Neurology‎ > ‎

Neuro-Pharmacology

Autonomic Pharmacology (cardiac output, blood flow distribution, digestion) (Chapter 6, Basic and Clinical Pharmacology, 13th edition, Lange publication)
  • 1. Sympathetic (thoracolumbar) division
    • Most preganglionic Fibers are short and end in paravertebral chains. The other preganglionic fiber end in pre vertebral ganglia
  • 2. Parasympathetic (carniosacral) division
    • CN 3, 7, 9, 10
    • 3rd, and 4th Sacral Spinal Nerve Roots
    • Preganglionic fibers end mostly in the target organs, however, in following cases ganglia are located near target organ with separate ganglia
      • Ciliary Ganglia
      • Pterygopalatine ganglia
      • Submandibular ganglia
      • Otic ganglia
      • Pelvic Ganglia
  • 3. Enteric Nervous System (ENS)
    • sometimes described as 3rd division of ANS 
    • extends from esophagus to distal colon
    • both motor and sensory activities are seen 
    • receives preganglionic parasympathetic fibers, and postganglionic sympathetic fibers. These have modulatory effect. 
    • ENS functions in semi-autonomous manner. Uses ANS input for modulation of GI activity, and sends back sensory fibers back to the CNS.
    • Includes
      • Myenteric Plexus (The Plexus of Auerbach)
      • Submucous Plexus (The Plexus of Meissner)
  • Autonomic Receptors
    • Cholinoreceptors (Muscarinic and Nicotinic)
      • M1
      • M2
      • M3
      • M4
      • M5
      • Nn
      • Nm
    • Adrenoreceptors
      • Alpha 1
      • Alpha 2
      • Beta 1
      • Beta 2
      • Beta 3
    • Dopamine Receptors 
      • D1 (DA1), D5
      • D2 (DA2)
      • D3
      • D4
Cholinomimetic Drugs
  • Direct Acting Cholinominetic Agents 
    • directly bind to the autonomic receptors (Muscarinic, and Nicotinic)
    • Types:
      • Choline Esters (Acetylcholine, Methacholine, Cabachol, Bethanechol)
      • Alkaloids (
  • Indirect-acting Cholinomimetic Agents 
    • inhibits acetylcholinesterase, increasing endogenous Ach concentration
    • thus are amplifiers of endogenous Ach
    • Types
      • Alcohols (Edrophonium)
      • Carbamates and related agents (Neostigmine, Pyridostigmine, Physostigmine)
      • Organophosphates (Echothiophate)
  • Clinical Uses
    • The Eye
      • Glaucoma
        • Acute-angle-closure glaucoma
    • GI and Urinary Tract
      • Post-operative Ileus
      • Congenital Megacolon
      • Urinary Retention
    • Neuromuscular Junction
    • Heart
    • Antimuscuarinic Drug Intoxication
    • Central Nervous System 
  • Toxicity
    • Direct-Acting Muscarinic Stimulants
    • Direct-Acting Nicotinic Stimulants
    • Cholinersterase Inhibitors 

Comments