L1 CNS Overview PDF

(penyampai maklumat] N E R VO US S YS T E M hinteraf) Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and...

(penyampai maklumat] N E R VO US S YS T E M hinteraf) Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. ChemicalR messenger ( 4. Differentiate between types of neurotransmitters and their functions. - 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. t. Explain reflex are Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. Overview: The nervous system is a network of neurons whose main feature is to - generate, modulate and transmit information between all the -acc - different parts of the human body. sath sistem * neuron semua - nervous system ada neuron. process - menghantar information  Cells of the nervous system (Neuron vs Glial cells) & bagi garisan ( ( and isi apata X C (. Celia fatup die har axon( , compat & fx of dan lebih cepat - node & mi Chita mmg nah die compat) hahspeed up ( Neuron S Cells of the nervous system (Neuron vs Glial cells) & chwar cell Glial cell ligodendrocht-X semna birn ni Yang Microglial cell E percymal cell A strong tr D Name ( example of glial cell - - die support tapi Glial cells die , tak boleh bagi manan and etc generat... Cells of the nervous system fx glial cells = The nervous system consists of neurons and glial cells. Neurons generate and propagate action potential/signals/nerve impulses. Glial cells do not conduct nerve impulses, but, instead, support, nourish, and protect the neurons. Cells of the nervous system Neurons classifications w Multipolar Bipolar Unipolar Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. Divisions of the nervous system Legala saraf except M brain & spinal cord. C ( I.. 2 * - die guan * tapi dalam process mazan Sama hitalase nervous control · benda yang macan nah anghet targan defi jantung real-tenary laJh. CNS vs PNS taktangs Central Nervous Peripheral Nervous "penting Feature Similarities System (CNS) System (PNS) Both consist of Cranial nerves, nervous tissue and Brain and spinal - Components spinal nerves, and are essential parts cord - ganglia boleh jawab of the overall - all nerves in the body - nervous system. except brain Aspinal Both work together Integrates sensory Connects the CNS to maintain data; processes, to limbs and homeostasis and Main Function stores, and organs; transmits - enable voluntary coordinates motor sensory and motor - and involuntary commands signals - - actions. Somatic vs autonomic Feature Somatic Nervous System (SNS) Autonomic Nervous System (ANS) Chelefel Voluntary (conscious musile) Involuntary (automatic Control movement) Jalan functions) degupa janting , nyanyi , , & igestion , bernafas Smooth muscles, cardiac muscles, Target Organs Skeletal muscles - - - and en glands Regulates involuntary functions Controls voluntary movements Function (heart rate, digestion, and reflex arcs respiration) Somatic vs autonomic * Feature Somatic Nervous System (SNS) Autonomic Nervous System (ANS) Acetylcholine (ACh) in Neurotransmitter Acetylcholine (ACh) parasympathetic; Noradrenaline - (NE) in sympathetic adrenaline Sympathetic (fight or flight) - Divisions None and Parasympathetic (rest and - digest) Sympathetic vs Parasympathetic & Cencibo : benda j boleh Scenario : relax Control were mejar tengah tegon ft anging. parasympathetic = sympathetic Feature Sympathetic - - Parasympathetic - - Restores and conserves energy Prepares the body for action Main Function ("Rest and Digest") ("Fight or Flight") & here fan reaction para and Sympa apa Acetylcholine (ACh) for [ ] Acetylcholine (ACh) for both preganglionic; Noradrenaline kIV Neurotransmitter preganglionic and (NE) for most postganglionic postganglionic neurons - neurons - Sympathetic vs Parasympathetic * n paling banyan alla Parasympathetic Parts Sympathetic helna. Constrict ( Pupil ( Dilates sempit mengembang Increases S I Saliva X Decreases Decreases I Heart rate I Increases Constrict sempit [ Bronchus X Dilates Stimulate L GI tract Inhibit rangan I - Contract ↓ Bladder L Relax T Relax I Urethra & Contract Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. Main functions of nervous systems - Sensory Input: Detects and transmits sensory information from the body and environment to the CNS. Integration: Processes and interprets sensory information to determine appropriate responses. gennas Motor Output: Sends signals from the CNS to muscles and glands to execute responses. lahsanakan Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc.  chemical mesgeger Neurotransmitters ~ & & Neurotransmitters are often referred to as the body’s chemical