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Autonomic Nervous System

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Autonomic Nervous System CholinomimeticCholinomimetic drugsdrugs (cholinergic(cholinergic drugs)drugs) CholinomimeticCholinomimetic drugsdrugs (cholinergic(cholinergic drugs)drugs) WhatWhat studentsstudents shouldshould know:know: NervousNervous systemsystem ClassificationsClassifications ofof autonomicautonomic nervousnervous systemsystem CholinergicCholinergic nervousnervous systemsystem ChemicalChemical neurotransmittersneurotransmitters SynthesisSynthesis –– ActionsActions –– MetabolismMetabolism CholinergicCholinergic receptorsreceptors CholinomimeticCholinomimetic drugsdrugs && anticholinergicanticholinergic drugsdrugs KineticsKinetics DynamicsDynamics UsesUses AdverseAdverse effectseffects && contraindications.contraindications. TheThe nervousnervous systemsystem isis aa communicationcommunication networknetwork thatthat allowallow anan organismorganism toto interactsinteracts withwith thethe environmentenvironment inin appropriateappropriate ways.ways. ItIt cancan bebe classifiedclassified inin toto thethe centralcentral nervousnervous systemsystem andand thethe peripheralperipheral nervousnervous systemsystem.. TheThe centralcentral nervousnervous systemsystem isis composedcomposed ofof brainbrain andand spinalspinal cord.cord. TheThe peripheralperipheral nervousnervous systemsystem isis somaticsomatic .N.S.N.S andand thethe autonomicautonomic nervesnerves system.system. WhatWhat areare thethe differencesdifferences betweenbetween thethe somaticsomatic andand thethe autonomicautonomic N.S?N.S? SomaticSomatic N.SN.S ControlControl skeletalskeletal musclesmuscles VoluntaryVoluntary SomaticSomatic nervenerve isis oneone fiberfiber AutonomicAutonomic N.SN.S ControlControl smoothsmooth musclesmuscles ofof viscera,viscera, bloodblood vessels,vessels, exocrineexocrine glandsglands && cardiaccardiac musclesmuscles InvoluntaryInvoluntary AutonomicAutonomic nervesnerves havehave twotwo neuronsneurons Efferent neurons of autonomic nervous system AUTONOMICAUTONOMIC NERVOUSNERVOUS SYSTEMSYSTEM consistsconsists ofof :: 1. TheThe sympatheticsympathetic oror thoracolumbarthoracolumbar outflow.outflow. 2.2. TheThe parasympatheticparasympathetic oror craniosacralcraniosacral outflow.outflow. AnatomyAnatomy OfOf TheThe AutonomicAutonomic NervousNervous SystemSystem SympatheticSympathetic ParasympatheticParasympathetic ThoracolumbarThoracolumbar CraniosacralCraniosacral Preganglionic fibers leave CNS Preganglionic fibers leave the through first thoracic to CNS through cranial nerves second lumbar segments of ( 3,7,9,10 ) and sacral spinal nerves segments of spinal cord Preganglionic is shorter than Preganglionic is longer than postganglionic postganglionic Ganglia form chain near the Ganglia present near organs spinal cord. innervated or nearly embedded in it Ergotropic system. Trophotropic system. (Fight & flight) (rest & digest) ANATOMY OF THE AUTONOMIC NERVOUS SYSTEM MostMost organsorgans areare duallydually innervatedinnervated byby bothboth sympatheticsympathetic andand parasympatheticparasympathetic systemsystem BUTBUT oneone systemsystem usuallyusually predominatespredominates SomeSome organsorgans asas adrenaladrenal medulla,medulla, kidney,kidney, bloodblood vessels,vessels, sweatsweat glandsglands andand pilomotorpilomotor musclesmuscles receivereceive onlyonly sympatheticsympathetic system.system. ChemicalChemical substancessubstances responsibleresponsible forfor communicationcommunication betweenbetween nervenerve cellscells andand betweenbetween nervenerve cellscells andand effectoreffector organs.organs. NeurotransmitterNeurotransmitter inin sympatheticsympathetic systemsystem isis noradrenalinenoradrenaline andand nervesnerves areare adrenergicadrenergic NeurotransmitterNeurotransmitter inin parasympatheticparasympathetic systemsystem isis acetylcholineacetylcholine andand nervesnerves areare cholinergiccholinergic CholinergicCholinergic nervousnervous systemsystem SitesSites ofof AchAch releaserelease 1.1. NeuromuscularNeuromuscular junction.junction. 2.2. AutonomicAutonomic ganglia:ganglia: allall preganglionicpreganglionic nervenerve fibersfibers ofof bothboth sympatheticsympathetic andand parasympparasymp nerves.nerves. 3.3. ParParaassyympatheticmpathetic postganglionicpostganglionic fibers.fibers. 4.4. SympatheticSympathetic postganglionicpostganglionic fibersfibers toto sweatsweat glands.glands. 5.5. PreganglionicPreganglionic sympatheticsympathetic nervenerve toto AdrenalAdrenal medullamedulla.. CHOLINERGICCHOLINERGIC TRANSMISSIONTRANSMISSION ConsistsConsists ofof :: SynthesisSynthesis ofof acetylcholineacetylcholine (Ach)(Ach) StorageStorage ReleaseRelease BindingBinding toto receptorsreceptors MetabolismMetabolism (fate).