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 Action potential propagation

Drug Example Local anesthetics, tetrodotoxin,1 saxitoxin2

Site Nerve axons

Action 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

Cholinergic vesicles Adrenergic nerve terminals

Prevents storage, depletes

Prevents release Promote transmitter release

Transmitter release

Botulinum toxin Tyramine, amphetamine

Process Affected Transmitter reuptake after release

Drug Example Cocaine, tricyclic antidepressants

Site Adrenergic nerve terminals

Action

Inhibit uptake; increase transmitter effect on postsynaptic receptors Binds receptors; causes contraction Binds nicotinic receptors; opens ion channel in postsynaptic membrane Prevents activation Binds muscarinic receptors; prevents activation Inhibits enzyme; prolongs and intensifies transmitter action

Receptor activation or blockade

Norepinephrine Nicotine

Receptors at adrenergic junctions Receptors at nicotinic cholinergic junctions (autonomic ganglia, neuromuscular end plates) Neuromuscular end plates Receptors, parasympathetic effector cells Cholinergic synapses (acetylcholinesterase)

Tubocurarine Atropine

Enzymatic inactivation of transmitter

Neostigmine

TERIMA KASIH