messengers. die antara buhan neutron , dalam neuron. X They are the molecules used by the nervous system to transmit & - messages between neurons, or from neurons to muscles. Excitatory neurotransmitters “excite” the neuron and cause it to & X * “fire off the message,” meaning, the message continues to be passed along to the next cell. Inhibitory neurotransmitters block or prevent the chemical message ↓ from being passed along any farther 8 How are neurotransmitters removed from synapse? (partembyr- Neurotransmitter anturn were attach 2 neurons) dalan midt action potential bilesesuate -degrade. Ou degradative - one direction only dan dilansangham - - hanchr renotransmitter alan a the bernlary-ulang lasi What can go wrong? Too much/ little neurotransmitters are produced/released. f The receiver cell’s receptor isn’t working properly. ↓ The cell receptors aren’t taking up enough neurotransmitter. ↓ Sufficient neurotransmitters released but are reabsorbed too quickly.  Neurotransmitters hatal fo binta ⑳etween nensor * ADRENALINE (Fight or flight) - GABA (Calming) (INHIBITORY)* Produced in stressful situations. Calms firing nerves in the central Increases heart rate and blood flow, nervous system. High levels improve focus, leading to physical boost and low levels cause anxiety. Also contributes heightened awareness to motor control and vision NORADRENALINE (Concentration) ACETYCHOLINE (Learning) - - Affects attention and responding Involved in thought, learning and actions in the brain. Contracts blood memory. Activates muscle action in the vessels, increasing blood flow body. Also associated with attention and awakening  Neurotransmitters PDOPAMINE (Pleasure) (EXCITATORY) - GLUTAMATE (Memory) - (excitatory) * Feeling of pleasure, also addiction, Most common neurotransmitter. movement and motivation. People repeat Involved in learning and memory, behaviors that lead to dopamine release regulates development and creation of nerve contacts *SEROTONIN (Mood) ~ ENDORPHINS (Euphoria) ~ Contributes to well-being and happiness. Released during exercise, excitement and Helps sleep cycle and digestive system sex, producing well-being and euphoria, regulation. Affected by exercise and reducing pain light exposure - Neurotransmitters Substance Receptor S Adrenaline A Noradrenaline * Dopamine apakah Serotonin nama GABA receptor. Acetylcholine * Glutamate Endorphins Next lecture…. Piercel Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. Action potential dalam neuron. Outside Nerve signals are transmitted by Action potential (A.P). inside AP are rapid changes in the membrane potentials that spread rapidly along the neurons. resting potential Membrane potential is the difference in voltage between the inside and outside of the cell. Conc of Na+ is higher in the outside cell whereas conc of K+ is higher in the inside cell resulting in neuron resting potential of -70mV. At resting potential, neuron is said to be - polarized, and ion channels are closed. (Voltage gated sodium channel and Voltage en ~ gated potassium channel) When a neuron is stimulated by a receptor or other neuron, the membrane potential becomes slightly positive due to opening of voltage gated a sodium channel ↓be yerah hea Sikit marke da lau If the stimulus is strong enough to exceed the threshold, full depolarisation occurs diedhanbergerah-to--60--50 high dis boleh indi positif.  when soglium open During Cdepolarisation, voltage gated sodium channel open (Na gets in) then the inside of the cell becomes more positive. This spike is called the peak of action potential Then, Voltage gated potassium channel open - allowing more potassium gets outside of the cell - which- then causes repolarisation. U + ala pageran dienkam pade dolam he luar jadi negativea Hyperpolarisation happens when the membrane repolarises beyond its resting potential and through this time a neuron could not fire another action potential. This is to ensure that each sbb diefanak overlap die , Kalanbanyah msg action potential does not overlap. 11 Witeahangila allan Pentbbthea melebih.. covers Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. Synapses The site where an axon connects to another cell to pass the neural impulse is called a synapse. - Most synapses are chemical; doesn't connect to the next cell directly. = Instead, the impulse triggers the release of chemicals called neurotransmitters from the very end of an axon. They are chemical messenger used within nervous system · Synapses Other synapses are electrical. In these synapses, direct physical connection between the presynaptic neuron and the postsynaptic neuron and ions flow directly between cells. Electrical synapses transmit signals more rapidly than chemical synapses do. Some synapses are both electrical and chemical. Chemical vs Electrical synapses Chemical synapse Objectives: At the end of this lecture, students should be able to: 1. Describe the structure of neurons and the function of their components. 