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PREREQUISITE Sympathetic Nervous System PHYSIOLOGY Needed for studying SNS PHARMACOLOGY

PREREQUISITE Sympathetic Nervous System PHYSIOLOGY Needed for studying SNS PHARMACOLOGY.  Differ in: Site of ganglia Length of pre & postganglionic fiber Mediators of postganglionic fiber Ramifies adrenal medulla and its mediator circulate in blood. Transmitter is

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PREREQUISITE Sympathetic Nervous System PHYSIOLOGY Needed for studying SNS PHARMACOLOGY

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  1. PREREQUISITE Sympathetic Nervous System PHYSIOLOGY Needed for studying SNS PHARMACOLOGY

  2. Differ in: Site of ganglia Length of pre & postganglionic fiber Mediators of postganglionic fiber Ramifies adrenal medulla and its mediator circulate in blood

  3. Transmitter is Mainly norepinephrine [NE] Rarely Ach  M2 or Dopamine  D1 Transmitter is Mainly epinephrine [E ]  circulates and acts a1, a2, b1 , b2 Gland cells

  4. POSTGANGLIONIC SYMPATHETIC NERVE ENDING Na Norepinephrine (NE) Tyrosine Dopa Tyrosine SYNTHESIS DA STORAGE NE RELEASE Ca ACTION REUPTAKE NET DEGRADE Dopamine (DA) NE  E E ADRENAL MEDULLA COMT

  5. SYMPATHETIC ACTIONS Fight & Flight a receptors b1 receptors b2 receptors EYE: Contract Dilator Pupilli EYE: Relax Ciliary m. SALIVARY GLANDS  Salivation BLOOD VESSELS Vasoconstriction VESSELS Vasodilatation • HEART •  Force Inotropic • HR Chronotropic • AV conduction • Dromotropic BRONCHUS Bronchodilatation GIT Contraction of sphincters GIT & G. Bladder Motility LIVER  Glucose PANCREAS  Insulin secretion KIDNEY Renin from Juxta-glomerular cells URINARY BLADDER Contraction of sphincters BLADDER Detrusalm.:Relax UTERUS Relax :Tocolysis PENIS Ejaculation

  6. D1

  7. SYMPATHETIC NERVE ENDING SNS actions at a1&2 and b2 receptors in smooth m. SYMPATHETIC SUPPLY TO SMOOTH MUSCLES a 2 Gq Presynaptic action of NE at a2 receptor CONTRACTION RELAXATION CONTRACTION

  8. SNS actions at b1 receptors in heart SNS actions at b receptors in organs controlling metabolism

  9. Sum up of physiological actions of Epinephrine (adrenaline) Acts on all ADR; b =/> a Heart  inotropic, chronotropic, dromotropic & lusiotropic (excitability)(b1) BP  systolic (b1)/ diastolic   low dose (b2)&  high dose (a1) Vascular SMC; constrict skin + peripheral (a1) / dilate coronary+skeletal(b2) Non vascular SMC; Lung  bronchiodilatation(b2) GIT  motility (b2)/ contract sphincter (a1) Bladder   detrusor m. (b2)/ contract trigone & sphincter (a1) Pregnant uterus  tocolytic(b2) Eye  mydriasis(a1)  no sig. change; accommodation & intraocular pressure(IOP) ??? Metabolism insulin (a2), glucagon (b2), liverglycogenolysis + sk. m. glycolysis(b2) /   adipose lipolysis(b3 /b2) CNS little, headache, tremors & restlessness

  10. Eye Mydriasis Accomodation Mydriasis Paralysis of constrictor pupilli (M) Contraction of dilator pupilli (a)

  11. Glaucoma Treatment-An Evolving Paradigm Intra-Ocular Pressure [IOP] Kept by a balance between formation & drainage If balance disturbed by increasing formation or decreasing drainage  IOP glaucoma SNS; No or slightly increase formation !!! No or slightly increase drainage !!! SNS; So collectively hardly an effect on IOP

  12. GOOD LUCK

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