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Chapter: Basic & Clinical Pharmacology : Antihypertensive Agents

Ganglion-Blocking Agents

Historically, drugs that block activation of postganglionic auto-nomic neurons by acetylcholine were among the first agents used in the treatment of hypertension.

GANGLION-BLOCKING AGENTS

Historically, drugs that block activation of postganglionic auto-nomic neurons by acetylcholine were among the first agents used in the treatment of hypertension. Most such drugs are no longer available clinically because of intolerable toxicities related to their primary action .

Ganglion blockers competitively block nicotinic cholinoceptors on postganglionic neurons in both sympathetic and parasympatheticganglia. In addition, these drugs may directly block the nicotinic acetylcholine channel, in the same fashion as neuromuscular nico-tinic blockers (see Figure 27–6).


The adverse effects of ganglion blockers are direct extensions of their pharmacologic effects. These effects include both sym-pathoplegia (excessive orthostatic hypotension and sexual dys-function) and parasympathoplegia (constipation, urinary retention, precipitation of glaucoma, blurred vision, dry mouth, etc). These severe toxicities are the major reason for the abandonment of ganglion blockers for the therapy of hypertension.


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Basic & Clinical Pharmacology : Antihypertensive Agents : Ganglion-Blocking Agents |


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