Dr. Omar Rashid Sadeq., MD., Ph.
D
Assistant Head of Basic medical Sciences
Assistant Professor of Basic Medical Sciences Unit
Head of Pharmacology Department.
.
Divisions of The ANS
Autonomic Nervous System
Autonomic NS is subdivided into:
1. Sympathetic division: (thoracolumbar).
• Preganglionic fibers: are short ► most of them form
2 paravertebral chains (ganglia ) and prevertebral
ganglia ►postganglionic fibers ►visceral organs.
• Adrenal medulla: sympathetic ganglion without
postganglionic fibers.
Parasympathetic division: (Craniosacral division).
• Preganglionic fibers, cranial nerves (III, IV,IX,X)
and sacral nerves►ganglia (near or within organs)
►postganglionic fibers ►visceral organs.
Enteric division: ENS:
• Location: within the wall of G.I.T, preganglionic
PSNS and postgaglionic S.N.S
• Myenteric plexus: b/n circular and longitudinal
fibers.
• Submucous plexus.
• Interconnection of SNS and PSNS.
Organs receiving only sympathetic innervations: Adrenal medulla, kidney, blood
vessels, pilomotor muscles, sweat glands and liver.
Organs receiving only parasympathetic innervations: Lacrimal glands, bronchiloles
and glands GIT.
ANS Receptors
Sympathetic NS Parasympathetic NS
Adrenergic Cholinergic
neurotransmitters neurotransmitters
Alpha Beta
receptors receptors Muscarinic Nicotinic
β1
Catecholamines β2 Decreased
Tachycardia &
contractility and
HTN
HR
Contraction / Relaxation
Stimulation of VSM
Sites of ANS Drugs Action
How Do Drugs Influence The ANS?
Mimic or block the effects of the two primary
neurotransmitters, Acetylcholine and
Norepinephrine/Epinephrine.
Drugs that mimic neurotransmitters are referred to
as “receptor agonists”
These drugs activate receptors.
Drugs that block neurotransmitters are referred to as
“receptor antagonists”.
These drugs block the endogenous
neurotransmitters from activating receptors.
Classification of Drugs Affecting The ANS
Parasympathetic nervous system:
1. Mimic acetylcholine = cholinergic = muscarinic
agonists = parasympathomimetic
2. Block acetylcholine = anticholinergic =
muscarinic antagonist = parasympatholytic
Sympathetic nervous system:
1. Mimic norepinephrine = adrenergic = adrenergic
agonist = sympathomimetic
2. Block norepinephrine = antiadrenergic =
adrenergic antagonist = sympatholytic
Classification of Cholinoceptors
Classification of Cholinoceptors
Clinical Pharmacology of Cholinomemetics
Drugs with no clinical uses: Ach, carbachol as miotic
I. The Eye:
Glaucoma (↑ IOP)→ damage of retina IICN→
blindness
1. Cholinomemitics:
a. Contraction of ciliary body cyclospasm, ↑
outflow.
b. Decreased production of aqueous humour.
ACUTE GLUCOMA: pilocarpine +physostigmine.
Eye Anatomy
Toxicity of Chlinomimetics
Hyperactivity of parasympathetic NS:
SLUDGEM: Useful to remember some of the
symptoms of increased cholinergic stimulation
through the mnemonic:
Salivation,
Lacrimation,
Urination,
Defecation,
GIT upset:
Emesis
Miosis or Muscle spasm.
X X
Muscarinic receptor blockade does not interfere with
transmission at autonomic ganglionic sites, the adrenal medulla,
or skeletal muscle fibers. Sympathetic adrenergic functions are
not affected.
In Dual Innervated Organs, Muscarinic Receptor Blockade
Allows Sympathetic Dominance
X
Toxicity of Antimuscarinic Cholinoblockers
Dry mouth, blurred vision (cycloplegia), tachycardia, agitation, hot
and flashed skin, body temperature, constipation, and urinary
retention. These effects are memorized in the adage dry as bone,
blind as a bat, red as beet, mad as a hatter.
Classification of Adrenoceptors
Alpha -Receptors
Adrenergic Receptors
Subdivisions of The Autonomic Nervous System
Sympathetic Parasympathetic
Primary Norepinephrine
Acetylcholine
Neurotransmitter Epinephrine (~20%)
Receptors Adrenergic GPCRs Muscarinic GPCRs
& 1 – IP3/DAG, [Ca2+] M1 – IP3/DAG, [Ca2+]
Second 2 - cAMP M2 – cAMP
Messenger M3 – IP3/DAG, [Ca2+]
Systems 1 - cAMP
Adrenal 2 - cAMP
3 - cAMP
Adrenal Medulla E- 80% NE-20 %
Adrenergic Receptor Subtypes
Thank you…
WITH MY BEST
WSIHES
