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autonomic

autonomic

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Published by: Danielle on Feb 20, 2011
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11/23/2013

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CHOLINERGIC & PARASYMPATHOMIMETIC AGENTS
cholinergic and parasympathomimetic agents can be divided into three groups,1.Choline esters- carbachol, methacholine2.Alkaloids- pilocarpine, muscarine, arecoline3.Anticholinesterases- neostigmine, pyridostigmine
The Parasympathetic Nervous System
 acetylcholine
(ACh) serves as the synaptic transmitter at,a.all autonomic ganglia, SNS & PNSb.postganglionic parasympathetic nerve endingsc.postganglionic SNS endings to eccrine sweat glandsd.neuromuscular junctione.central nervous systemACh also has a direct
vasodilator
action on arterioles, despite the absence of PNS innervation
 choline acetyl transferase
cataylses the formation of ACh from
 choline
and
 acetyl-CoA
the later is synthesised in the nerve terminal & choline taken up by active transport from the ECFwithin the nerve, ACh is stored in synaptic vesicles, which are released as discrete
"
quanta
"
inresponse to depolarisation of the nerve terminal and an increased influx of Ca
++
 there are a number of different ACh receptors throughout the body,a.nicotinic- autonomic ganglia & adrenal medulla- neuromuscular junctionb.muscarinic- autonomic effector cells
 muscarinic receptors
have been further subdivided into,1.M
1
-receptorswhich appear to be localised to the CNS and perhaps the PNS ganglia
 pirenzipine
, still under investigation, is selective at M
1
receptors2.M
2
-receptorswhich are the non-neuronal receptors of smooth muscle, cardiac muscle, andglandular epithelium
 bethanecol 
appears to be a selective agonist at M
2
receptors
Autonomic Pharmacology
1
 
the cellular events associated with receptor activation remain uncertain, but may involve,a.accumulation of cGMPb.increased permeability to monovalent ionsc.hydrolysis of phosphatidylinositold.mobilization of, or increases in the intracellular [Ca
++
]e.inhibition of adenylate cyclase
cAMP rapid hydrolysis of ACh at the synaptic cleft by
 acetylcholinesterase
(AChE) inactivates theenzymethis enzyme is distinct from butyrocholinesterase BChE found in the plasma
Autonomic Pharmacology
2
 
Physiological Responses to Cholinergic Stimulation
TissueResponse
EyeSphincter muscle (iris)Ciliary musclecontraction- miosiscontraction- near visionHeartSA nodeAtriaAV nodeVentricledecrease in HRdecrease in contractilitydecrease in conduction ± block ± decrease in contractilityLungBronchial smooth muscleBronchial glandsconstrictionincreased secretionStomachGastric smoothSphinctersGastric glandsincreased motility & tonerelaxationincreased secretionIntestinesIntestinal smoothSphinctersIntestinal glandsincreased motility & tonerelaxationincreased secretionBladderDetrusorTrigone & internal sphinctercontractionrelaxationAdrenal Medullaincreased secretion NA & AExocrine glandsPancreasSalivaryLacrimalPharyngealincreased secretionincreased secretionincreased secretionincreased secretionSweat Glandsincreased secretionSexual organserection (male)
Autonomic Pharmacology
3

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