Hyperhidrosis Flashcards
what is the post-ganglinc sympathetic innervation for the two types of glands
- eccrine - Ach
2. apocrine - catecholamines
what are the sweat gland receptors?
alpha 1 has localized effect and M2/M3 have generalized effect
How does the SNS affect the sweat glands in skin and mucosal blood vessels
via alpha 1 and 2 contriction
How does the PNS affect the sweat glands in skin and mucosal blood vessels
there is no direct innervation. NO-derived dilation in response to exogenous agents
What are the adverse effects of AchEsterase Inhibitors (Cholinergic agonists?)
DUMBBELS Diarrhea Urination Miosis/muscle weakness Bronchorrhea Bradycardia Emesis Lacrimation Salivation/sweating
What are the adverse effects muscarinic antagonists?
constipation, urinary retention, mydriasis/blurred vision, large bronchiole dilation, tachycardia, antiemesis, decreased glandular secretions, restlessness, confusion, delirium, hallucinations
What happens to the electrolytes of a cell when Ach binds?
increases IC Ca causing K+ and water loss leading to cell shrinkage
What is the progression of Rx for primary axillary hyperhidrosis?
- topical antiperspirant
- onabotulium toxin A
- consider systemic medications
- endoscopic thoracic sympathectomy
MOA of botulinum toxin
Heavy chain portion binds to cell membrane and is endocytosed. –> Light chain cleaves protein (SNAP25) that enables fusion of Ach vesicles w/ cell membrane.
* also blocks release of pain neuropeptides
How can body overcome botulinum toxin?
sprouting – new nerve endings sprout and reconnect the muscle
adverse effects of botunlinum toxin?
Fucked up face. systemic botulism is rare. typical anticholinergic effects, contains albumin so HSR possibility
glycopyrrolate MOA
Anti-Muscarnic agent; quaternary ammonium compound that doesn’t cross BBB
what does propranolol do?
reduce sympathetic CNS stimulation - emotional stability improved
Diltiazem MOA
blocks Ca channel involved in secretion process
