Pharmacology – Autonomic Nervous System

0:00 – Nervous System

3.30 - Somatic Nervous System

 Voluntary – peripheral skeletal muscles
 Neurotransmitter – Acetylcholine
o Location - Neuromuscular Junction
o Function – Contraction
o Needs optimal concentration.
 Too less – no contraction
 Too much – acetylcholine crisis – fasciculation and jerking >
Desensitization and flaccid paralysis
 Eg Succinylcholine is an agonist but causes depolarization and flaccid
paralysis.
o If Neuromuscular blocking agents given – Directly blocks, no fasciculations
and tremors. Eg. D-tubocurarine, mivacurium, Gentacurium(5-10mins),
doxacurium (120min), Pancuronium (85-100mins)
o Nerve transection – Flaccid paralysis + muscular atrophy
13.55 - Autonomic Nervous System
 Autonomous / Involuntary
  NT: Varies dependent on site.
 Functions:
○ Contraction / relaxation of smooth ms
○ Glandular secretion
○ BP / HR
○ Metabolic function

15.36 - Types of ANS

 Sympathetic
 PS
 ENS: GUT – Mesenteric and Myenteric plexus.
Aurbach’s / Myenteric Submucosal Mesenteric
Between outer longitudinal and inner Submucosal layer – needed for GI
circular for muscular contractions secretions
 Ganglion: Relay center in between nerve fiber
 Ganglions of sympathetic and parasympathetic
parasympathetic Sympathetic
Presynaptic – long Presynaptic – short
Post synaptic - short Post synaptic - long
Preganglionic – Ach Preganglionic – Ach
Post ganglionic - Ach Post ganglionic – Nor Adrenaline
Exception – Sweat gland post ganglionic
uses Ach

19.41 - Parasympathetic and Sympathetic

parasympathetic Sympathetic
Presynaptic – long Presynaptic – short
Post synaptic - short Post synaptic - long
Origin – Craniosacral outflow Origin - Throracolumbar
Cranial Nerves – 3, 7, 9, 10 (75% of all T1 to L2 vertebra
PS outflow)
Sacral – 2,3,4
Nuclei – Anterior and Midline of Nuclei –Posterior and Lateral of
Hypothalamus Hypothalamus
Penile Erection Penile Ejaculation
34.19 - Ach Supplies
 Somatic motor neuron
 All preganglionic
 Cholinergic post synapse
 Sweat gland (sympathetic cholinergic)
35.30 - Parasympathetic Nervous System

Nicotinic (Ligand Gated Receptors)

Nn Nm
Site Ganglia, Adrenal Medulla Neuromuscular Junction
Function Impulse Transmission for contraction
Agonist NE Succinylcholine
Epinephrine Acetylcholine
Antagonist  Hexamethonium  D-Tubocuraine
(Nicotine poisoning)  Alpha-bungarotoxin
 Trimethaphan
(Nicotine poisoning)
 Mecamylamine (HTN
management, antismoking
drug)

39.41 - Receptors in Parasympathetic

Nicotinic (Ligand Gated Receptors)
M1 (Gq) M2 (Gi) M3 (Gq) M4/
M5
Site  CNS  Heart SA node  Eye CNS
 Gastric Parietal  Respiratory
Cell  Bladder
 Glands
Function  CNS excitation  Reduces heart  Miosis,
 Gastric Secretion rate Bronchoconstriction
 Increase secretions
 Increase urine
outflow
Agonist  OXTREMORINE  METACHOLINE  Pilocarpine
Antagonis  Pirenzepine  Atropine  Darifenacin
 t  Telenzepine

10.02.29 - Add Ons in Nervous System

 Parasympathetic has no effect on blood vessels
 Acetylcholine has an effect on blood vessels
o M3 receptors on endothelium
 Exogenous Ach causes EDRF, NO release
 Vasodilatation
o Stripped endothelium, reveals M3 of smooth muscles
 Vasocontraction of smooth muscles

1.12.52 - Ach Synth
● Ach synth steps

● Rate Limiting Enzyme – Acetylcholine transferase

● Drugs – Hemicolinium, Vancuroium, Botulinum toxin
● Ach Esterase – Inhibition causes parasympathomimetic (neostigmine)
● AutoAb against Ca+ channel: Lambert Eaton Syndrome
● Pre-syn K → cause Ach release

1.21.25 - Uses of Botulinum Toxin

CAST @ FB
● Chr resistant migraine (Injection every 12weeks)
● Achalasia cardia, Axillary hyperhidrosis
● Spastic cerebral palsy, spasmodic dysphonia
● Torticollis
● Facial wrinkles (beauty treatment)
● Blepharospasm
● Black widow spider toxin: Induces massive release of Ach and depletion