CLINICAL PHARMACOLOGY: REVIEW OF THE AUTONOMIC NERVOUS SYSTEM DR.

DIMASICIL

Utilize input from the motor outflow of

AUTONOMIC NERVOUS SYSTEM
the ANS for modulation of GI activity
Largely autonomic (independent) and sending sensory information back
Activities are not under direct conscious control to the CNS
Drugs that mimic or block the actions of ANS chemicals Provides necessary synchronization of
transmitters modify many anatomic functions impulses that ensures forward
Essential in studying anesthetic and optha drugs, propulsion of gut contents and
antipsychotic meds, recreational drugs, cardiac and relazation of sphincters
pulmonary drugs, anti-seizure meds.
NEUROTRANSMITTERS

A large number of peripheral ANS fibers synthesize and

ANS DIVISIONS
release acetylcholine cholinergic fibers (release Ach)
Sympathetic (thoracolumbar) o Include all preganglionic efferent autonomic
o Fight or flight fibers and the somatic (nonautonomic) motor
o The sympathetic preganglionic fibers leave the fibers to skeletal muscle
CNS through the thoracic and lumbar spinal o most parasympathetic postganglionic and a few
nerves sympathetic postganglionic fibers are
cholinergic.
Parasympathetic (craniosacral)
o The parasympathetic preganglionic fibers leave Most postganglionic sympathetic fibers release
the CNS through the cranial nerves (especially norepinephrine (adrenergic) noradrenergic (release
the 3rd, 7th, 10th) and the 3rd and 4th sacral spinal norepinephrine)
nerve root
Acetylcholine (Ach)
Enteric nervous system (ENS) o Primary transmitter at ANS ganglia, somatic and
o Considered as 3rd division neuromuscular junctions
o Is a large and highly organized collection of
neurons located in the walls of the Norepinephrine
gastrointestinal system o Primary transmitter at most sympathetic post
o Involved in both motor and secretory activities of ganglionic nerve endings
the gut
o Critical in the activity of the colon Five key features of neurotransmitter function:
o Includes: o Synthesis
Myenteric plexus (plexus of Auerbach) o Storage
Submucous plexus (plexus of Meissner) o Release
o Functions: o Termination of action
o Receptor effects

HELLO KITTY UPH-DJGTMU BATCH 2017 1/5

 CLINICAL PHARMACOLOGY: REVIEW OF THE AUTONOMIC NERVOUS SYSTEM DR. DIMASICIL

Other essential neurotransmitters METABOLISM OF CATECHOLAMINES

ATP (adenosine triphosphate)
CGRP (calcitonin gene related peptide) Enzymes responsible for the metabolism of epinephrine,
CCK (cholecystokinin) NE, and DOPA into VMA and homovanillic acid
Dopamine highly studied in antipsychotic medications o COMT: catechol-O-methyltransferase
Enkephalins and opioid peptides o MAO: monoamine oxidase
Galanin
GABA (gamma-aminobutyric acid) AUTONOMIC RECEPTORS
Neuropeptide Y (NPY)
GRP (gastrin-releasing peptide) Cholinoceptors: muscarinic receptors
NO (nitric oxide) o Receptors (muscarinic and nicotinic) that
Norepinephrine (NE) responds to acetylcholine
Serotonin (5-HT)
Adrenoceptors:
Substance P
o Receptors that responds to catecholamines
Vasoactive intestinal peptide (VIP)
(norepinephrine)
Histamine
o alpha and beta receptors
Angiotensin II
o Dopamine receptors
D1, D5: brain, renal vascular bed
D2: brain
D3: brain
D3: brain, CVS

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 CLINICAL PHARMACOLOGY: REVIEW OF THE AUTONOMIC NERVOUS SYSTEM DR. DIMASICIL

SYMPATHETIC ACTIVITY PARASYMPATHETIC ACTIVITY

Fight or flight mechanism (ergotropic-leading to energy Rest and digest action in the gut (trophotropic- leading to
expenditure) growth)
Increased heart contractility
Relaxation of bladder wall Pupils constricted/ miosis
Increased sweating
Increased renin release Increased secretory action in the GIT
Mydriasis- pupillary dilation

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DRUGS

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HELLO KITTY UPH-DJGTMU BATCH 2017 5/5