Figure 718

Central and peripheral adrenergic neuronal blocking agents. Rauwolfia alkaloids act both within the central nervous system and in the peripheral sympathetic nervous system [6,9]. They effectively deplete stores of norepinephrine (NE) by competitively inhibiting the uptake of dopamine by storage granules and by preventing the incorporation of norepinephrine into the protective chromaffin granules; the free catecholamines are destroyed by monoamine oxidase. The predominant pharmacologic effect is a marked decrease in peripheral resistance; heart rate and cardiac output are either unchanged or mildly decreased.

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