Pharmacological Actions

In any given tissue, the magnitude of the response produced by ganglionic blocking drugs depends largely on the quantity and relative proportion of the total autonomic input coming from sympathetic and parasympathetic nerves at the time of drug administration (Table 14.2). For example, if cardiac vagal tone is high at the time ganglion blockade is induced, tachycardia results. If heart rate is high, a decrease in rate may be seen.

The extent of the hypotension, especially postural hypotension, produced by a ganglionic blocking agent also depends on the degree of sympathetic tone at the time of drug administration. For instance, patients with normal cardiac function may have their cardiac output diminished after ganglionic blockade, while patients in cardiac failure often respond to ganglionic blockade with an increase in cardiac output. To date, it has not been possible to develop ganglionic blocking drugs that have a high degree of selectivity for either sympathetic or parasympathetic ganglia. However, since these drugs do not affect all of the various ganglia equally, and since the time at which their peak effect occurs will vary among the various types of ganglia, some degree of selectivity of action does in fact exist.

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