Autonomic cardiovascular control during a novel pharmacologic alternative to ganglionic blockade.
Clin Pharmacol Ther
; 83(5): 692-701, 2008 May.
Article
en En
| MEDLINE
| ID: mdl-17687267
ABSTRACT
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 alpha-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.
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Base de datos:
MEDLINE
Asunto principal:
Trimetafan
/
Sistema Cardiovascular
/
Dexmedetomidina
/
Bloqueadores Ganglionares
/
Glicopirrolato
Tipo de estudio:
Clinical_trials
Idioma:
En
Revista:
Clin Pharmacol Ther
Año:
2008
Tipo del documento:
Article