Hyperhydrosis Flashcards
post ganglionic sympathetic innervation of eccrine sweat gland is carried out by what molecule
Ach (this is extremely different because its usually NE)
post ganglionic sympathetic innervation to apocrine sweat glands is carried out by what molecule
Norepinephrine
where are eccrine sweat glands found
“Everywhere”–> soles of feet, forehead, palms, cheeks
where are appocrine sweat glands
axilla, butt, nards
Sympathetic innervation to sweat glands
alpha 1= localized effect +
M2 and M3= generalized effect +++
Skin an mucosal blood vessels
Sympa vs Parasympa
S: Alpha 1 and Alpha 2–> constriction
PS: none- NO carries out vasodilation
vasodilaiton of skin and mucosal boood vessels
no direct PS innervation–> NO mediated vasodilation occurs and is the main mechanism
Effects of Cholinergic Excess/ AchEi’s
DUMBBELS Diarrhea Urination Miosis/ Muscle ache Bradycardia Bronchorrhea Emesis Lacrimation Sweating
Effects of Cholinergic deficit
Constipation Urinary retention Mydriasis/blurred vision large bronchiole dilation tachycardia antiemesis dec gand secretion hypo-hydosis restlesss, confusion, delerium
MOA for Aluminum chloride agents
short term occlusion of eccrine and apocrine sweat gland ducts–> combines with kerratin to produce fibrillar contraction of ducts
MOA for botulinum toxin
LIGHT CHAIN–> cleaved SNAP25 that enables fusion of Ach vesicles with cell membrane–> Ach cann never be released into the cleft, because the VAMP cannot properly bind tot he SNARES
another thing botulinum toxin does
blocks release of pain neuropeptides
substance P, glutamate, CGRP
what makes up the VAMP (all are snare prots)
synaptobrevin–> on the Ach vesicle
what makes up the SNAPS (all are snare prots)
SNAP25 and syntaxin
blocks both muscarinic and nictoinic receptors
botulinum toxin A
Major side effect of botulinum toxin
systemic botulism–> respiratory arrest and death
other side effects of botulinum
anti-cholinergic effects
dry mouth, tiredness, HA, pain in injection site, decreased eye sight, droping eyeluds etc
other drugs for hyperhydrosis–> antimuscarinic effects might be problemeatic
ATROPINE–> access to BBB can be problematic–> limit dose
THIS SHIT IS NOT USED
QUATERNARY AMMONIUM COMPOUNDS
glycopyrrolate
propantheline
nicotinic and muscarinic blocker given orally
proprantheline
quaternary amines do not
cross BBB
teritary amine that crosse BBB
oxybutinin
tx of hyperhydrosis by reducing sympathetic CNS stimulation
propranolon and clonidine
anti-hydrotic that works by inhibiting Voltage dependent calcium channels in Ach secretion process
CCB’s–> diltaizem
only two places with sympathetic cholinergic dilator fibers
ECCRINE SWEAT GLANDS
Vascular Smooth Muscle in SKELETAL MUSCLE
