P R E S E N TAT I O N B Y S H R E E YA S H A R M A

DRUGS
ACTING ON
ANS
 D I R E C T LY A C T I N G
• These act by stimulating the nicotinic or muscarinic
CHOLINERGIC
receptors.
AGONIST
•
( PA R A S Y M PA T H O Choline esters
• Acetylcholine (all acetylcholine receptors)
MIMETICS) • Bethanechol (M3 receptors)
• Carbachol (all muscarinic receptors and some
nicotinic receptors)
• Methacholine (all muscarinic receptors)
• Plant alkaloids
• Arecoline
• Nicotine
• Muscarine
• Pilocarpine (M3 receptors): eyedrop for glaucoma IO
 BETHANECOL
CHOLINERGIC
• Stimulates muscarinic ACh receptor
AGONIST • Longer duration of action than ACh
• More resistant to cholinesterase mediated hydrolysis
( PA R A S Y M PA T H O
• S/c better than Oral
MIMETICS) • Adverse effects: vomitting, diarrhoea, salivation,
bradycardia, arrhythmia, hypotension,
bronchoconstriction
• Antagonists: other cholinergic and anticholinesterase
agents, quinidine, procainamide, adrenaline, atropine
• Dog: 5-25mg PO q. 8h
• Cat: 2.5-7.5 mg q.8h
 AT R O P I N E
CHOLINERGIC
• PAM
A N TA G O N I S T
• Reduce salivation and resp tract secretions
( PA R A S Y M PA T H O • treat bradyarrhymia
• antidote to OPC and carbamate poisoning, overdose
LY T I C S )
of cholinergic
• competitive antagonist at muscarinic Ach recpetor
• high doses: inhibit gastric secretion
• PAM: 0.02-0.4 mg/kg
cholinergic toxicity: 0.2-2.0 mg/kg, one quarter IV, rest
SC
incompatible with noradrenaline
CHOLINERGIC OTHERS:

A N TA G O N I S T • Pilocarpine
• Tropicamide
( PA R A S Y M PA T H O • Isopropamide
LY T I C S )
ACh receptor promoters:
Droperidol (antidopaminic, antiemetic, sedative,
antipsychotic)
Domperidone
Metoclopramide (against nausea vomitting and
emptying stomach)
 NON POLARIZING MUSCLE RELAXANTS

NICOTINIC
• Atracurium besylate (0.2-0.5 mg/kg BW),
A N TA G O N I S T pancuronium bromide (0.05-0.1 mg/kg BW),
pavulon,vecuronium bromide (0.05-0.1 mg/kg BW)
• Enhance muscle relaxation during surgery
• faciliatate mechanical ventilation
• competitively bind to cholinergic receptors at NMJ
causing muscle paralysis
• reversed using cholinesterase inhibitor
• Adverse effect: BP and heart rate increase, histamine
release (Vecuronium is the safest)
 DEPOLARIZING MUSCLE RELAXANTS

NICOTINIC
• succinylcholine chloride
A N TA G O N I S T • rapid onset (30-60s) and duration of action, used in
cats
• Ultra short acting
• Dogs 0.3 mg/kg IV
• Cats 1mg/kg IV
• lasts longer in cats, dogs are deficient in pseudo
cholinerase, prolonged in diseased condition
• similar action as Ach, arrythmias, muscle soreness,
myglobinuria
NICOTINIC C H O L I N E S T E R A S E I N H I B I TO R
• Neostigmine for tx of myasthenia gravis (disorder of
A N TA G O N I S T
NM transmission) and reversal of non depolarizing
muscle relaxants
• competitive reversible antagonist of enzyme
cholinesterase, prolonged transmission in cholinergic
synapses
• 0.1 mg/kg , reversal of muscle relaxation
• 0.5mg/kg myasthenia gravis
 ADRENALINE
• Injection as 0.1mg/mL (1:1000)
• Topical : hemorrhage (constriction of skin vessels
ADRENERGIC
and dilatation of skeletal muscle vessels)
AGONIST • Helps in anaphylactic shock
• reduces blood flow and alleviates edema of the
glottis (bites and stings)
• relaxes bronchial SM, reducing flow and congestion
• prolong action of LA, to prevent risk of arrhythmia
• used in hyotension
• cardiac resuscitation: 0.05-0.5 mg IV
• Anaphylaxis: 0.02mg/kg
• Dont inject in small appendages (cause necrosis)
ADRENERGIC
AGONIST OTHERS
Dobutamine
Phenylpromanolamine
Dopamine
Salbutamol (B2 agonist)
Ephedrine
Isoprenaline
Xylazine
 PHENOXYBENZAMINE
Tumor of adrenal medulla which causes high level of
ADRENERGIC catecholamines (Pheochromocytoma)
A N TA G O N I S T Relaz internal bladder sphincter
Reduce blood pressure by tick (Ixodes holocyclus)
Competitively blocks alpha adrenoceptor
If rapid IV hypotension
Dose: 0.25mg/kg PO (dog), up to 1.5mg/kg
(hypertension)
0.5 mg/kg PO (cats) for detrusor areflexia

Others: Propanolol (B blocker, in hypertension)

Yohimbine
Atenolol
THANK
YOU
TA L K TO U S