The Hemodynamic Effects of Hypotensive Drugs in Man. Iii. Hexamethonium 123

While searching for derivatives of d-tubocura- rine, Barlow and Ing (1) and Paton and Zaimis (2) independently synthesized a series of poly- methylene bistrimethylammonium salts. The lat- ter investigators demonstrated that the pharma- cological properties of this series were related to the length of the polymethylene chain; the deca- compound produced neuromuscular block while the penta and hexa-compounds prevented the transmission of impulses across the synapses in all autonomic ganglia. They also carried out pre- liminary trials in man (3) but Arnold and Rosen- heim were the first to use these agents in hy- pertension (4). Finally, Restall and Smirk demonstrated that it was possible to reduce blood pressure and obtain clinical improvement in hyper- tensive patients for long periods by the use of repeated parenteral doses of hexamethonium (5).