ganglionic stimulants and blockers Flashcards

1
Q

ONE ganglionic stimulant important medically

A
nicotine 
-releases DA in the brain
can reach brain in 6 seconds
-oily liquid alkaloid
-rapidly absorbed from smoke in lung or mouth
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2
Q

nicotine receptors

A

nAChR expressed on DA neurons which are plentiful in VTA of midbrain

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3
Q

stimulation of DA

A

in nucleus accumbens and prefrontal cortex

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4
Q

what increases nicotine addiction

A

MAOI

-tobacco contains naturally occurring MAOI’s

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5
Q

CNS actions of nicotine

A
  • increases alertness
  • calming effect
  • enhances motor sensory abilities
  • relaxes skeletal muscle by inhibiting spinal reflexes
  • analgesia
  • prevents parkinsonism
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6
Q

nicotine used to break smoking habit

A

satisfy craving without smoking

  • chew nicotine gum (chew gum slowly)
  • nicotine spray
  • nicotine transdermal
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7
Q

medical precautions of smoking

A

Related to sympathetic

  • hypertension
  • paroxysmal atrial tachycardia
  • peripheral vascular disease

Related to parasympathetic

  • IBS
  • peptic ulcer
  • colitis
  • colic in an infant (milk/plasma ratio=2.9)
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8
Q

other actions of nicotine

A

-skeletal muscle effect only at high doses (not enough in cigarettes)
Symptoms of mild intoxication with gum:
-increased salivation
-nausea due to sensory nerves in stomach
-increase respiration due to carotid sinus stimulation

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9
Q

what does fetal/neonatal nicotine exposure causes

A

type 2 diabetes

  • 15-20% pregnant women smoke
  • nicotine destroys insulin secreting cells by mito apoptosis
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10
Q

non-nicotine for smoking cessation

A

Varenicline (nicotine analog)

  • partial agonist at nicotine receptors in mesolimbic dopaminergic system
  • decreases smoking satisfaction as antagonist
  • counteracts craving as agonist
  • clinical studies show increase success with counseling
  • nausea usually mild
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11
Q

what are some other treatments for smoking cessation

A

bupropion
antidepressants (blocks NET, DAT)
may block some nicotines effect
dry mouth, insomnia

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12
Q

serious nicotine toxicity

A
  • Not common in humans

- can be lethal at dose of 60mg

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13
Q

no specific antidote for nicotine

A

Artificial respiration till effect wears off

-half-life: 2 hours (oxidized in liver)

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14
Q

what were the first orally effective anti-hypertensives

A

ganglionic blockers

  • limited use now
  • sometimes used to orthopedic surgery to decrease BP and blood loss
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15
Q

classes of ganglionic blockers

A

first stimulate then block (nicotine)

block without first stimulating (Mecamylamine)

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16
Q

side effects of ganglionic blockers

A
  • dry mouth with difficulty swallowing
  • dilate pupils and cause cycloplegia
  • block body temperature regulation
  • severe urinary regulation
  • severe constipation