2. List the divisions of the nervous system and describe the characteristics of each. 3. List the functions of the nervous system. 4. Differentiate between types of neurotransmitters and their functions. 5. Explain how an action potential is generated and propagated. 6. Explain the processes involved in synaptic transmission. 7. Differentiate voluntary neural pathway vs reflex arc. Voluntary neural pathway vs Reflex arc?? A voluntary neural pathway generally refers to the standard pathway &of neural communication involving conscious thought, decision- making, and voluntary control. A standard neutral pathway. refers to generally neural communication both and PNS involving CNS Stimulus > Sensory neurons/afferent neurons > interneurons > brain & spinal cord > motor neurons/efferent neurons > effector organ Wh Voluntary neural pathway vs Reflex arc?? A reflex arc is the neural pathway that mediates a reflex action—an automatic and rapid response to a stimulus without conscious thought. Stimulus > Sensory neurons/afferent neurons > interneurons > brain & spinal cord > motor neurons/efferent neurons > effector organ. Reflex arcs are designed to protect the body from harm by enabling quick reactions to potentially dangerous situations. 1. Differentiate normal arc vs reflex arc. vide link denat wassap. C N S S TI M U L A N TS  Objectives At the end of this lecture, students should be able to: 1. State the effects of psychomotor stimulants and hallucinogens 2. Explain the examples of Psychomotor stimulants, their mechanism of action, therapeutic indications and side effects 3. State the example of hallucinogens  Objectives At the end of this lecture, students should be able to: 1. State the effects of psychomotor stimulants and hallucinogens 2. Explain the examples of Psychomotor stimulants, their mechanism of action, therapeutic indications and side effects 3. State the example of hallucinogens  CNS Stimulants CNS Stimulants A type of drug that increases the levels of certain chemicals/neurotransmitters in the BRAIN and increases alertness, attention, energy, and physical activity. Psychomotor Hallucinogens stimulants Cause excitement, euphoria (intense Distort perception (hallucinations - seeing, happiness), decrease feelings of fatigue hearing, tasting, smelling, or feeling something and increase motor activity that isn't there)  Objectives At the end of this lecture, students should be able to: 1. State the effects of psychomotor stimulants and hallucinogens 2. Explain the examples of Psychomotor stimulants, their mechanism of action, therapeutic indications and side effects 3. State the example of hallucinogens Psychomotor Stimulants Caffeine Found in cocoa, coffee products, tea, cola drinks, energy drinks, etc MOA: increases levels of dopamine by blocking its reuptake. Therapeutic uses: Used in combination with PCM and aspirin for pain/headache to increase alertness Side effects: insomnia, anxiety, gastritis, frequent urination, increased heart rate, addiction Tolerance and withdrawal occur (fatigue, sedation)  Psychomotor Stimulants Nicotine Active ingredient in tobacco, Low dose cause relaxation, improves attention, learning, problem solving, but high dose can cause respiratory paralysis. MOA: Nicotine binds to nicotinic acetylcholine receptors in the brain, causing the release of dopamine, which is linked to pleasure and reward. Therapeutic uses: Nicotine replacement therapy (NRT) but without tars and carbon monoxide. S/E: skin irritation when using patches, irritation of nose, throat or eyes when using a nasal spray, difficulty sleeping (insomnia), sometimes with vivid dreams, upset stomach, dizziness, headaches and addiction. Psychomotor Stimulants Cocaine Highly addictive and causes intense euphoria Extracted from coca leaves, cocaine was originally developed as a painkiller. Sniffed, ingested or rubbed into the gums. MOA: Cocaine primarily works by blocking the reuptake of dopamine, serotonin, and noradrenaline in the brain. Cocaine has limited therapeutic use, but it is very rare and highly controlled due to its addictive potential and risk of abuse.  