Although effective at reducing salivary or bronchial secretions that are vagally
mediated, anticholinergic medications have limited usefulness in diminishing rattling that is related to other underlying pathology (Wildiers & Mentens, 2002).
However, Patient 12 had vagally
induced PAF but an observational period of only 3 months.
Could the presence of too much mucus in the nose and throat be the result of direct irritation from LPR or the result of vagally
mediated responses to throat irritation?
Although the exact mechanism of atrial fibrillation after European hornet sting is unknown, it may involve vagally
mediated shortening of atrial refractoriness, the venom itself, and/or the human catecholamine response to bee stings (2,4).
In the second, gastric reflux irritates the esophageal tissue enough to evoke laryngeal reflexes without ever reaching the larynx--a vagally
mediated response associated with symptoms such as chronic cough, throat-clearing sensations, and bronchoconstriction.
mediated sinus bradycardia occurs as a physiological response to apnoea and hypoxaemia.
These drugs work by inhibiting vagally
Opioid-induced hypotension is most likely caused by a centrally mediated decrease in sympathetic tone and vagally
induced bradycardia (33).
Explanations for the superiority of anticholinergic action in COPD are debated but may relate to the complicated, inflammatory, noncholinergic pathways seen in asthma, especially due vagally
mediated reflex bronchoconstriction.
The micro-aspiration of acid and vagally
mediated bronchospasm triggered by intra-esophageal acid exposure have also been implicated in GERD-associated asthma (Wu, 1994).
The bradycardic component of the vasovagal response is vagally
mediated whilst vasodilatation (and hence hypotension) is believed to result from sympathetic withdrawal (4).
mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure.