autonomic nervous system - pharmacology
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AUTONOMIC DRUGS
Autonomic Nervous System(Visceral Efferent Nervous SYSTEM)
Involuntary Efferent( motor fibers) Preganglionic and Postganglionic neurons Effectors: smooth muscles, cardiac muscle,
gland
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
Divisions
a. Sympathetic (Thoracolumbar )-
* 1st thoracic vertebrae extending through the 2nd and 3rd
lumbar
* fight and flight division
* Epinephrine and Nor epinephrine
b. Parasympathetic (Cranio-Sacral)
* Nuclei of the 3rd, 7th, and 10th cranial
nerve and 1 to the 4th sacral spinal
segments
* acetycholine
Pharmacology of the parasympathetic division
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
II. Cholinesterase inhibitorsa. Slowly reversible neostigmine ( drug of choice for myasthenia gravis)
physostigmine b. Rapidly reversible: Edrophonuim
c. Non Reversible: chemical warfare and insecticides
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
b. Synthetic anticholonergic
* propantheline bromide (Pro-Banthine)
* aid in ulcer therapy
Side effects: blurred vision, tachycardia sweating and
dry skin
Pharmacology of the Sympathetic Division
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
* 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
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
d. Dopamine
* alpha and beta
* shock associated with sepsis and myocardial etiology
e. Ephedrine
* alpha and beta
* intranasal solution for localized decongestive effect
Synthetic adrenergic drugs
Phenylephrine- nasal decongestant Terbutaline- bronchodilator Dextroamphetamine sulfate- narcolepsy,
attention deficient disorder
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)
C. Neuronal blocker
D. Ganglionic blocker
CNS STIMULANTS
Heterogeneous group of compound that produce various degree of stimulation depending on the compound, the dose and occasion and use
Classification
I. Analeptics and Respiratory stimulants
a. Pentelynetetrazol (Metrazol)
b. Nikethamide( Coramine)
c. Doxapram (Dopram)
d. Picrotoxin
e. Strychine
II. Xanthine Bases
(Caffeine, theophylline and theobromine)
pharmacologic effects:
CNS and Respiratory stimulants
diuretics
cardiac stimulants
bronchodilator
A. Caffeine
□ most widely ingested CNS stimulants
□ insomia, nervousness, palpitation
tachycardia
□ Increase gastric secretion
□ habituation
B. theophylline
+ ethylne diamide= aminophylline
severe cases of asthma
C. theobromine
III. Sympathomimetic amide
A. Amphetamine and related drugs)
□ Wakefulness, alertness,
decrease fatigue
□ Increase ability to concentrate
□ Euphoric effect
□ Mood will be elevated
Headache Hallucination Dysphoria Anorexia Psychotic episode
B. Cocaine – local anesthetic
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
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