2 sympathetic ne review structure nts receptors of

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Unformatted text preview: ic Inhibition: hetero-inhibition Sympathetic NE Auscarinic? ch m Parasympathetic Ach Muscarinic NE onto or Sympathetic 2 Parasympathetic Ach onto muscarinic E F F E C T O R What about AUTO-inhibition? 2 Sympathetic NE Review: • Structure, NTs, & receptors of Somatic, Parasympathetic, & Sympathetic • Receptors on tissues – Note: exceptions and oddities • Where are we going? – understand the neurotransmitters that maintain homeostasis and how drugs we employ can alter ANS function V. Case Study • BD is a 74 yr old African American male with diabetes mellitus and hypertension (HT) who presents at routine eye examination. Intraocular Pressure (IOP) = 39 mmHg (normal 10-20 mmHg) in right eye and 25 mmHg in left eye. Ophthalmoscopy reveals slight cupping of right optic disc. Visual field exam is normal. Patient denies pain or change in vision. Current meds include: metformin, fosinopril and glyburide. Germann andStanfield miosis mydriasis Overview Ciliary muscle relaxation (No PS input) Sympathetic input dilates radial fibers Ciliary muscle contracts with PS input to constricts pupil Increases drainage from canal of Schlemm Decrease IOP Figure 12-9 Kalant et al. Open Angle Glaucoma Based on the information we have just reviewed...what would you recommend? parasympathetic Overview Ciliary muscle relaxation (No PS input) Sympathetic input dilates radial fibers Ciliary muscle contracts with PS input to constricts pupil Increases drainage from canal of Schlemm Decrease IOP Figure 12-9 Kalant et al. Agents for Open Angle Glaucoma Drug Class CHOL or ADR MOA Beta Blockers: Betaxolol, Timolol Inhibit Adr R ↓ production ↓ aqueous inflow 2 Agonists: Apraclonidine 2 Adr R agonist Pre and post synaptic ↓ aqueous inflow Parasympathomimetics: Pilocarpine Carbachol; Physostigmine mAch R constricts ciliary muscle ↑ aqueous outflow Sympathomimetics: Epinephrine Dipivegrin Carbonic anhydrase Inhibitors Prostaglandin Analogues and agonists Decr. Bicarbonate and decr. Fluid transport ↑ aqueous outflow ↓ aqueous inflow ↑ aqueous outflow IV A. Parasympathetic Nervous System Review Housekeeping—digestion, urination, glandular secretion, and energy conservation Actions oppose those of the sympathetic system Decreases heart rate Constricts coronary vessels Constricts tissues in the lungs Dilation of vasculature to visceral organs REST AND DIGEST IV B. Sympathetic Nervous System Review Fight-or-flight—prepares you for acute stress or physical activity Facilitates your motor response with increases in Heart rate and strength of heart contraction Blood pressure Blood supply to the heart and active muscles Metabolic rate and release of glucose by the liver Rate of gas exchange between lungs and blood Mental activity and quickness of response AUTONOMIC: SYMPATHETIC BRANCH THORASIC & LUMBAR CNS SEGMENTS NICOTINIC PREGANGLIONIC FIBER: or or MYELINATED, TISSUE CHOLINERGIC POSTGANGLIONIC: UNMYELINATED & ADRENERGIC PARAVERTEBRAL GANGLION 3 parasympathetic tone sympathetic tone parasympathetic tone parasympathetic parasympathetic Germann and Stanfield parasympathetic tone parasympathetic tone sympathetic tone...
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This document was uploaded on 03/20/2014.

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