Psychomotor Stimulants Methylphenidate MOA: Increases the release of dopamine and noradrenaline to improve attention span and reduce hyperkinesia. Therapeutic uses: Attention deficit hyperactivity disorder (ADHD) - lack of dopamine and noradrenaline - hyperkinetic, lack the ability to be involved in one activity for longer than a few minutes - p/s: Atomoxetine (non-stimulant) also commonly used in Malaysia for - ADHD - Psychomotor Stimulants Amphetamines: Used medically for ADHD and narcolepsy, with a moderate risk of addiction when used improperly. (Not available in Malaysia) Methamphetamines: Far more potent, more addictive, and associated with illicit drug use, though it has limited medical applications. Psychomotor Stimulants insomnia nah tido susah Modafinil. Sentido - > - a Used for narcolepsy (chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep) MOA – increases dopamine level to promote wakefulness  Psychomotor Stimulants Phentermine MOA: Phentermine stimulates the release of noradrenaline. This triggers a "fight-or-flight" response, which helps suppress appetite and boost Nikocado Avocado energy levels, making people feel less hungry and more alert. Therapeutic use: Obesity For short term use only (12 weeks)- tolerance Side effects: Insomnia, confusion, nausea, addiction  Objectives At the end of this lecture, students should be able to: 1. State the effects of psychomotor stimulants and hallucinogens 2. Explain the examples of Psychomotor stimulants, their mechanism of action, therapeutic indications and side effects 3. State the example of hallucinogens  Hallucinogens Marijuana Extracted from Cannabis plants Altered perceptual states, dreams Midhem +1 - + 6 21/11/24 C H O L I N ER GI C A G O N I S TS  Objectives At the end of this lecture, students should be able to: 1. Understand the cholinergic system 2. Identify the classification of cholinergic agonist 3. Provide the examples of cholinergic agonist based on therapeutic indications 4. Explain the side effects of cholinergic agonists  Objectives At the end of this lecture, students should be able to: 1. Understand the cholinergic system 2. Identify the classification of cholinergic agonist 3. Provide the examples of cholinergic agonist based on therapeutic indications 4. Explain the side effects of cholinergic agonists Cholinergic system The cholinergic system refers to the components of the nervous system that use acetylcholine (ACh) as a neurotransmitter. ACh is the primary neurotransmitter in the parasympathetic nervous system (PNS) that controls rest and digest responses, but to some extent, plays a role in the central nervous system (CNS). Cholinergic drugs mainly act on Parasympathetic of the PNS and Somatic nervous system. Cholinergic system They are two receptors that uses ACh: ( (Muscarinic Receptors (M1, M2, M3, M4, M5): These are G-protein - coupled receptors that are found in the parasympathetic target organs (smooth - - muscle – digestive tract, blood vessels, respi, urinary, heart, - - - - - glands). (Para) - (Nicotinic Receptors( (Nn, Nm): These are ionotropic receptors found in autonomic ganglia (Para&Sympa) and in the skeletal muscles – arms, legs, neck, shoulder (Somatic) Ganglia Smooth Skeletal muscles muscles  Objectives At the end of this lecture, students should be able to: 1. Understand the cholinergic system 2. Identify the classification of cholinergic agonist 3. Provide the examples of cholinergic agonist based on therapeutic indications 4. Explain the side effects of cholinergic agonists Classification of cholinergic agonist drugs Cholinergic agonists are drugs that mimic the action of ACh by activating cholinergic receptors. C Direct-ActingC Cholinergic Agonists: These drugs bind directly to cholinergic receptors and stimulate them, mimicking the effects of acetylcholine. (Indirect-Acting (Cholinergic Agonists: These drugs do not bind to receptors directly but inhibit acetylcholinesterase (AChE), the enzyme that breaks down ACh. This increases the concentration of ACh at synaptic sites, enhancing cholinergic transmission.  Objectives At the end of this lecture, students should be able to: 1. Understand the cholinergic system 2. Identify the classification of cholinergic agonist 3. Provide the examples of cholinergic agonist based on therapeutic indications 4. Explain the side effects of cholinergic agonists Direct-acting muscarinic agonists cindication - glucoma Xerostomia Pilocarpine C - Therapeutic Use: Used in the treatment of glaucoma to reduce intraocular pressure by causing miosis (pupil constriction) and ~ increasing aqueous humor outflow. 