Faculty of Pharmacy

Pharmacology 1
Pharmacology & Toxicology Department
Pharmacology (4141)
Fall 2021 fifth lab
Application on autonomic nervous system
Prepared by: Pharmacology and Toxicology Department
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Cholinomimetics Anti-Cholinergic drugs Nn (ganglionic R blockers)
Ach (endogenous) ttt: produce miosis during Nm (skeletal muscle relaxants)
ophthalmic surgery.
Choline esters Carbachol (Synthetic) ttt: glaucoma 1- Antimuscarinic: Atropine
1- Direct
Bethanechol (Synthetic) ttt: post operative urinary 1- Eye: Mydriasis , Cycloplesia.
restriction
2-GIT:M3 antispasmodic (-) motility
3-CVS: small dose : M1 (presynaptic) bradycardia
Nicotine ttt: Smoking deterrence large dose : M2 at SA node tachycardia
Alkaloids Muscarine ( no effect on blood vessels)
Pilocarpine ttt: Glaucoma (emergency) 4- Exo.glands: M3 Xerostomia (dry mouth)
Ach xerostomia.( salivation)
1- CVS : M3 Heart V.D Cholinergic (-) lacrimal and bronchial secretions
2-Exo.glands: M3 secretions (-) sweat glands secretions body temp.
3- Sm: lung M3 bronch.const and secretions
drugs
GIT M3 motility and M1 (+) gastric acid secretions
ttt: ophthalmic, antispasmodic, antisecretory,
Urinary bladder:M3 motility of the wall and relax of sphincter antidote for cholinergic agonists, bradycardia.
Eye M3 circular muscle contraction: Miosis S.E: blurred vision (sandy eye), dry mouth, urinary
ciliary muscles : near vision accommodation retention, glaucoma, tachycardia, CNS effects.
Indirect (Anticholinesterase) : Reversible or Irreversible 2- Scopolamine: ttt: motion sickness,
a) Reversible (short or intermediate acting):
1-Edrophonium: diagnosis of MG (IV) but high dose cholinergic crisis. post operative nausea and vomiting.
2- Physiostigmine: (interm.) ttt of overdoses of atropine. 3- Ipratropium: ttt: asthma and COPD.
3- Neostigmine: (interm.) ttt MG , intestinal and bladder atony , antidote for 4- Tropicamide: Ophthalmic.
comp, NM-blocking agents.
4-Pyridostigmine: Chronic management of MG.
5- Benztropine: Parkinson.
5- Donepezil and Galantamine: ttt of Alzheimer. 6-Oxybutin: urinary incontinence.
b) Irreversible:
Organophosphates : gases (Sarine: nerve gas) and insecticides (parathion and
malathion: head lice)
 Sympathomimetics

Direct Indirect

Release agents
Amphetamines Reuptake inhibitors
α β
Ephedrine Cocaine
tyramine

α1 selective α2 selective Nonselective β1 selective β2 selective β3 selective

Phenylephrine Clonidine Isoproterenol Dobutamine Albuterol Mirabegron
Epinephrine (α,β) α agonist:
1- Heart: β1 (+) inotropic (+) vol. 1- α1 selective:
(+) chronotropic (+) HR Phenylephrine
2-Blood vessels: β1 : Kidney: (+) renin (+) Ang II (+) PR Mild (+)SBP/DBP (Reflex bradycardia)
Liver& skin: V.D (-) PR dec. ttt: Nasal decongestant, ophthalmology (Mydriasis), hypotension
in PR in hospitalized patients
α1: Skin &GIT: V.C (+) PR
2- α2 selective:
3- Respiratory: β2 bronchodilation. 1- Clonidine (Central)
(-) histamine in allergy (-) VMS (-) sympathetic outflow to periphery (-) BP
4-Metabolic: (+) blood glucose (Hyperglycemia). ttt: essential HTN
β2 (+) glycogenolysis (+) glycogen (anti-insulin). 2- α methyl dopa
α2 (-) insulin Sympatho α methyl noradrenaline (false transmitter).
ttt: Anaphylactic shock, Cardiac arrest, prolonged local ttt: HTN in pregnancy.
mimetics
anesthesia L.A+ Weak soln. Ep V.C α1 S.E: Sedation and drowsiness.
β agonists:
Norepinephrine (mainly α) 1- nonselective β agonist:
1- Blood vessels: α1 (+) V.C (+) SBP&DBP Isoproterenol
ttt: Circulatory shock α1 (+) PR (+)BP 1- Heart: β1 (+) inotropic.
(+) chronotropic.
Not used : Asthma or LA (tissue necrosis)
2- Blood vessels: β2 V.D (-)PR
2- Heart: β1 (+) inotropic (+) vol. (+)SBP/(-)DBP
(+) chronotropic (+) HR ttt: stimulation of the heart in emergency situation.
(-)chronotropic (reflex baroreceptors) reflex 2- β1 selective agonist: Dobutamine (+) C.O in congestive heart failure
bradycardia without O2 demand (adv.).
3-β2 selective agonist: Salbutamol (short acting β2 agonist)
ttt: bronchodilator (inhaled)
S.E: tremors & tachycardia or arrythmia (systemically)
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