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Shivering is a mechanism to generate heat. Autonomic neural regulation of cutaneous blood flow and sweat production permit homeostatic control of body temperature (A). The sympathetic system can either reduce heat loss via vasoconstriction or promote it by enhancing sweat production.
They are mostly used in combination with thiazide diuretics, e. g. , hydrochlorothiazide, because the opposing effects on K+ excretion cancel each other, while the effects on secretion of NaCl complement each other. b) Aldosterone antagonists. The mineralocorticoid aldosterone promotes the reabsorption of Na+ (Cl– and H2O follow) in exchange for K+.


The alkaloids, pilocarpine (from Pilocarpus jaborandi) and arecoline (from Areca catechu; betel nut) also act as direct parasympathomimetics. As tertiary amines, they moreover exert central effects. The central effect of muscarinelike substances consists of an enlivening, mild stimulation that is probably the effect desired in betel chewing, a widespread habit in South Asia.
Due to their cationic amphiphilic nature, the TCA exert membrane-stabilizing effects that can lead to disturbances of cardiac impulse conduction with arrhythmias as well as decreases in myocardial contractility. All TCA lower the seizure threshold. Weight gain may result from a stimulant effect on appetite.


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