0710 · Also used in xerostomia (dry mouth) to stimulate salivary secretion. · Bethanechol Kencing ( Cannah Therapeutic Use: Used to treat urinary retention by stimulating bladder muscle contraction and promoting urination. Also used to treat atonic bladder in postpartum/postoperative and megacolon - urinaryretention - atonic bladder. Direct-acting nicotinic agonists Nicotine Therapeutic Use: Used in smoking cessation therapies to reduce withdrawal symptoms by stimulating nicotinic receptors. Varenicline Therapeutic Use: A partial agonist at nicotinic receptors, also used in smoking cessation. Indirect-Acting Cholinergic Agonists (Acetylcholinesterase Inhibitors) lenhinia Neostigmine Therapeutic Use: Used to treat myasthenia gravis, a condition characterized by muscle weakness. It increases acetylcholine availability at the neuromuscular junction (Somatic) Physostigmine Therapeutic Use: Used as an antidote for anticholinergic toxicity (e.g., atropine overdose). Indirect-Acting Cholinergic Agonists (Acetylcholinesterase Inhibitors) Donepezil, Rivastigmine, Galantamine Densipa Ro ⑧ Therapeutic Use: Used in the management of Alzheimer’s disease to enhance cholinergic transmission in the brain and improve cognitive function.  Objectives At the end of this lecture, students should be able to: 1. Understand the cholinergic system 2. Identify the classification of cholinergic agonist 3. Provide the examples of cholinergic agonist based on therapeutic indications 4. Explain the side effects of cholinergic agonists Side effects of cholinergic agonists (muscarinic) Additional effects: Bronchoconstriction: Can exacerbate conditions like asthma. Bradycardia: Slowed heart rate. Hypotension: Due to vasodilation. Miosis: Pupil constriction, potentially impairing vision in low light. Side effects of cholinergic agonists (nicotinic) Muscle Cramps: Due to excessive stimulation of skeletal muscles. Tachycardia: Increased heart rate (effect due to stimulation of sympathetic ganglia). Hypertension: Elevated blood pressure due to activation of sympathetic ganglia Cholinergic crisis Overdose of cholinergic agonists (particularly indirect-acting agents) can result in excessive stimulation of cholinergic receptors, leading to cholinergic crisis. Symptoms include severe muscle weakness, respiratory paralysis, and excessive SLUDGE effects. This condition can be life-threatening and requires prompt treatment, often with atropine (a muscarinic antagonist). A D R E N E R G I C A G O N I S TS  Objectives At the end of this lecture, students should be able to: 1. Understand the adrenergic system 2. Identify the classification of adrenergic agonist 3. Provide the examples of adrenergic agonists based on therapeutic indications 4. Explain the side effects of common adrenergic agonists  Objectives At the end of this lecture, students should be able to: 1. Understand the adrenergic system 2. Identify the classification of adrenergic agonist 3. Provide the examples of adrenergic agonists based on therapeutic indications 4. Explain the side effects of common adrenergic agonists  Adrenergic system The cholinergic system refers to the components of the nervous system that use noradrenaline (NA) or adrenaline as their neurotransmitters. - NA and adrenaline are the primary neurotransmitters in the (1)( sympathetic nervous system (SNS) that controls fight and flight responses. Adrenergic drugs mainly act on SNS. Adrenergic system Adrenergic neurons release noradrenaline as the primary neurotransmitter Adrenergic Receptors with functions Adrenergic receptors are classified into two main types Alpha receptors (α1 and α2) Beta receptors (β1, β2, and β3) Adrenergic Receptors with functions Alphe Alpha 2 - α2 receptor located negative feelback mecanism ↳ on presynaptic neuron When it is activated, it will further reduce NA D (negative feedback) Urethra constriction Adrenergic Receptors with functions o &  Objectives At the end of this lecture, students should be able to: 1. Understand the adrenergic system 2. Identify the classification of adrenergic agonist 3. Provide the examples of adrenergic agonists based on therapeutic indications 4. Explain the side effects of common adrenergic agonists  Classifications of adrenergic drugs Direct-acting Adrenergic Agonists - These drugs act directly on adrenergic receptors to stimulate their effects. Indirect-acting Adrenergic Agonists - These drugs increase the release of endogenous catecholamines (e.g., NA) from nerve terminals or inhibit - the reuptake of catecholamines, thus indirectly stimulating adrenergic receptors. Mixed-acting Adrenergic Agonists - These drugs stimulate adrenergic receptors directly and also promote the release of endogenous catecholamines.  