The Full Wiki

More info on Trimethaphan

Trimethaphan: Wikis

Advertisements

Note: Many of our articles have direct quotes from sources you can cite, within the Wikipedia article! This article doesn't yet, but we're working on it! See more info or our list of citable articles.

Encyclopedia

(Redirected to Trimetaphan camsilate article)

From Wikipedia, the free encyclopedia

Trimetaphan camsilate
Systematic (IUPAC) name
decahydro-2-oxo-1,3-bis(phenylmethyl)-
thieno(1',2':1,2)thieno(3,4-d)imidazol-5-ium
Identifiers
CAS number 7187-66-8
ATC code C02BA01
PubChem 23576
DrugBank APRD00044
Chemical data
Formula C 22H25N2OS1 (free base) 
Mol. mass 365.513 g/mol (free base)
Pharmacokinetic data
Bioavailability  ?
Metabolism  ?
Half life  ?
Excretion Renal, mostly unchanged
Therapeutic considerations
Pregnancy cat. D(US)
Legal status
Routes Oral, IM, IV

Trimetaphan camsilate (INN) or trimethaphan camsylate (USAN), trade name Arfonad, is a drug that counteracts cholinergic transmission at the ganglion type of 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.

Contents

Effects

Trimetaphan is a sulfonium compound 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.

Trimetaphan 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. Trimethaphan causes a histamine release which further lowers blood pressure. Effects on the heart include a decreased force of contraction and an increase in heart rate (tachycardia). Reflexive tachycardia can be diminished or undetected because trimetaphan 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 trimetaphan 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


Advertisements

Advertisements






Got something to say? Make a comment.
Your name
Your email address
Message