atropine sulphate + hexamethonium bromide

This is a combination drug consisting of atropine sulphate and hexamethonium bromide. Atropine is a competitive antagonist of muscarinic acetylcholine receptors, classified as an antimuscarinic or anticholinergic agent. It inhibits the action of acetylcholine on smooth muscle, cardiac muscle, secretory glands, and in the central nervous system. Hexamethonium bromide is a ganglionic blocker that acts as an antagonist at nicotinic acetylcholine receptors in autonomic ganglia, thereby inhibiting transmission through both sympathetic and parasympathetic ganglia. The combination has been studied for its effects on airway reactivity (e.g., bronchoconstriction/bronchodilation) and gastrointestinal motility. In clinical studies, inhaled hexamethonium caused bronchoconstriction which was reversed by inhaled atropine; together they provided some protection against histamine-induced bronchoconstriction[1]. The combination has also been used to induce pharmacological vagal blockade for research purposes[3].