Dimas P.Nugraha Departemen Farmakologi dan Terapi FK UR PENGANTAR OBAT OTONOM DAN GANGLION Dimas P.Nugraha Departemen Farmakologi dan Terapi FK UR

The efferent nerves of the autonomic nervous system

The autonomic nerves innervate smooth muscles, cardiac tissue and glands. Both parasympathetic and sympathetic systems have ganglia where ACh is the transmitter of the preganglionic fibers; ACh acts on nicotinic receptors on the postganglionic nerves. ACh is also the neurotransmitter at cells of the adrenal medulla, where it acts on nicotinic ACh receptors to cause release of the catecholamines epinephrine (Epi) and NE into the circulation

ACh is the predominant neurotransmitter of postganglionic parasympathetic nerves and acts on muscarinic receptors. NE is the principal neurotransmitter of postganglionic sympathetic nerves, acting on or adrenergic receptors

The somatic nerves innervate skeletal muscle directly without a ganglionic relay

Response to symphatetic activation

Sympathetic Fight or Flight Response

Response to parasymphatetic Activation

Action of sympathetic and parasympathetic nervous systems on effector organs

Efek utama yang dimediasi oleh Alpha and Beta adrenoceptors

Site at Which Drugs Act To Modify Cell Functions

Example of Cholonergic and adrenergic Drug Treatment : Glaucoma

Penyakit glaucoma tipe tertentu dapat diobati dengan memodifikasi aktivitas simpatik dan parasimpatik di bola mata. Cholinergic agonist seperti pilocarpin dapat meningkatkan pengeluaran aqueos humor melalui canalis schlemm Adrenergic antagonis seperti Timolol menurunkan aliran masuk aqueos humor sehingga dapat mengurangi gejala glaucoma

Drugs That act On The Autonomic nervous System

Process Affected Drug Example Site Action Action potential propagation Local anesthetics, tetrodotoxin,1 saxitoxin2 Nerve axons Block sodium channels; block conduction Transmitter synthesis Hemicholinium Cholinergic nerve terminals: membrane Blocks uptake of choline and slows synthesis Transmitter storage Reserpine Adrenergic terminals: vesicles Prevents storage, depletes Transmitter release Botulinum toxin Cholinergic vesicles Prevents release Tyramine, amphetamine Adrenergic nerve terminals Promote transmitter release

Process Affected Drug Example Site Action Transmitter reuptake after release Cocaine, tricyclic antidepressants Adrenergic nerve terminals Inhibit uptake; increase transmitter effect on postsynaptic receptors Receptor activation or blockade Norepinephrine Receptors at adrenergic junctions Binds receptors; causes contraction Nicotine Receptors at nicotinic cholinergic junctions (autonomic ganglia, neuromuscular end plates) Binds nicotinic receptors; opens ion channel in postsynaptic membrane Tubocurarine Neuromuscular end plates Prevents activation Atropine Receptors, parasympathetic effector cells Binds muscarinic receptors; prevents activation Enzymatic inactivation of transmitter Neostigmine Cholinergic synapses (acetylcholinesterase) Inhibits enzyme; prolongs and intensifies transmitter action

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