Term
| nicotine (Nicorette, NicoDerm, Nicotrol) |
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Definition
| ganglionic stimulant (nicotinic agonist) at low doses and depressant (nicotinic antagonist) at very high doses; used to treat addiction to cigarrette & cigar smoking and tobacco chewing; |
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Term
| Important Sites of Action of Nicotine |
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Definition
| acts on all subtypes of nicotinic receptors in body; CNS (hypothalamus, medullary centers, chemoreceptor zones); cardiovascular & GI via Autonomic Nervous System; Skeletal muscle at neuromuscular junctions |
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Term
| Effects of low doses of Nicotine on CNS |
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Definition
| acts on site of addiction; initially stimulates, causing increased respiration; also can cause vomiting by stimulating Chemoreceptor Trigger Zone (CTZ) |
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Term
| Effects of high doses of Nicotine on CNS |
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Definition
| initial CNS stimulation, then depression |
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Term
| Effects of low doses of Nicotine on CVS |
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Definition
| initially stimulates autonomic ganglia to produce largely adrenergic predominance --> increased peripheral vasoconstriction with acute hypertension |
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Term
| Effects of high doses of Nicotine on CVS |
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Definition
| causes a fall in BP due to reversal of its ganglionic stimulating action to a ganglionic blocking action |
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Term
| Effects of low doses of Nicotine on GI |
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Definition
| at this dose, it causes increased GI motility |
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Term
| Effects of high doses of Nicotine on GI |
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Definition
| at this dose, it causes decreased GI motility |
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Term
| Low dose nicotine toxicity |
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Definition
| increased flow of saliva, nausea, vomiting, abdominal cramps, diarrhea |
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Term
| High dose nicotine toxicity |
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Definition
| fainting, drop in blood pressure, prostration, collapse |
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Term
| Using atropine to treat side effects of nicotine |
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Definition
| this is an anticholinergic use to treat high levels of nicotine that cause GI symptoms (nausea, vomiting, cramps, diarrhea) due to parasympathetic ganglion stimulation |
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Term
| Adrenergic agonists used to treat high levels of nicotine |
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Definition
| use these drugs to treat high levels of nicotine that block neurotransmission through ganglia that support the cardiovascular system; |
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Term
| Therapeutic Goal of Nicotine gum, patches, inhalers, etc. |
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Definition
| 1) wean a patient off addiction to nicotine from smoking by gradually decreasing dosage of such controlled systems; |
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Term
| Treating accidental nicotine ingestion by children |
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Definition
| may need to induce vomiting followed by passage of activated charcoal through stomach |
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Term
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Definition
| ganglionic blocker used to treat very severe and/or malignant hypertension (high doses) and to treat Tourette's syndrome & suppress nicotine addiction (low doses) |
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Term
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Definition
| drug that blocks neuronal nicotinic receptors of ganglionic cell body, blocking transmission from pre-ganglionic to post-ganglionic fibers; this blockade DOES NOT affect post-ganglionic autonomic nerve terminals (pts can still respond to autonomic agonists like muscarinic & adrenergic receptor stimulants); DOES NOT affect neuromuscular nicotinic receptors so they will still be able to move their skeletal muscle |
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Term
| Adverse effects to mecamylamine (Inversine) |
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Definition
| postural hypotension symptoms due to interference with compensatory baroreflexes; dry mouth & difficulty swallowing; decreased GI and GU motility (constipation, urinary hesitancy); mydriasis (pupillary dilation), cycloplegia (loss of near vision, blurred vision); sedation & other CNS side effects |
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Term
| Antidotes for Ganglionic Blockade Toxicity |
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Definition
| if pt goes into neurogenic shock after taking mecamylamine (Inversine), give NE for cardiovascular support |
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