotine effects at low doses (such as smoking) (3)

Answer 2

• 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

Question 3

Of all deaths related to tobacco use, greatest number are due to…

Answer 3

…cardiovascular disease

Question 4

Acute nicotine poisoning

Answer 4

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

Question 5

Nicotine therapeutic use (1)

Answer 5

-facilitate withdrawal from smoking

Question 6

Nicotine chewing gum (nicorette, nicotine polacrilex) and ADR’s (3)

Answer 6

-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

Question 7

Nicotine inhaler (nicotrol inhaler) and ADR’s (3)

Answer 7

-Cigarette appearing device that thru puffing that delivers nicotine helping the psychological sensation of smoking being preserved

• dyspepsia
• throat irritation
• oral burning

Question 8

Nicotine nasal spray (nicotrol NS)

Answer 8

Differs from gum and patches since blood levels rise rapidly following administration, more closely simulates smoking

Question 9

Mecamylamine (inversine)

Answer 9

A ganglionic blocking agent that blocks Ach at nicotinic receptors, only used rarely in hypertension when it cannot be controlled with standard medications