GANGLION STIMULANTS

&






BLOCKING AGENTS













PROF. DR. S. MOSHIN TURAB
 GANGLION
A ganglion is a
nerve cell cluster or
a group of nerve
cell bodies located
in the autonomic
nervous system and
sensory system
 GANGLION STIMULANTS
 GANGLIONIC STIMULANTS
Agents that mimic neural transmission by
stimulation of the nicotinic receptors on
postganglionic autonomic neurons
e.g-Nicotine, lobeline, verenicline
 GANGLION STIMULANTS

 Selective nicotinic • Non

agonists Selective/Muscarinic
agonists
 Nicotine(small dose)
 Lobeline  Acetylcholine
 Dimethyl phenyl
 Carbachol
 Tetramethyl
ammonium(TMA)  Pilocarpine
 Varenicline  Anticholiester
MECHANISM OF GANGLION
STIMULANTS
 ACTIONS

 Activation of nicotinic • Stimulation of nicotinic

receptors on the plasma receptors at NMJ
membrane of the cells of
the adrenal medulla
 Contraction of skeletal muscle


Exocytotic release of E and NE
Actions
Treatment of smoking cessation/quiting
tobacco chewing
 Majority of smokers ( tobacco chewers) wish to
quit smoking/chewing, but fail to do so because
of nicotine dependence
 Measure to help smokers quit is counseling and
motivation
 The goals of pharmacotherapy are
 To reduce the craving foe the satisfying (reward)
effects of nicotine
 To suppress the physical withdrawal symptoms
of nicotine
The drugs currently utilized for the above goals
are
Nicotine replacement (nicotinic chewing gum)
Partial agonists of α4β2 NRs (Varenicline)
Antidepressants (Bupropion)
GANGLION BLOCKERS
 DEFINITION
 A ganglionic blocker (ganglioplegic) is a type of
medication that inhibits transmission between
preganglionic and postganglionic neurons in the
Autonomic Nervous System, often by acting as a
nicotinic receptor antagonist.
Muscarinic receptor subtypes in airways. M1 are localized to
parasympathetic ganglia. M2 on postganglionic cholinergic nerve terminals
inhibit the release of Ach. M3 that constrict airway smooth muscle.
CLASSIFICATION
 EFFECTS OF BLOCKING AGENT
Ganglionic blockers block both the parasympathetic nervous system
and sympathetic nervous system, the effect of these drugs depends
upon the dominant tone in the organ system.
Mechanism of action
Mechanism of action
 Antihypertensive use
The competitive ganglion blockers were used in the 1950s for hypertension and
peptic ulcer but have been totally replaced now because they produce a number of
intolerable side effects
Indication of ganglion blocker
 Malignant hypertension.
 Neurosurgery to control hypotension.
 Orthopedic surgery to control hypotension.
 Autonomic hyper reflexia.
Side effects
 Cardiovascular: Orthostatic hypotension with or
without reflex tachycardia
 ENT/glands:
ENT/glands xerostomia, dry eyes, blurred vision,
reduced bronchial secretion, hypohidrosis
 GIT: gastroparesis, constipation, urinary
retention
 Sexual dysfunction:
dysfunction failure of erection and
ejaculation
 in overdose risk of peripheral circulatory
collapse (shock) and paralytic ileus
THANKS