Beruflich Dokumente
Kultur Dokumente
of
Autonomic Nervous
System
urdu Mnemonics
Easy
are given in
Green Font to remember difficult names of drugs.
Cholinomimetics
Parasympathomimitics
cholinesterase inhibitors
Imp points
Methacoline act mainly on the M2 receptor and also stimulate the M3
receptor. It is use for the diagnostic purpose of the reactive reaction
inside the trachea .
Carbacol use in the glaucoma and the cycloplegia.
Pilocarpine is used in the open and close angle glaucoma and to clear
the adhesions in the eye. Also use in the sjogren syndrome.
Bathenicol.
Pilocarpine.
tear production).
Carbacol.
Methacoline
Neostigmine
Pyridostigmine
Edrophonium
Donepzol
INC ACH
Cholinergic transmission
1. Synthesis of Ach ( transport of choline is inhibitid by
Hemicholinium)
2. Uptake into storage vesicles
3. Release of neurotransmitter (release is blocked by Botulium
toxins)
4. Binding to the receptor (postsynaptic receptors activated by
binding of neurotransmitors)
5. Recycling of choline (choline is taken up by neuron)
6. Degradation of Ach (Ach rapidly hydrolyzed by enzyme acetyle
cholinestrase)
Cholinergic receptors
Muscurinic receptors
Gq
Gq
Nicotinic receptors
1. Nn (adrenal medulla , autonomic ganglia) no 2nd messenger
2. Nm (Neuromuscular junction)
no 2nd messenger
Imp points::
Muscurinic
Pralidoxine is use in Reactivation of acetylcholinesterase.
Ach has short half life, dec HR and BP.
Bathanecol use inc intestinal motility, inc urination.
Carbacol use to treat glaucoma
Pilocarpine does contraction of pupil (Miosis) {atropine does mydriasis}
Anti-cholergic
Parasympatholitics
cholinesterase Regenerators
1.. Anti-muscurinic
a. M1 selective (PIR, TEL, DARI, SOLI) (pirenzipine, telenzepine,
darifenacin, fesoterodine, solifenacin, tolterodine)
b. Non selective (atropine, scopolamine, ipratropium)
2.. Anti-nicotinic
a. ganglion blockers Mika ko methi khany ki vaja sy heza ho gia
(hexamethonium, Trimethaphan, Mecamylamine)
b. neuromuscular blockers (toba ki athara sal ki dosheza)
(tubocurarine, atracurium, Doxacurium)
Imp points::
Antimuscurinic
Atropine is protype drug in this class.
Can enter in CNS.
It is spamodytic, dec secretions, do mydriasis, cycloplegia, hyperthermia,
tachycardia, sedation, urinary retention and constipation.
Atropine excite the behavior.
AntiNicotinic
Others antimuscurinic
Hyptention
Scopolamine (motion sickness,cause sedation)
Mydriasis
Tropicamide (opthalmology)
Cycloplegia
Xerostomia
Ipratropium,Tiotropium (asthma and COPD)
Anhydrosis
Sympathomimetic
Adrenomimitics
Adenergic transmission
1. Syn of norepinephrine (Hydroxylation of tyrosine is rate limiting step)
2. Uptake into storage vesicles (dopamine enters a vesicle and is converted to
norepinephrine, it is protected from degradation . Transport into vesicle is
inhibited by Reserpine)
3. Release of neurotransmitter (influx of calcium is causes fusion of vesicle
with the cell membrane in a process known as exocytosis. Release is blocked
by Guanethidine and bretylium)
4. Binding to receptor (postsynaptic receptor is activated by binding of
neurotransmitter.)
5. Removal of norepinephrine (released norepinephrine is rapidly taken into
neuron, reuptake is inhibited by Cocaine and Imipramine)
6. Metabolism (norepinephrine is methylated by COMT and oxidized by MAO)
Adrenoceptors
Alpha 1 (vasoconstriction, inc peripheral resistance, inc BP, mydriasis, inc
closure of internal sphincter of Bladder){vascular smooth muscles, Liver}
Alpha 2 (Inhibition of norepinephrine release, inhibition of Ach release,
Inhibition of insulin){Adenergic and cholinergic nerve terminals,
platelets, fat cells , pancreatic B cells}
Beta 1 (Tachycardia, Inc lipolysis, Inc myocardial contractility, inc release
of renin){heart , Juxtaglomerular cells of kidney}
Beta 2 (vasodilation, dec peripheral resistance, bronchodialation, inc
release of glucagon, Relaxed uterine smooth muscle){airways, uterine
vasculature, liver, Pancreatic B cells, Heart}
Beta 3 (stimulate lipolysis) {Fat cells}
D1 (dilates){renal and other splanchnic blood vessels}
D2 (inhibit adenyl cyclase) {nerve terminals}
Imp points
Dopamine use in shock (D1>B1>A1)
Fenoldopam is a D1 agonist used for hypertension.
Alpha1 agonist inc mean blood pressure via vasoconstriction .
Phenylephrine is nasal decongestant and do mydriasis without cycloplegia.
Alpha 2 agonist stimulate prejunctional receptors in CNS, and use
hypertension.
Beta agonist Dec mean BP via vasodilation (B2) and inc HR (B1).
Salmeterol, albuterol and terbutaline used in asthma.
Terbutalin used in Premature labor.
Epinephrine act both on alpha and beta receptors. This is demonstrated by
Dale and so known as Dales phenomenon.
Nor-epinephrine have more effect on alpha-receptors , slight on B1, not on
B2. It causes inc BP, inc peripheral resistance, and cause reflex bradycardia.
Sympatholytic
Adrenolytic
Imp points
Common uses of alpha blockers is Hypertension
uses of non selective A blocker is pheocromocytoma.
Use of A1 blocker is Bening prostatic hyperplasia.
Use of B1 blockers is Dec HR, SV, CO and renin release.
Use of B2 blockers is vasospasm and bronchospasm in asthma.
Uses of all B blockers is angina, hypertension, Post MI.
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Timolol = glaucoma
Propranolol = migraine , antiarrhtymia
(only DPT).