ans physiology and drugs

7/21/2019 ANS Physiology and Drugs

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PHARMACOTHERAPEUTICSDrugs Afecting the ANS

Katherine Kyra D. Alonday, RPh

The Graduate School

University of Santo Tomas



OUTLINE OF REPORT• AUTONOMIC NERVOUS SYSTEM

– SYMPAT!T"# A$S %SA$S&

– PARASYMPAT!T"# A$S %PA$S&

• DRUGS AFFECTING SANS – ADR!$!RG"# AG'$"STS

– ADR!$!RG"# A$TAG'$"STS

• DRUGS AFFECTING PANS – #'("$!RG"# AG'$"STS

–

#'("$!RG"# A$TAG'$"STS



• CENTRAL NERVOUS SYSTEM !CNS"

• PERIPHERAL NERVOUS SYSTEM !PNS"

Sensr# Di$isin % sends stimuli to P$S

Mtr Di$isin % elicits res)onse from P$S

The P$S receives stimuli from the #$S * initiates res)onses



Un&er the Mtr Di$isin

A'Autn(ic + involuntary

acts on smooth muscles * -lands

)erson has little or no control

)' S(*tic + voluntary

acts on seletal muscles )erson has control



+h*t h*,,ens -hen #u *cci&ent*..#tuch * $er# ht /0ect1

"G T!MP!RATUR! S!$DS PA"$ST"MU("

%Sensory Division P$S #$S P$S Motor Division A$S&

A$S elicits the Withdrawal Refex in /ust a0out s)lit seconds throu-h the)ath1ay sho1n.



AUTONOMIC NERVOUS SYSTEM!ANS"

• De2nition3Ma/or involuntary, unconscious, automatic

)ortion of the nervous system that can 0edivided into the SANS2 PANS and in some

references, ENS'

• Roles3

4i-ht54li-ht * Rest5Di-est

• 6 Ma/or Divisions of ANS3

Sym)athetic !SANS" * Parasym)athetic!PANS"



AD"D Y'U K$'7 TAT8

y)othalamus is the ma/or control andinte-ration center of the A$S9

The !$S %!nteric $ervous System& is asemi autonomous )art of the A$Slocated in the G"T



ANS h*s 3 Sets 4 Neurns5

6' Aferent !sensr#" sendsim)ulses to the #$S forinter)retation

3' Eferent !(tr" receivesim)ulses %information& from the

0rain * transmits from the s)inalcord to the e:ector or-an cells

;!:erent <ranches + SA$S and PA$S



SYMPATHETIC DIVISION

• Also called thoraco-lumbar system

• (eads to every )art of the 0ody %unlie

)arasym).&

• Norepinephrine is the neurotransmitterreleased 0y most )ost-an-lionic 20ers

• 7ADRENERGIC8

SA$S %Adrener-ic&



S#(,*thetic Res,nse

• Stress = 2-htor>i-ht res)onse

• = )roduction of ATP

• Dilation of the )u)ils

• = heart rate and 0lood )ressure

• Dilation of the air1ays

• #onstriction of 0lood vessels that su))ly the

idneys and -astrointestinal tract. ??

SA$S %Adrener-ic&

S th ti R



Sym)athetic Res)onsecontinued..

• = 0lood su))ly to the seletal muscles,cardiac muscle, liver and adi)ose tissue

• = -lyco-enolysis = 0lood -lucose

• = li)olysis

S#(,*thetic Res,nse 9 ENERGYE:PENDITURE

?6

SA$S %Adrener-ic&



SYMPAT!T"# R!SP'$S!S

%Adrener-ic&



PARASYMPATHETICDIVISION

• Also called the cranio-sacral system

•

'nly innervate internal or-ans %notsin&

• Acetylcholine is neurotransmitter atend or-an as 1ell as at )re-an-lionicsyna)se

• 7CHOLINERGIC8

PA$S %#holiner-ic&



P*r*s#(,*theticRes,nses

• Restanddi-est res)onse

• = di-estive and urinary function

• @ 0ody functions that su))ort )hysical

activity

P*r*s#(,*thetic 9 ENERGY

CONSERVATION ?

