Ganglionic Blocking Agents
Ganglionic
blocking agents such as hexamethonium,
meca-mylamine, pempidine, pentolinium, and trimethaphan areeffective antihypertensive drugs, but their use is
now curtailed to the treatment of hypertension associated with dissecting
aneurysm of aorta. They interfere with neurotransmission in sympathetic and
parasympathetic ganglia.
·
Constipation (sometimes diarrhoea),
paralytic ileus, urinary retention, impotence, dry mouth, postural hypotension,
tachycardia, drowsiness, and blurred vision.
·
Various arrhythmias (AV block, left
bundle branch block, ventricular fibrillation) have been reported with
trimetha-phan therapy. Respiratory arrest has also been reported following high
doses. Chronic therapy has led to coughing, dyspnoea, and intra-alveolar and
interstitial pulmonary fibrosis.
1.Respiratory arrest can occur.
2.Mydriasis, urinary retention, and
seizures may occur, espe-cially following large doses of mecamylamine. Tremor,
hallucinations, and confusion may also follow high dose mecamylamine.
·
Intravenous crystalloid boluses.
·
Attempt initial control of seizures
with a benzodiazepine (diazepam or lorazepam). If seizures persist or recur
admin- ister phenobarbitone.
·
Physostigmine or neostigmine (0.5 to
1 mg IV, slowly) have proved useful in some cases.
·
Gastrointestinal function may be
restored with cholinergic agents such as bethanechol.
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