No

Ganglionic Blocking Agent

Treatment of moderately severe to severe hypertension and in uncomplicated malignant hypertension

C

Coronary insufficiency, pyloric stenosis, glaucoma, uremia, recent myocardial infarction, unreliable, uncooperative patients

Use with caution in patients receiving sulfonamides or antibiotics that cause neuromuscular blockade; use with caution in patients with impaired renal function, previous CNS abnormalities, prostatic hypertrophy, bladder obstruction, or urethral strictive; do not abruptly discontinue

Percentage unknown: Postural hypotension, drowsiness, convulsions, confusion, mental depression, decreased sexual ability, xerostomia, loss of appetite, nausea, vomiting, bloating, frequent stools, followed by severe constipation, dysuria, uncontrolled movements of hands, arms, legs, or face, trembling, blurred vision, enlarged pupils, shortness of breath

Symptoms of overdose include hypotension, nausea, vomiting, urinary retention, constipation. Signs and symptoms are a direct result of ganglionic blockade.

Treatment is supportive; pressor amines may be used to correct hypotension; use caution as patients will be unusually sensitive to these agents.

Increased effect with sulfonamides and antibiotics that cause neuromuscular blockade; action of mecamylamine may be increased by anesthesia, other antihypertensives, and alcohol

Mecamylamine is a ganglionic blocker. This agent inhibits acetylcholine at the autonomic ganglia, causing a decrease in blood pressure. Mecamylamine also blocks central nicotinic cholinergic receptors, which inhibits the effects of nicotine and may suppress the desire to smoke.

Adults: Oral: 2.5 mg twice daily after meals for 2 days; increased by increments of 2.5 mg at intervals greater than or equal to 2 days until desired blood pressure response is achieved; average daily dose: 25 mg (usually in 3 divided doses)

Dosing adjustment/comments in renal impairment: Use with caution, if at all, although no specific guidelines are available

Should be administered after meals

May cause drowsiness, confusion, or depression

None reported

No information available to require special precautions

>10% of patients experience dry mouth

Take after meals at the same time each day; notify physician immediately if frequent loose bowel movements occur; rise slowly from sitting or lying for prolonged periods; do not restrict salt intake

Check frequently for orthostatic hypotension; aid with ambulation

Tablet, as hydrochloride: 2.5 mg

Harington M and Kincaid-Smith P, "Psychosis and Tremor Due to Mecamylamine," Lancet, 1958, 1(7019):499-501.

Rokseth R and Storstein O, "Pulmonary Complications During Mecamylamine Therapy," Acta Med Scand, 1960, 167(1):23-7.

Sanberg PR, Shytle RD, and Silver AA, "Treatment of Tourette's Syndrome With Mecamylamine," Lancet, 1998, 352(9129):705-6.