PA$S %#holiner-ic&

P th ti



Parasym)atheticRes)onses

PA$S %#holiner-ic&



COMPARISON!S#(,*thetic $s'

P*r*s#(,*thetic"STANDARD SYMPATHETIC

!SANS"PARASYMPATHETIC!PANS"

'ther $ame 4i-ht54li-ht Thoracolum0ar

Rest*Di-est#raniosacral

Rece)tors Al)ha3 a?,a6,aB<eta3 0?,06

$icotinicMuscarinic

#onsidered as ADRENERGIC CHOLINERGIC

Ma/or$eurotransmitter

!)ine)hrine %!& Acetylcholine %A#h&

4unction5%s& Uses ener-y #onserves ener-y



SA$S %Adrener-ic&

; TYPES OF ADRENERGIC RECEPTORORGAN CELLS5

A.,h*<6 5 Casoconstriction of Peri)heral <loodCessels

A.,h*<3 5 inhi/its NE re.e*se Casodilation

)et*<6 5 "ncrease in R and 4orce of contraction

)et*<3 5 RelaEes smooth muscle in <ronchi, Uterus,Peri)heral <C



A&renergic Agnists!S#(,*th(i(etics"

•

Dru-s that Stimulate the Sym)athetic $ervousSystem %adrener-ics, adrener-ic a-onists,sy)athomimetics, or adrenomimetics&

• Mimic the neruotransmitters nore)ine)hrine ande)ine)hrine

• Act on one or more adrener-ic rece)tor siteslocated on the cells of smooth muscles heart,

0ronchioles, G" tract, 0ladder, eye

• F main rece)tors + al)ha ?, al)ha 6, 0eta?, 0eta6



ADRENERGIC AGONISTS

". #entrallyActin-

"". "ndirectActin- Sym)athomimetics

A. Releasers

<. Reu)tae"nhi0itors""". DirectActin-

NON-SELECTIVE 3 #atecholamines

SELECTIVE:

A. Al)ha a-onists %Al)ha ?, Al)ha6&

<. <eta a-onists %<eta?, <eta6, $onS&

#. Do)a a-onist



ADRENERGIC AGONISTS

". #entrallyActin- Sym)athomimetics

Ris for Addiction and emorrha-ic Stroe

A %Am)hetamine&

M %Methyl)henidate& D'# for ADD

M %Moda2nil& D'# for $arcole)sy

P %Pemoline&

P %Phenmetraine& AnoreEiant #" in T$

P %Phentermine& AnoreEiant #" in T$



ADRENERGIC AGONISTS

"". "ndirectActin- Sym)athomimetics3

A. Releasers

Am)hetamine derivatives*TyraminePseudoe)hedrine

!)hedrine "3 y)otension *<ronchos)asm

<. Reu)tae"nhi0itors

T#As

#ocaine



ADRENERGIC AGONISTS

""". DirectActin- (Non-Selective

E %!)ine)hrine& 4irst line heart stimulant

D'# for Ana)hylaEis

N %$ore)ine)hrine& D'# for Se)ticShoc

D %Do)amine& D'# for #ardio-enic

Shoc



ADRENERGIC AGONISTS DirectActin- (Selective


A(PA? S!(!#T"C! #auses Casoconstriction

#auses Urinary retention

: %Hylometaoline& "3 $asal con-estion5y)otensionDo not use more than 3 days (nasal)

Do not use more than 5 days (IV/PO)

P %Phenyle)hrine&

M %MethoEamine&O %'Eymetaoline&

M %Midodrine& "3 'rthostatic y)otension





A(PA6 S!(!#T"C!

#auses Sedation and5or De)ression

C %#lonidine& "3 ADD %neEt to Methyl)henidate&#om0ined 1ith La!etalol to avoid re0ound T$

M %Methyldo)a& D'# for T$ Pre-nancy

G %Guanfacine&

) %<rimonidine&

A %A)raclonidine&

G %Guana0en&




<. <eta a-onists %<eta?, <eta6, $onselective&

<!TA? S!(!#T"C!

Do0utamine D'#3 #ardio-enicShoc





<!TA6 S!(!#T"C! #auses Tremor

I SA)A !Re.ie$ers"

PATterols

%Prenalterol, Al0uterol, Ter0utaline&

I LA)A !Cntr..ers"

4Sterols

%4ormoterol, Salmeterol&





$'$S!(!#T"C!

"so)roterenol "3 Asthma

'0solete use %Tolerance&

#. Do)a a-onist

4enoldo)am



!$D '4 ADR!$!RG"#AG'$"STS



A&renergic Ant*gnists!S#(,*th,.egics"

". "$D"R!#T SYMPAT'P(!G"#S

"". D"R!#T SYMPAT'P(!G"#S

A. Al)ha Anta-onists

$onSelective Al)ha Anta-onistSelective Al)ha? Anta-onist

Selective Al)ha6 Anta-onist

<. <eta Anta-onists$onSelective <eta Anta-onist

Selective <eta? Anta-onist

#. MiEed Al)ha5<eta Anta-onists



A&renergic Ant*gnists!S#(,*th,.egics"

