Introduction to ANS Pharmacology

• Objectives:
• Describe the steps in the synthesis, storage,
release, and termination of action of the major
autonomic transmitters
• Cotransmitter substances
• Describe organ system effects of stimulation of
parasympathetic and sympathetic systems
• Name examples of inhibitors of Ach and NE
synthesis, storage, and release
• Name the major types of receptors found on
autonomic effector tissues
• Describe the actions of several toxins that affect
nerve functions: tetrodotoxin, saxitoxin,
botulinum toxin, and latrotoxin
A.N.S
• ANS is the major involuntary, unconscious, automatic
portion of the NS and differs in several ways from the
somatic (voluntary) NS.
• Anatomic aspects of the ANS
• The motor (efferent) portion of the ANS is the major
pathway for information transmission from CNS to the
involuntary effector tissues. It has 2 major divisions: the
sympathetic and the parasympathetic. The enteric NS
(ENS) is a semiautonomous part of the ANS, with
specific functions for the control of GIT. ENS consists of
myenteric plexus(plexus of Auerbach) and the
submucosal plexus (plexus of Meissner) and includes
inputs from parasympathetic and sympathetic NS.
Spinal roots of origin

• Parasympathetic preganglionic motor

fibres originate in cranial nerve nuclei III,
VII,IX, and X and in sacral segments
(usually S2 – S4) of the spinal cord
• The sympathetic preganglionic fibres
originate in the thoracic (T1-T12) and
lumbar (L1-L5) segments of the spinal cord
 –Location of ganglia
• Most sympathetic ganglia are located in 2
paravertebral chains that lie along spinal
column. Most of parasympathetic ganglia are
located in the organs innervated
• Length of pre- and postganglionic fibres
• Preganglionic sympathetic fibres are short, and
postganglionic fibres are long. For
parasympathetic the opposite is true
• Uninnervated receptors: Some receptors
such as M receptors on endothelium of blood
vessels, some presynaptic receptors and some
adrenoceptors on apocrine sweat glands, and
alpha2 and beta adrenoceptors in blood vessels
has no innervation
Neurotransmitter Aspects of ANS

• Cholinergic transmission
• Synthesis, storage, release, and termination of
action of Ach.
• Adrenergic Transmission
• Synthesis, storage release and termination of
action of NE
• Cotransmitters: ATP, enkephalins, VIP,
neuropeptide Y, substance P, neurotensin, and
somatostatin
Functions of the Sympathetic System
• Though continually active to some degree
(e.g. in maintaining the tone of vascular
beds), the sympathetic division has the
property of adjusting in response to
stressful situations, such as trauma, fear,
hypoglycemia, cold, or exercise
• 1- Effects of stimulation of sympathetic
division
• 2- Fight or flight response
• Sympathetic system is not essential to life
Functions of the parasympathetic
system
• Parasympathetic division maintains essential
bodily functions, such as digestive processes and
elimination of wastes, and is required for life.
• It usually acts to oppose or balance the actions
of the sympathetic division and is dominant over
the sympathetic in “rest and digest” situations.
• Parasympathetic system is not a functional entity
as such and never discharges as a complete
system. If it did, it would produce massive,
undesirable, and unpleasant symptoms. Instead,
discrete parasympathetic fibres are activated
separately, and the system functions to affect
specific organs, such as stomach or eye.
Role of CNS in autonomic control of viscera

• 1- Reflex arcs (Baroreceptors for BP control)

• 2-Emotions and ANS (Rage, fear or pleasure)
• 3-Innervation by ANS
• A-Dual innervation
• B-Organs receiving only sympathetic
innervation: adrenal medulla, kidney, pilomotor
muscles, sweat glands and also blood pressure
control
• Somatic NS: to skeletal muscle Ach is the
neurotransmitter without interrupting ganglia
Chemical signaling between cells

• A- Local mediators: (histamine, PG’s). They act on the

cells in their immediate environment. They are rapidly
destroyed or removed, thus they do not enter the blood.
• B- Hormones: specialized endocrine cells secrete
hormones into blood stream, exerting their effect on
distal organs.
• C- Neurotransmitters: Ach, NE, and Epinephrine
• Second messenger system in intracellular response:
• 1. Actions on membrane receptors
• 2. Regulation involving second messenger molecules