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Part 2. nb. Asthma / COPD: Ipratropium Beta blockers Pilocarpine. Bronchoconstriction. Parasympathetic. Sympathetic chains. Vagi. Sympathetic nerves. Sympathetic nerves. Left vagus. Sympathetic trunk, middle cervical ganglion. Thoracic aortic plexus. Vagus nerve on aortic arch.

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slide2

Asthma / COPD:

Ipratropium

Beta blockers

Pilocarpine

Bronchoconstriction

Parasympathetic

slide3

Sympathetic chains

Vagi

Sympathetic

nerves

Sympathetic

nerves

slide4

Left vagus

Sympathetic trunk, middle cervical ganglion

Thoracic aortic plexus

Vagus nerve on aortic arch

Sympathetic trunk, thoracic ganglia

Cardiac plexus

slide5

Lacrimal gland

III

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide6

Autonomic drugs are very important in cardio-vascular system e.g. hypertension, angina, stable cardiac failure, shock, postural hypotension

slide10

Anhydrosis:

Neoplasms

Spinal cord injuries

Lumbar sympathectomy

Lacrimal gland

III

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide12

Lacrimal gland

III

Pheochromacytoma:

Alpha blockers

Beta blockers ?

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide13

Lacrimal gland

III

Glycogenolysis / gluconeogenesis:

β2 effects.

Beta blockers may mask the effects of anti-diabetic therapy

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide16

Lacrimal gland

III

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide17

P

A

R

A

S

Y

M

P

A

T

H

E

T

I

C

S

Y

M

P

A

T

H

E

T

I

C

slide19

Lacrimal gland

Overflow incontinence

Urge incontinence

Antimuscarinics

III

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide20

Parasympathetic

Sympathetic

slide22

Premature Labor:

β2 receptors cause relaxation of both pregnant and non –pregnant uteri. Beta agonists e.g. ritodrine

Lacrimal gland

III

VII

IX

X

T1

T1

T2

T2

T3

T3

T4

T4

T5

T5

T6

T6

T7

T7

Parasympathetic

Sympathetic

T8

T8

T9

T9

T10

T10

T11

T11

T12

T12

L1

L1

L2

L2

L3

L3

L4

L4

L5

L5

S1

S1

S2

S2

Pre-ganglionic

Blue

Pre-ganglionic

Red

S3

S3

S4

S4

Post-ganglionic

Pink

Post-ganglionic

Green

slide24

or

-

+

Heteroceptor

Synaptic Vesicle

Presynaptic

-

Autoreceptor

Reuptake

Synaptic cleft

An autoreceptor is located on the nerve terminal

A heteroceptor is located on the nerve terminal

and it is activated by the neurotransmitter released by the same nerve terminal

it is activated by a neurotransmitter secreted by another nerve

and modulates the release of the same neurotransmitter

but modulates the release the neurotransmitter secreted by the nerve terminal on which it is located

Postsynaptic

slide25

Autoreceptor:

ACh inhibiting its own release from presynaptic terminal

Autoreceptor:

NE inhibiting its own release from presynaptic terminal

Heteroceptor:

ACh inhibiting release of NE from adrenergic presynaptic terminal

Heteroceptor:

NE inhibiting release of ACh from cholinergic presynaptic terminal

Presynaptic regulation of transmitter release from noradrenergic and cholinergic nerve terminals

Sympathetic

Parasympathetic

NA = Norepinephrine

ACh = Acetylcholine

+

-

-

-

-

-

NO

PG release

Endothelial

cells

Exocrine gland

Smooth muscle

slide27

e.g. stimulating with insulin in type 2 diabetes

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

+

Cell

Receptor down-regulation

slide28

e.g. blocking with beta-blockers

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

Cell

Receptor up-regulation