Premium
Autonomic Cardiovascular Control During a Novel Pharmacologic Alternative to Ganglionic Blockade
Author(s) -
Wilkins BW,
Hesse C,
Charkoudian N,
Nicholson WT,
Sviggum HP,
Moyer TP,
Joyner MJ,
Eisenach JH
Publication year - 2008
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/sj.clpt.6100326
Subject(s) - baroreflex , phenylephrine , medicine , blood pressure , blockade , antagonist , pharmacology , anesthesia , agonist , glycopyrrolate , heart rate , endocrinology , atropine , receptor
The purpose of this study was to compare ganglionic blockade with trimethaphan (TMP) and an alternative drug strategy using combined muscarinic antagonist (glycopyrrolate, GLY) and α ‐2 agonist (dexmedetomidine, DEX). Protocol 1 : incremental phenylephrine was administered during control and combined GLY‐DEX, or control and TMP on two control combined GLY and DEX or TMP infusion on two randomized days. Protocol 2 : muscle sympathetic nerve activity (MSNA) and the baroreflex MSNA relationship was determined before and after GLY–DEX. Blood pressure was higher with GLY–DEX (99±3 mm Hg) and lower with TMP (78±3 mm Hg) relative to control (GLY–DEX: 90±2 mm Hg; TMP: 91±2 mm Hg; P <0.05). Incremental phenylephrine increased pressure during GLY–DEX ( P <0.01 vs control) and TMP ( P <0.01 vs control) to a similar degree. Both GLY–DEX and TMP infusion inhibited norepinephrine release ( P <0.01 vs control). GLY–DEX inhibited baseline MSNA ( P <0.05) and baroreflex changes in MSNA ( P <0.01). We conclude that the GLY–DEX alternative drug strategy can be used as a reasonable alternative to pharmacologic ganglionic blockade to examine autonomic cardiovascular control. Clinical Pharmacology & Therapeutics (2008); 83 , 5, 692–701. doi: 10.1038/sj.clpt.6100326