(fate). RecyclingRecycling ofof thethe cholinecholine CHOLINERGICCHOLINERGIC TRANSMISSIONTRANSMISSION 1) SynthesisSynthesis CholineCholine isis transportedtransported intointo cytoplasmcytoplasm ofof thethe cholinergiccholinergic presynapticpresynaptic nervenerve terminalsterminals byby carriercarrier CholineCholine ++ acetylacetyl CoACoA →→ AChACh ++ CoACoA (( InhibitionInhibition byby hemicholiniumhemicholinium,, triethylcholinetriethylcholine)) 2)2) StorageStorage AChACh isis transportedtransported intointo thethe storagestorage vesiclesvesicles byby activeactive transporttransport systemsystem (( InhibitionInhibition byby vesamicol)vesamicol) CHOLINERGICCHOLINERGIC TRANSMISSIONTRANSMISSION 3)3) ReleaseRelease AChACh isis releasedreleased uponupon nervenerve stimulationstimulation →→ influxinflux ofof calciumcalcium →→ exocytosisexocytosis →→ AchAch releaserelease intointo synapticsynaptic cleftcleft (Inhibition(Inhibition byby Magnesium,Magnesium, aminoglcosidesaminoglcosides)) 3)3) MetabolismMetabolism (FATE)(FATE) acetylcholinesteraseacetylcholinesterase CholinergicCholinergic nervousnervous systemsystem CholinergicCholinergic transmissiontransmission CHOLINERGICCHOLINERGIC TRANSMISSIONTRANSMISSION TrueTrue CholinesteraseCholinesterase PseudocholinesterasePseudocholinesterase SpecificSpecific NonNon specificspecific CholinergicCholinergic fibers,fibers, RBC,RBC, Plasma,Plasma, liver,liver, skin,skin, CSFCSF intestineintestine SlowSlow turnover,turnover, 120120 dayday RapidRapid turnoverturnover ACh,ACh, methacholinemethacholine Succinylcholine,Succinylcholine, ButyrylcholineButyrylcholine CholinergicCholinergic receptorsreceptors 1. NicotinicNicotinic (Central(Central cholinergiccholinergic )) receptors.receptors. 2.2. MuscarinicMuscarinic (Peripheral(Peripheral cholinergic)cholinergic) receptors.receptors. NicotinicNicotinic receptorsreceptors ionion channelschannels--linkedlinked receptorsreceptors (( FastFast )) TypesTypes 1. NeuronalNeuronal (NN).(NN). 2. MuscularMuscular (NM).(NM). NicotinicNicotinic receptorsreceptors LocationsLocations ofof nicotinicnicotinic receptorsreceptors 1.1. AutonomicAutonomic gangliaganglia NNNN (( neuronalneuronal typetype ).). 2.2. AdrenalAdrenal medulla.medulla. 3.3. CNSCNS 3.Neuromuscular3.Neuromuscular junctionjunction (NM)(NM) CholinergicCholinergic receptorsreceptors MuscarinicMuscarinic receptorsreceptors M1M1——M5M5 M1,M3,M5M1,M3,M5 areare excitatoryexcitatory .. M2,M4M2,M4 areare inhibitoryinhibitory .. C.N.SC.N.S hashas allall receptorsreceptors .. PeripheryPeriphery i.e.i.e. G.I.TG.I.T ,, U.TU.T .etc.etc havehave M2&M3.M2&M3. TheThe heartheart mainlymainly M2M2 .. MuscarinicMuscarinic receptorsreceptors (Peripheral(Peripheral cholinergiccholinergic receptors)receptors) GG--proteinprotein linkedlinked receptorsreceptors FiveFive subclassessubclasses ;; MM1 - MM5 MM1,M,M3,M,M5 areare excitatoryexcitatory inin function.function. MM2,M,M4 areare inhibitoryinhibitory inin functionfunction .. LocationsLocations inin allall effectoreffector organsorgans innervatedinnervated byby cholinergiccholinergic fibersfibers asas –– SmoothSmooth musclesmuscles (GIT,(GIT, urinaryurinary tract,tract, bronchialbronchial muscles).muscles). –– ExocrineExocrine glands,glands, C.N.SC.N.S M1 (Neural) Autonomic ganglia, CNS, gastric parietal cells Excitatory Activation of phospholipase C ↑ IP3 & DAG CNS excitation Gastric acid secretion M2 (Cardiac) Heart – Presynaptic cholinergic fibers Inhibitory Inhibition of adenyl cyclase ( ↓ cAMP) Activation of K channels Cardiac inhibition Presynaptic inhibition M3 (Glandular) Exocrine glands - smooth muscles Vascular endothelium Excitatory – Secretion – Smooth muscle contraction – Vasodilatation (via NO) Activation of phospholipase C---increased IP3. Receptor Locations Effects M1 (Neural) CNS CNS excitation Excitatory Autonomic Gastric acid secretion ganglia Activation of phospholipase C ↑ gastric parietal IP3 &DAG → ↑ Ca cells M2 Heart Cardiac inhibition (Cardiac) Presynaptic Presynaptic inhibition Inhibitory cholinergic fibers Inhibition of adenyl cyclase (↓ cAMP) Opening of K channels M3 Exocrine glands Secretion (Glandular) Smooth muscles Smooth muscle contraction Excitatory Vascular Vasodilatation (via NO) endothelium Activation of phospholipase C ↑ IP3 & DAG. MuscarinicMuscarinic ReceptorsReceptors ExcitatoryExcitatory MuscarinicMuscarinic receptorsreceptors WhatWhat areare actionsactions ofof cholinergiccholinergic systemsystem activation?activation? NicotinicNicotinic actionsactions MuscarinincMuscarininc actionsactions CNSCNS NICOTINICNICOTINIC ACTIONSACTIONS OFOF ACHACH SkeletalSkeletal muscles:muscles: stimulationstimulation →→ musclemuscle fasciculationfasciculation (twitching).(twitching). HighHigh concconc →→ persistentpersistent depolarizationdepolarization && paralysis.paralysis. Ganglia:Ganglia:
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