Objectives At the end of this lecture, students should be able to: 1. Understand the adrenergic system 2. Identify the classification of adrenergic agonist 3. Provide the examples of adrenergic agonists based on therapeutic indications 4. Explain the side effects of common adrenergic agonists Adrenergic Agonists Adrenaline Indication ? Advertine Act on both α and β adrenoreceptors. Given IV, SC (upper arm/abdominal fat), IM (thigh) as not stable orally. Used for: Anaphylactic shock: Vasoconstriction via α1 and bronchodilation via β2 action Cardiac arrest: restore cardiac rhythm as can increase heart muscle contractility and output via β1 action Aid in anaesthesia: Contained in local anaesthetics to increase duration as can stay longer in injection site (delay absorption into systemic due to vasoconstriction – α1 action)  Adrenergic Agonists Dobutamine Used in acute heart failure - Increase cardiac output (β1 action) Oxymetazoline (spray) Phenylephrine, Ephedrine and Pseudoephedrine (oral) – also called decongestants Used for congested nose and eye redness due to vasoconstriction (α1 action). Use max 1 week or else rebound! Decongestants Adrenergic Agonists Clonidine Used in hypertension. Provides vasodilation effect (B2 action) Salbutamol, Terbutaline, Albuterol (SABA) and Salmeterol, Formoterol (LABA) Used in COPD and asthma. Provides bronchodilation effect (β2 action) Mirabegron Used in overactive bladder. Increases bladder capacity by relaxing the muscle bladder (β3 action)  Objectives At the end of this lecture, students should be able to: 1. Understand the adrenergic system 2. Identify the classification of adrenergic agonist 3. Provide the examples of adrenergic agonists based on therapeutic indications 4. Explain the side effects of common adrenergic agonists Adrenergic Agonists side effects (common) Adrenaline: increased heart rate, hypertension, and anxiety. Salbutamol: tremors, palpitations, and headache. Phenylephrine: hypertension and rebound congestion with prolonged use. Dobutamine: increased heart rate and arrhythmias. A D R E N E R G I C A N TA G O N I S T S  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of adrenergic antagonist based on therapeutic indications 2. Explain the side effects of common adrenergic antagonists  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of adrenergic antagonist based on therapeutic indications 2. Explain the side effects of common adrenergic antagonists Adrenergic Antagonist classification Adrenergic antagonists, also known as adrenergic blockers are drugs that inhibit the action of catecholamines (such as adrenaline and noradrenaline) at adrenergic receptors. These drugs primarily block alpha (α) and beta (β) adrenergic receptors, which mediate (intervene) the effects of the sympathetic nervous system. α-blocker classification + therapeutic indications α blocker Non-selective α blocker Selective α blocker * α-blocker classification + therapeutic indications Non-selective α blocker Previously, used to treat hypertension by blocking α1 receptor causing vasodilation But also block α2 receptor that produces negative feedback to noradrenaline production So, no inhibition of noradrenaline secretion. henaa gara Excess noradrenaline secretion then stimulate b1 in the heart causing tachycardia and cardiac arrythmias. Hence not commonly used for HPT anymore α-blocker classification + therapeutic indications Selective α1 blocker Prazosin Causes vasodilation in blood vessels Used for hypertension Doxazosin, Terazosin, Tamsulosin, Alfuzosin, Silodosin Relax sphincter muscle (urethra) of the urinary bladder Used for - Benign Prostate Hyperplasia (BPH) ada thmom - tapidiethethe a β -blocker classification + therapeutic indications - - * * * β -blocker classification + therapeutic indications Non-selective β blockers Block both β1 and β2 receptors, reducing resear heart rate and contractility (β1 effect) while also inhibiting bronchodilation and vasodilation (β2 - --- effect). ~  β -blocker classification + therapeutic indications - Indications: Hypertension: Reduce cardiac output and renin release (β1 - blockade). Angina: Decrease oxygen demand of the heart by reducing heart = kurang & onnigen rate. Arrhythmias: Used for rhythm control in conditions like atrial - die fibrillation. beating tak salenta. mater Glaucoma: Timolol reduces intraocular pressure by decreasing - aqueous humor production. Migraine Prophylaxis: Propranolol is often used to prevent = migraines. β -blocker classification + therapeutic indications Selective β1 blockers Block β1 receptors predominantly in the heart, leading to reduced heart rate and contractility with less effect on β2 receptors (bronchi, vasculature). - > - - β -blocker classification + therapeutic indications Indications: Hypertension: Particularly beneficial in patients with asthma or COPD because of their selectivity. Heart Failure: Used in chronic heart failure to reduce mortality (e.g., metoprolol, bisoprolol). Myocardial infarction: Reduce cardiac workload and improve survival.  