Ganglionic stimulants and blockers Flashcards
ganglionic agents are primarily made from what stimulant
nicotine
Only ganglionic drug used
mecamylamine
low dose nicotine effects on physiology of human body
stimulator of nicotinic receptor
high dose nicotine effects on physiology of human body
Inhibits nicotinic receptor signalling leading to desensitization of receptors
What occurs when Nicotine increase at nicotinic receptor sites
increase response then suppresses the signaling from nicotinic receptors
Nicotine effects on which nicotinic receptors
- CNS: neuronal brain subtype
- Cardiovascular and GI: subtype in autonomic ganglia
- Muscular subtype in neuromuscular junctions
ALL NICOTINIC RECEPTORS
2 phases of nicotine poisoning
- Stimulatory phase
- Depressor phase
Stimulatory phase symptoms
-Nausea/vomitting
- sweating
- seizures
-excessive salvation
-headache
-hypertension
-tachycardia
- tremor
- ETC negative impacts
Depressor phase symptoms
Basically the opposite
- hypotension
- bradycardia
- respiratory failure
- difficulty breathing
- muscle weakness
- coma
- CNS depression
Diaphragm paralysis
green tobacco sickness
nicotine poisoning that occurs while handling tobacco plants. High risk with clothing absorption
green tobacco sickness symptoms
Nausea, vomitting, headaches, difficulty sleeping/eating, dizziness
-similar to heat illness and organophosphate posioning
fatal dose of nicotine
60mg in a adult
what makes nicotine posinoning in the body so difficult to acheive
Nicotine is metabolized very rapidly and inactivated.
What drug to give when cardiovascular symptoms arise from nicotine poisoning
Norepinephrine
What must be done to a patient if CNS and skeletal muscle symptoms such as respiratory paralysis occur
Give patient artificial ventilation.
Forms of nicotine cessation
- gum
- patches
- sprays
- Inhalers
Strategy for smoking cessation
gradually decrease doses to wean patients off of addiction
vaping uncertanties
-Not sure about long term health effects
- not certain about stopping smoking
Define electronic cigarettes
Battery operated devices that heat a nicotine liquid producing a vapor to inhale
vaping public health concerns
concerned with vaping becoming a gateway to using other tobacco products like cigarettes
first generation vaping products
mimic the shape and size of cigarettes in two versions: disposables and reusables
Second generation vaping products
Larger than conventional cigarettes, pen or tank style. stronger, refillable and rechargeable, allowing user to adjust contents
Third generation vaping products
allow custom modifications. range of options and flavors. Adjust the heating elements. JUUL
Liquid components of vaping product
- Nicotine (0-36mg/ml)
- Polyethylene glycol(produces fake smoke)
- Flavorings (increases youth attractiveness)
- Metal compounds (tin, lead, nickel, arsenic)
Can you die from nicotine poisoning?
Yes
Most predominant people for deaths related to nicotine poisoning
Children
vaping adverse effects
- No data for long term effects
- vaping can be safer but have toxic chemicals
- pulmonary issues
- device itself can be dangerous
- Burns, battery explodes
E-ciggarette or vaping associated lung injury effects (EVALI)
Acute respiratory illness, can be developing into life threatening scenarios. More than 2800 cases, 68 deaths.
- Compromised pulmonary function
- peaked in 2019
what is the suspicion regarding E-ciggarette or vaping associated lung injury
People smoking Black market THC containing Vitamin E acetate likely the problem
mecamylamine
First effective therapy for hypertension. Reserved for severe hypertension and is the only drug you can get in USA
Side effects of mecamylamine
Affects both sympathetic and parasympathetic ganglionic transmission
Ganglionic blocking agents function
response determines by which division of ANS is dominant control of various organs
physiologic effects of ganglionic blockade
effect of the blockade is the opposite of the autonomic system given for the organ
primary determinant factor of the degree of ganglionic blockade
existing sympathetic tone
heart rate change in mecamylamine treatment
mild tachycardia with hypotension
how does cardiac output change in patients with normal function with mecamylamine treatment
cardiac output is reduced due to venodilation, pooling of blood and reduced venous return
What occurs in a heart failure patient with compromised cardiac output with mecamylamine treatment
increased cardiac output due to increased peripheral resistance
with mecamylamine treatment In hypertensive patients what occurs
cardiac output is reduced
