Pharmacology and clinical use of ganglionic blocking agents in the treatment of hypertension

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      Hexamethonium, pentolinium and mecamylamine are all classified as ganglionic blocking agents. However, mecamylamine appears to be the compound of choice because of longer duration of action, gastrointestinal absorbability and smoothness of effect.
      Regardless of which ganglionic blocking agent is used, the same caution should be observed in the administration of these potent compounds. First, the dose should be titrated on an individual basis; secondly, the clinician should be aware of the side effects associated with each compound and know how to combat them; thirdly, the advantages of combination therapy such as diuretics and/or rauwolfia compounds; and last, but not least, observations on the blood urea nitrogen to prevent unnecessary complications.
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