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of adrenergic antagonist based on therapeutic indications 2. Explain the side effects of common adrenergic antagonists Side effects Non-selective alpha Selective alpha 1 - block at - blockers - bold alpha l S blockers - Postural hypotension Postural hypotension (due to α1 blockade) Dizziness Tachycardia (due to α2 blockade, leading to increased norepinephrine release) Nasal congestion amje Side effects * nitanya - Non-selective beta Selective beta 1 blockers blockers Bronchoconstriction due Bradycardia to β2 blockade Hypotension (asthmatic!) Fatigue Bradycardia Dizziness Fatigue Cold extremities  - Summarize Cholinergic Antagonist Solifenacin, oxybutynin very important , ahan hea a Relax detrusor muscle Cholinergic Agonist Bigger bladder to hold Bethanechol urine Contract detrusor Treat urinary muscle Incontinence Don’t Get Smaller bladder to promote urination Urinary Retention Confused!! Adrenergic Agonist Adrenergic Antagonist Tamsulosin, Alfuzosin Mirabegron Relax sphincter muscle Relax detrusor muscle to promote urination Bigger bladder to hold Urinary Retention urine Treat urinary Incontinence C H O L I N ER G I C A N TA G O N IS TS  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of cholinergic antagonists. 2. Provide examples of cholinergic antagonists based on therapeutic indications. 3. Understand the side effects of anticholinergic drugs  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of cholinergic antagonists. 2. Provide examples of cholinergic antagonists based on therapeutic indications. 3. Understand the side effects of anticholinergic drugs Classifications of Cholinergic antagonists Cholinergic antagonists (also known as anticholinergics) are drugs that inhibit the action of acetylcholine by blocking its receptors. Muscarinic antagonists Block muscarinic receptors in the parasympathetic nervous system. Prevent parasympathetic effects like decreased heart rate and increased digestive activity. Nicotinic Antagonists Inhibit nicotinic receptors at both somatic (skeletal muscle) and - autonomic (sympa&para)  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of cholinergic antagonists. 2. Provide examples of cholinergic antagonists based on therapeutic indications. 3. Understand the side effects of anticholinergic drugs Cholinergic antagonists (Muscarinic antagonists aka antimuscarinic) Atropine ( ~ Therapeutic uses: Treats bradycardia, gives mydriasis before surgery Used in pre-anesthesia to reduce salivation. Reversal of cholinergic drugs poisoning. Mechanism: Blocks muscarinic receptors in the heart, increasing heart rate by preventing parasympathetic-induced slowing of the heart. Cholinergic antagonists (Muscarinic antagonists aka antimuscarinic) Ipratropium and Tiotropium Therapeutic uses: Used as bronchodilators in chronic obstructive pulmonary disease (COPD) and asthma. Mechanism: Blocks muscarinic receptors in the lungs, preventing bronchoconstriction and promoting bronchodilation. Oxybutynin and Tolterodine Therapeutic uses: Treats ① overactive bladder and urinary incontinence. num Mechanism: Blocks muscarinic receptors in the bladder, reducing bladder muscle contractions. Cholinergic antagonists (Nicotinic antagonists) Rocuronium Therapeutic uses: Used for muscle relaxation in surgery or mechanical ventilation. Mechanism: Neuromuscular blocker that competes with ACh at the neuromuscular junction of the skeletal muscle, leading to muscle relaxation.  Objectives At the end of this lecture, students should be able to: 1. Identify the classification of cholinergic antagonists. 2. Provide examples of cholinergic antagonists based on therapeutic indications. 3. Understand the side effects of anticholinergic drugs Cholinergic antagonist (muscarinic) –⑧side effects ⑨ Blurred vision Urinary retention Dry mouth - Decreased GI motilityI constipation. Cholinergic antagonist (nicotinic) – side effects Muscle paralysis (with neuromuscular blockers like rocuronium). Respiratory depression (due to paralysis of respiratory muscles). Hypotension (due to ganglionic blockade disrupting autonomic regulation of blood pressure).