Ganglionic Stimulants & Blocking Agents

Ganglionic Stimulants & Blocking Agents

Ganglionic Stimulants

a. Selective nicotinic agonists

•  Nicotine (small dose)
•  Lobeline
•  Dimethyl phenyl piperazinium (DMPP)
•  Tetramethyl ammonium (TMA)
•  Varenicline

b. Nonselective/muscarinic agonists

•  Acetylcholine
•  Carbachol
•  Pilocarpine
•  Anticholinesterases
•  MCN 343-A

Ganglionic Blocking Agents

a. Competitive blockers

  i) Quaternary ammonium comps.

•  Hexamethonium
•  Pentolinium

 ii) Amines

• Mecamylamine 
• Pempidine 

iii) Monosulfonium comp.

• Trimethaphan- camforsulfonate

b. Persistent depolarizing blockers

• Nicotine (large dose) 
• Anticholinesterases (large dose)

Preparations 

1. Nicotine transdermal: NICOTINELL-TTS 10, 20, 30 cm2 patches releasing 7, 14, 21 mg nicotine per 24 hr respectively. In those smoking > 20 cigarettes every day—start with 30 cm2 patch, shift to smaller patches every 3–5 days, treat for 3–4 weeks. 

2. Nicotine chewing gum: NULIFE 1, 2, 4 mg chewing gum; In those smoking > 20 cigarettes/day—start with 4 mg gum chewed slowly for 30 min when urge to smoke occurs—gradually reduce to 2 mg gum and then 1 mg gum. In less heavy smokers—start at lower doses.