autonomic nervous system - pharmacology
DESCRIPTION
uploaded by Morteza EsmaeiliManila Central UniversityTRANSCRIPT
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AUTONOMIC DRUGS
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Autonomic Nervous System(Visceral Efferent Nervous SYSTEM)
Involuntary Efferent( motor fibers) Preganglionic and Postganglionic neurons Effectors: smooth muscles, cardiac muscle,
gland
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Autonomic Nervous System
CNS Sympathetic } smooth muscle preganlionic postganglionic effector } cardiac muscle
●---------------- ●---------------------- Ο ↓ ↓ acetylcholine norepinephrine
adrenal preganglionic gland ●------------------------ Ο → epinephrine ↓ acetylcholine
Parasympathetic preganglionic postganglionic effector ●-------------------- ●---------------------- Ο ↓ ↓ acetylcholine acetylcholione
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Divisions
a. Sympathetic (Thoracolumbar )-
* 1st thoracic vertebrae extending through the 2nd and 3rd
lumbar
* fight and flight division
* Epinephrine and Nor epinephrine
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b. Parasympathetic (Cranio-Sacral)
* Nuclei of the 3rd, 7th, and 10th cranial
nerve and 1 to the 4th sacral spinal
segments
* acetycholine
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Pharmacology of the parasympathetic division
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Pharmacology of the Parasympathetic Division
I. Cholinergic agonist (Parasympathomimetic)
a. Choline esters: acetylcholine chloride methacholine chloride
bethanecol chloride
carbachol chloride
b. Alkaloids: Muscarine,
Pilocarpine- miotic in glaucoma
increase salivation
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II. Cholinesterase inhibitorsa. Slowly reversible neostigmine ( drug of choice for myasthenia gravis)
physostigmine b. Rapidly reversible: Edrophonuim
c. Non Reversible: chemical warfare and insecticides
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III. Cholinergic blocking drugs (parasympathomimetic) a. Naturally occurring alkaloids: 1. Atropine * Atropine sulfate, 0.5-1mg 1-2 hours before dental procedure
* antisialogogue * mydriasis, antispasmodic, decrease gastric and
salivary flow 2. Scopolamine
* Scopolamine Hydrobromide, 0.3- 0.6mg* pre-anesthetic
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b. Synthetic anticholonergic
* propantheline bromide (Pro-Banthine)
* aid in ulcer therapy
Side effects: blurred vision, tachycardia sweating and
dry skin
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Pharmacology of the Sympathetic Division
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I. Adrenergic Agonist (Sympathomimetic)
a. Epinephrine hydrochloride
( adrenaline)• Cardiac stimulant• Alpha and beta stimulating ( vessels of skin,
mucous membrane, kidney- vasoconstriction• Smooth muscles of the bronchi- vasodilation
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* topical solution (1:1000) –gingival retraction, hemostatic agent
* drug of choice for acute anaphylaxis
and asthmatic attack
(0.2-0.5 ml: 1:100,000 aqueous solution)
* Vasoconstrictor in local anesthesia
(1: 50, 000, 1:100, 000)
* Used in caution: elderly, CV disease,
hypertension, hyperthyroidism
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b. Nor epinehrine
* alpha stimulating
* hypotension in shock
c. Isoproterenol ( Isuprel)
* beta stimulating
* cardiac stimulant
* primary used in the treatment of
asthma and heart problem
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d. Dopamine
* alpha and beta
* shock associated with sepsis and myocardial etiology
e. Ephedrine
* alpha and beta
* intranasal solution for localized decongestive effect
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Synthetic adrenergic drugs
Phenylephrine- nasal decongestant Terbutaline- bronchodilator Dextroamphetamine sulfate- narcolepsy,
attention deficient disorder
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Adrenergic Blocking drugs(sympatholytic)
a. Alpha blockers
prazosin (Minipress)
b. Beta blockers
1. selective B1 (cardioselective
i. acetabutalol ( Sectral)
ii. Atenolol ( Tenormin)
iii. Metroprolol (Lopressor)
2. non selective
i. propranolol (Inderal)
ii. timolol ( Blocadren)
iii pindolol ( Visken)
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C. Neuronal blocker
D. Ganglionic blocker
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CNS STIMULANTS
Heterogeneous group of compound that produce various degree of stimulation depending on the compound, the dose and occasion and use
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Classification
I. Analeptics and Respiratory stimulants
a. Pentelynetetrazol (Metrazol)
b. Nikethamide( Coramine)
c. Doxapram (Dopram)
d. Picrotoxin
e. Strychine
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II. Xanthine Bases
(Caffeine, theophylline and theobromine)
pharmacologic effects:
CNS and Respiratory stimulants
diuretics
cardiac stimulants
bronchodilator
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A. Caffeine
□ most widely ingested CNS stimulants
□ insomia, nervousness, palpitation
tachycardia
□ Increase gastric secretion
□ habituation
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B. theophylline
+ ethylne diamide= aminophylline
severe cases of asthma
C. theobromine
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III. Sympathomimetic amide
A. Amphetamine and related drugs)
□ Wakefulness, alertness,
decrease fatigue
□ Increase ability to concentrate
□ Euphoric effect
□ Mood will be elevated
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Headache Hallucination Dysphoria Anorexia Psychotic episode
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B. Cocaine – local anesthetic
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Drugs
I. hemostatics/ antihemorragic
II. Antibiotic
III. Antihistmine
IV. Analgesic, Antipyretic
Antiinflammatory
V. Anesthetics
VI . Minor tranquilizer, sedative-hypnotic
sedative antihistamine
Bleeding
infection
Allergy
Pain, Fever Inflammation
Pain
Anxiety/fear