". "$D"R!#T SYMPAT'P(!G"#S

G %Guanidine&

R %Reser)ine&

"". D"R!#T SYMPAT'P(!G"#S

A. Al)ha Anta-onists<. <eta Anta-onists

#. MiEed Al)ha5<eta Anta-onists



D"R!#T SYMPAT'P(!G"#SA. Al)ha Anta-onists

S!(!#T"C! A(PA A$TAG'$"STS

ISelective Al)ha? Anta-onists

"$D"#AT"'$3 Pheochromocytoma and T$

T %Teraosin&

I %"ndoramin&

T %Tamsulosin&

P %Praosin&A %Alfusoin&

D %DoEaosin&



D"R!#T SYMPAT'P(!G"#SA. Al)ha Anta-onists

S!(!#T"C! A(PA A$TAG'$"STS

ISelective Al)ha6Anta-onists%"nvesti-ational&

R %Raunuolscine&

Y %Yohim0ine&



D"R!#T SYMPAT'P(!G"#S<. <eta Anta-onists

$'$ S!(!#T"C! <!TA A$TAG'$"STS

"S LOC"L "NEST#ETICS

L %(a0etalol&A %Ace0utolol&

M %Meto)rolol&

P %Pro)ranolol&P %Pindolol&




$'$ S!(!#T"C! <!TA A$TAG'$"STS

"S $"RTI"L "NT"%ONISTS

T %Timolol&

C %#arteolol&

L %(a0etalol&

A %Ace0utolol&P %Pen0utolol&

P %Pindolol&




$'$ S!(!#T"C!

S!(!#T"C!

<eta? Selective Anta-onists) %<iso)rolol&

) %<etaEolol&

E %!smolol&

A %Atenolol&

A %Ace0utolol&

M %Meto)rolol&



C %#arvedilol&

L %(a0etalol&

D"R!#T SYMPAT'P(!G"#S#. MiEed Al)ha5<eta Anta-onists



!$D '4 ADR!$!RG"# A$TAG'$"STS

Ch .i i A i t



Ch.inergic Agnists!Ch.in(i(etics"

Ch .i i A i t




". D"R!#TA#T"$G #'("$'M"M!T"#S

"". #!$TRA((YA#T"$G#'("$'M"M!T"#S

""". "$D"R!#TA#T"$G#'("$'M"M!T"#S

Ch .i i A i t




". D"R!#TA#T"$G #'("$'M"M!T"#S

A. #holine !sters

M %Metacholine&

A %Acetylcholine&

C %#ar0achol&

)eth %<ethanechol&

Ch .i i A i t




". D"R!#TA#T"$G #'("$'M"M!T"#S

<. Alaloids

Nic %$icotine&

L %(o0eline&

Pi %Pilocar)ine&

Mu %Muscarine&

Ch .i i A i t




"". #!$TRA((YA#T"$G#'("$'M"M!T"#S

"3 AlheimerJs

Dn %Done)eil&

G*.*nt* %Galantamine&

T*c %Tacrine&

Ri$*s %Rivasti-mine&

Ch .i i A i t




"". "$D"R!#TA#T"$G #'("$'M"M!T"#S

I#ar0amates

Ne %$eosti-mine&

Ph# %Physosti-mine&

P# %Pyridosti-mine&

C*r %#ar0aryl&

I'r-ano)hos)hates

M*,* %Mala5Parathion&S(*n

Ech %!chothio)ate&

IE&r,hniu(



!nd of #holoner-ic A-onists



Ch.inergic Ant*gnists

". MUS#AR"$"# A$TAG'$"STS

"". $"#'T"$"# GA$G("'$"#A$TAG'$"STS

""". M"H!D MUS#AR"$"#5$"#'T"$"#A$TAG'$"STS

A. $onDe)olariin-

<. De)olariin-

"C. #'("$!ST!RAS! R!G!$!RAT'RS




". MUS#AR"$"# A$TAG'$"STS

C %#yclo)entolate&

A %Atro)ine&

S %Sco)olamine&

H %omatro)ine&

I %")ratro)ium&

T %Tiotro)ium&

D %Dicyclomine&O %'Ey0utinin&

T %Tolterodine&

S %Solifenacin&




"". $"#'T"$"# GA$G("'$"#A$TAG'$"STS

T %Trimetha)han&

T %Triethylammonium&

H %eEamethonium&

M %Mecylamine&




". M"H!D MUS#AR"$"#5$"#'T"$"#A$TAG'$"STS

A. $onDe)olariin-

M %Mivacurium&

R %Rocuronium&

P %Pancuronium&

T %Tu0ocurarine&

M %Metocurine&

A %Atracurium&

D %DoEacurium&




". M"H!D MUS#AR"$"#5$"#'T"$"#A$TAG'$"STS

<. De)olariin-

Succin#.ch.ine



END OF PRESENTATION

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