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Ans pharmacology

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KMU (IPM&R)
pharmacology

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Ans pharmacology

  1. 1. ANS Pharmacology25th April, 2013
  2. 2. Important Things to Remember aboutANS• ANS/Visceral/Vegetative System involuntarilyregulates smooth muscles and glands» heart, respiratory system, GI tract, peristalsis (digestion),bladder, and eyes• Has two divisions i.e. PANS & SANS(homeostasis)• Both have relay stations (ganglia) b/w CNS &end organ.• Use the neurotransmitters Ach & NE
  3. 3. Anatomy of ANS•Pre & Post-ganglionic Neuron•Afferent Neurons•Sympathetic &ParasympatheticDivisions•Enteric Neurons•Innervate•motility, exocrine andendocrine, microcirculation ofGI
  4. 4. Parasympathetic Ganglionic SynapseAction PotentialNa+ACHAcetylcholinesteraseNa+Preganglionic neuronNicotinicReceptor
  5. 5. Parasympathetic Organ SynapseAction PotentialNa+ACHAcetylcholinesteraseK+GPostganglionic neuronMuscarinicReceptor
  6. 6. Sympathetic Ganglionic SynapseAction PotentialNa+ACHAcetylcholinesteraseNa+Preganglionic neuronNicotinicReceptor
  7. 7. Sympathetic Organ SynapseAction PotentialNa+NEPostganglionic neuronAdrenergicReceptor
  8. 8. SummarySummary of parasympathetic neuronsand synapsesPreganglionic neurons• Long• Synapse with postganglionicneurons at or near organ• Release acetylcholine (ACH) toactivate nicotinic receptors onpostganglionic neuronsPostganglionic neurons• Short• Synapse on the target organ• Release acetylcholine (ACH) toactivate muscarinic receptors onthe target organSummary of sympathetic neuronsand synapsesPreganglionic neurons• Short• Synapse with postganglionicneurons near spinal cord• Release acetylcholine (ACH) toactivate nicotinic receptors onpostganglionic neuronsPostganglionic neurons• Long• Synapse on the target organ• Release norepinephrine to activateadrenergic receptors on targetorgans
  9. 9. Summary
  10. 10. Exceptions in the sympathetic nervous system:• Sweat glands:» Postganglionic neuronsinvolved with stress-relatedexcretion releasenorepinephrine (“sweatypalms”)» Postganglionic neuronsinvolved withthermoregulation releaseacetylcholine
  11. 11. Exceptions in the sympathetic nervous system:• Kidneys:» Postganglionic neurons to thesmooth muscle of the renalvascular bed release dopamine• Adrenal gland:» Preganglionic neurons do notsynapse in the paraverterbralsympathetic ganglion» Preganglionic neurons synapsedirectly on the adrenalgland, release acetylcholine, andactivate nicotinic receptors onthe adrenal gland» Adrenal glands releaseepinephrine into systemiccirculation
  12. 12. Functions• Sympathetic Stimulation (Fight or Flight)– ↑HR, BP, blood flow– Diffuse distribution (more than one organ innervated)• Parasympathetic Stimulation (Rest & Digest)– Maintaining homeostasis– Discrete distribution/activation• Role of CNS– Reflex Arcs : Afferent input ~ hypothalamus, medulla oblongata, andspinal cord ~ efferent reflex impulse via ANS– Emotions:• Innervation by ANS– Dual– Only sympathetic (adrenal medulla, kidney, pilomotor muscles, andsweat glands)
  13. 13. Branch Type LocationTypical AgonistDrugsTypical AntagonistDrugsSympathetic(adrenergic)α1Most vascular arterioles, Sphincters of bladder& GI tract, Iris dilatorNorepinephrineEpinephrinePhenoxybenzaminePhentolaminePrazosinα2 GI tract, presynaptic sympathetic neuronsClonidineEpinephrineYohimbineβ1 Heart muscle, Salivary glands, Fat cellsNorepinephrineIsoproteronolDobutamineEpinephrine"Beta blockers"PropranololMetoprololβ 2Bronchioles of lung, Arterioles of skeletalmuscles, brain and lungs, Bladder wall, GITEpinephrineIsoproteronolAlbuterol"Beta blockers"PropranololButoxamineParasympathetic(cholinergic)MHeart muscle, Sphincters of bladder & GI tractBronchioles of lung, Sweat glands IrisconstrictorAcetylcholineMuscarineCarbacholAtropineScopolamineN Neuromuscular junctions, Autonomic gangliaAcetylcholineNicotineCarbacholCurare
  14. 14. Dual Innervation of the Iris
  15. 15. Without Dual Innervation• Some effectors receive only sympathetic– adrenal medulla, arrector pili muscles, sweat glandsand many blood vessels• Sympathetic tone– a baseline firing frequency– vasomotor tone provides partial constriction• increase in firing frequency = vasoconstriction• decrease in firing frequency = vasodilation• can shift blood flow from one organ to another as needed– sympathetic stimulation increases blood to skeletal and cardiacmuscles -- reduced blood to skin
  16. 16. Classification of drugs affecting the ANS• Parasympathetic nervous systemMimic acetylcholine = cholinergic = muscarinic agonists = parasympathomimeticBlock acetylcholine = anticholinergic = muscarinic antagonist = parasympatholytic• Sympathetic nervous systemMimic norepinephrine = adrenergic = adrenergic agonist = sympathomimeticBlock norepinephrine = antiadrenergic = adrenergic antagonist = sympatholytic

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