Trimethaphan

Revision as of 23:17, 24 July 2014 by GeraldChi (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search
Trimethaphan
Clinical data
Routes of
administration
Oral, IM, IV
ATC code
Identifiers
CAS Number
PubChem CID
DrugBank
E number{{#property:P628}}
ECHA InfoCard{{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value).
Chemical and physical data
FormulaC22H25N2OS
Molar mass365.513 g/mol

WikiDoc Resources for Trimethaphan

Articles

Most recent articles on Trimethaphan

Most cited articles on Trimethaphan

Review articles on Trimethaphan

Articles on Trimethaphan in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Trimethaphan

Images of Trimethaphan

Photos of Trimethaphan

Podcasts & MP3s on Trimethaphan

Videos on Trimethaphan

Evidence Based Medicine

Cochrane Collaboration on Trimethaphan

Bandolier on Trimethaphan

TRIP on Trimethaphan

Clinical Trials

Ongoing Trials on Trimethaphan at Clinical Trials.gov

Trial results on Trimethaphan

Clinical Trials on Trimethaphan at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Trimethaphan

NICE Guidance on Trimethaphan

NHS PRODIGY Guidance

FDA on Trimethaphan

CDC on Trimethaphan

Books

Books on Trimethaphan

News

Trimethaphan in the news

Be alerted to news on Trimethaphan

News trends on Trimethaphan

Commentary

Blogs on Trimethaphan

Definitions

Definitions of Trimethaphan

Patient Resources / Community

Patient resources on Trimethaphan

Discussion groups on Trimethaphan

Patient Handouts on Trimethaphan

Directions to Hospitals Treating Trimethaphan

Risk calculators and risk factors for Trimethaphan

Healthcare Provider Resources

Symptoms of Trimethaphan

Causes & Risk Factors for Trimethaphan

Diagnostic studies for Trimethaphan

Treatment of Trimethaphan

Continuing Medical Education (CME)

CME Programs on Trimethaphan

International

Trimethaphan en Espanol

Trimethaphan en Francais

Business

Trimethaphan in the Marketplace

Patents on Trimethaphan

Experimental / Informatics

List of terms related to Trimethaphan

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Trimethaphan is a drug that counteracts cholinergic transmission at the nicotinic receptors of the autonomic ganglia and therefore blocks both the sympathetic nervous system and the parasympathetic nervous system. It acts as a non-depolarizing competitive antagonist at the nicotinic acetylcholine receptor, is short-acting, and is given intravenously.

Effects

Trimethaphan is a quaternary amine and therefore carries a positive charge. Being charged, it cannot cross lipid cell membranes, such as those that comprise the blood-brain barrier. Due to this, trimethaphan does not have any effect on the central nervous system.

The ciliary muscle of the eye functions to round the lens for accommodation and is controlled mainly by parasympathetic system input. With administration of a ganglion-blocking drug, the ciliary muscle cannot contract (cycloplegia) and the patient loses the ability to focus their eyes.

Trimethaphan has a strong effect on the cardiovascular system. The size of blood vessels is primarily controlled by the sympathetic nervous system. Loss of sympathetic system input to the blood vessels causes them to get larger (vasodilation) which has the effect of lowering blood pressure. Postural hypotension is a common side effect of such drugs. Effects on the heart include a decreased force of contraction and an increase in heart rate (tachycardia). Although it is important to note that this reflexive tachycardia can be diminished or undetected due to the fact that Trimethaphan is also blocking the sympathetic ganglia innervating the heart.

The motility of the gastrointestinal tract is regulated by the parasympathetic system, and blockage of this input results in diminished motility and constipation.

Therapeutic Uses

The therapeutic uses of trimethaphan are very limited due to the competition from newer drugs that are more selective in their actions and effects produced. It is occasionally used to treat a hypertensive crisis and dissecting aortic aneurysm, to treat pulmonary edema, and to reduce bleeding during neurosurgery.

Adverse Effects

The adverse effects are due to its nonselective ganglion block and are described in the "Effects" section above. The side effects are severe enough to limit this drugs use to emergency and acute situations.

References

  • "Ganglion-blocking Drugs." Drug Benefits and Risks: International Textbook of Clinical Pharmacology. (2001). ISBN 0-471-89927-5
  • Katzung, Bertram G. Basic and Clinical Pharmacology, 9th ed. (2004). ISBN 0-07-141092-9