Week 10 TBL Session for ICSA 5014 PDF

**Week 10 TBL Session for ICSA 5014** Autonomic Nervous System (ANS) **Objectives** - - - All preganglionic axons release acetylcholine.  - Epinephrine is synthesized from NE by the enzyme phenylethanolamine *N*-methyltransferase. Approximately 20% of the neurotransmitter release...

**Week 10 TBL Session for ICSA 5014** Autonomic Nervous System (ANS) **Objectives** - - - All preganglionic axons release acetylcholine.  - Epinephrine is synthesized from NE by the enzyme phenylethanolamine *N*-methyltransferase. Approximately 20% of the neurotransmitter released by the adrenal medulla is NE with Epi accounting for the other 80%.  Epinephrine degradation occurs by: **Metabolic breakdown**: The physiological effects of epinephrine are terminated by metabolic breakdown through monoamine oxidase (MAO) or catechol-O-methyltransferase (COMT). **Reuptake**: Epinephrine can be reabsorbed into nerve endings. **Diffusion**: Epinephrine can diffuse away from active sites. - - TABLE 6.2 Responses of Effectors to Parasympathetic and Sympathetic Stimulation ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- **Region** **Effector** **Parasympathetic\ **Sympathetic\ (Muscarinic Receptors)** (Adrenergic Receptors)** --------------------------- ------------------------- ------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- *Eye and face* Pupil Constriction:\ Dilation (α~1~):\ via circular muscle contraction\ via radial muscle contraction\ (miosis) (mydriasis) Ciliary muscle Contraction Relaxation (β~2~) Müller muscle None Contraction (α~1~) Lacrimal gland Secretion None Nasal glands Secretion Inhibition (α~1~) Salivary glands Secretion Amylase secretion (β) *Skin* Sweat glands None Secretion (cholinergic muscarinic receptors) Piloerector muscles None Contraction (α~1~) *Blood vessels* Skin (general) None Constriction (α) Facial and neck muscles Dilation (?)[\*](https://premiumbasicsciences-lwwhealthlibrary-com.scnmlib.idm.oclc.org/content.aspx?sectionid=165533446&bookid=2188#rhoades5-ch006-tbl002-fn001) Constriction (α)\ Dilation (?)[\*](https://premiumbasicsciences-lwwhealthlibrary-com.scnmlib.idm.oclc.org/content.aspx?sectionid=165533446&bookid=2188#rhoades5-ch006-tbl002-fn001) Skeletal muscle None Dilation (β~2~)\ Constriction (α) Viscera None Constriction (α~1~) *Heart* SA Node Decrease heart rate Increase heart rate (β~1~ \> β~2~) AV Node Decrease conduction velocity Increase conduction velocity (β~1~ \> β~2~) Atria Decrease contractility Increase contractility\ (β~1~ \> β~2~) Ventricle Little effect Increase contractility\ (β~1~ \> β~2~) *Lungs* Bronchioles Constriction Dilation (β~2~) Glands Secretion Decrease (α~1~)\ Increase (β~2~) *Gastrointestinal tract* Wall muscles Contraction Relaxation (α, β~2~) Sphincters Relaxation Contraction (α~1~) Glands Stimulation Inhibition (α~2~) *Metabolic functions* Liver None Glycogenolysis and gluconeogenesis (α~1~, β~2~) Pancreas (insulin) Increased secretion Decreased secretion (α~2~) Adipose Cells None Lipolysis (β~3~) Kidney None Renin release (β~1~) Adrenal medulla None Secretion of epinephrine (cholinergic nicotinic) *Urinary system* Ureter Relaxation Contraction (α~1~) Detrusor Contraction Relaxation (β~3~ \> β~2~)[^†^](https://premiumbasicsciences-lwwhealthlibrary-com.scnmlib.idm.oclc.org/content.aspx?sectionid=165533446&bookid=2188#rhoades5-ch006-tbl002-fn002) Sphincter Relaxation Contraction (α~1~) *Reproductive system* Uterus Variable Contraction (α~1~)\ Relaxation (β~2~) Genitalia Erection (ACh and NO) Ejaculation/vaginal contraction (α) *Autonomic nerve endings* Autoreceptor Presynaptic inhibition of ACh release Presynaptic inhibition of NE release (α~2~) Heteroreceptor Presynaptic inhibition of NE release Presynaptic inhibition of ACh release (α~2~) ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- - - TABLE 6.4 Common Treatments for Disorders Involving the ANS ---------------------------------------------------------------------------------------------------------------------------------------------------- **Indication** **Example Generic** **Example Brand Name** --------------------------------- -------------------------- ------------------------------ ------------------------------- ------------------------ **ACh Receptor Agonists:** Muscarinic Receptor Glaucoma Pilocarpine Salagen Sjögren\'s syndrome Urinary retention Bethanechol Urecholine Bronchoprovocation testing Methacholine Provocholine Nicotinic Receptor Smoking cessation Varenicline (partial agonist) Chantix **ACh Receptor Antagonists:** Muscarinic Receptor COPD Ipratropium Atrovent Motion sickness Scopolamine Transderm-Scop Overactive bladder Tolterodine\ Detrol\ Darifenacin Enablex Parkinson\'s disease Trihexyphenidyl Artane Nicotinic Receptor:\ Surgical paralysis Succinylcholine Anectine (Depolarizing) Nicotinic Receptor:\ Surgical paralysis Rocuronium Zemuron (Nondepolarizing) **NE Receptor Agonists:** Nonselective agonist Anaphylaxis Epinephrine EpiPen Indirect Sympathomimetic Decongestant Pseudoephedrine Sudafed Narcolepsy Amphetamine Adderall, Vyvanse ADHD Amphetamine Adderall, Vyvanse Methylphenidate Ritalin α~1~ Receptor Decongestant Phenylephrine Sudafed-PE α~2~ Receptor Hypertension Clonidine Catapres Glaucoma Brimonidine Agan P β~1~ Cardiogenic shock Dobutamine Dobutrex β~2~ Asthma rescue therapy Albuterol Proventil HFA Asthma prophylaxis Salmeterol Serevent Diskus Premature labor Terbutaline Terbulin β~3~ Overactive bladder Mirabegron Myrbetriq **Blockers of NE Transporter:** ADHD Atomoxetine Strattera **NE Receptor Antagonists:** α~1~ Hypertension Terazosin Hytrin Benign prostatic hyperplasia Tamsulosin Flomax β~1~ Hypertension\ Metoprolol Lopressor Arrhythmias\ Angina\ Congestive heart failure Glaucoma Timolol Timoptic ---------------------------------------------------------------------------------------------------------------------------------------------------- **Preparation** Rhoades and Bell [Chapter 6](https://scnmlib.idm.oclc.org/login?url=https://premiumbasicsciences.lwwhealthlibrary.com/content.aspx?sectionid=253086161&bookid=3211) Instructor's lecture materials for the autonomic nervous system **Note**: No access to non-SCNM internet resources will be permitted during this TBL session. Please do not expect to use google or any other search engine or online resources like Wikipedia. You may bring your textbooks and lecture notes and use resources that are available online through the SCNM library.