Summary of Parasympathetic Nervous System of ANS
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Muscarinic 1 (M1)
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Ganglia cells
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Muscarinic 2 (M2)
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Cardiac muscle
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Muscarinic 3 (M3)
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Sweat glands
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Heart
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↓HR
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M2
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Eye (circular musc.)
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Pinpoint pupil
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M2 & M3
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Eye (cilliary musc.)
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Contract
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M3
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Vascular musc.
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Relax
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M3 (NO)
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Lungs (Broncho mus.)
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Contract
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M3
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GI-tract
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↑ motiility
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M3
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Genito-urinary musc.
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Contract
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M3
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Sweat & Salivary Gland
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↑ excretion
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M3
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Heart
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↓ CO = ↓ contraction & ↓ AV conduction speed = BRADYcardia
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Vascular musc.
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Vasodilation via (NO) production
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Smooth musc.
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↑ intestine & bladder tone (motility) & ↓ sphincter tone
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Eye
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↑ contraction of sphincter (miosis) & ciliary muscle (NEAR vision)
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Glands
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↑ sweating, saliva, gastric acid secretion
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Heart
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↑CO = ↑AV node firing = ↑ HR = TACHYcardia
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Vascular musc.
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NO EFFECT b/c NO innervation
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Smooth musc.
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Relaxation = ↓GI & Urinary tract contraction
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Eye
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Pupil dilation & Loss of NEAR focus (FAR vision)
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Glands
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↓ sweat, saliva, gastric acid secretion
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Central NS (CNS)
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Belladonna Symptoms
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Miosis
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Paralysis of ciliary muscle (loss of accommodation, ability to focus)
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Mydriatic
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Contraction of pupil (leads to pinpoint pupil, ie. Ach)
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Cycloplegia
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Relaxation of pupil (dilation); Atropine: belladonna compound)
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Antimuscarinic
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Block ACh in Parasymp. Effector Junctions
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Antinicotinic
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Block ACh in Ganglia (Para- & Sympathic; NN/N1)
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Antinicotinic
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Block ACh in NMJ (skeletal muscle relaxant, NM/N2)
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Antinicotinic
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Block ACh in Ganglia (both Para- & Sympathetic, NN/N1)
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Agonist
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(1) Acetylcholine, ACh (2) Bethanecol (3) Pilocarpine (4) Methacholine
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Antagonist (-tropine)
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(1) Atropine (2) Scopolamine (3) Homatropine (4) Benzotropine (5) pirenzepine
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mAChs
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Choline Ester
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Acetylcholine; Methacholine
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Carbachol; Bethanechol
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Alkaloids
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Muscarine; Pilocarpine
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nAChs
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Ganglionic Stimulants
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Acetylcholine; Nicotine
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Vareniclinie (partial)
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Acetylcholine
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Ophthalmic (brief miosis)
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Methacholine
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Belladonna poisoning; Urinary retention
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Bethanechol
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Reverse post-op GI depression
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Pilocarpine (alkaloid)
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DOC for Glaucoma
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Reversible
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Edrophonium (Tensilon)
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For myasthenia gravis (extreme muscle weakness)
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Irreversible (comp. Inhibs)
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Neostigmine
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NO (X) BBB; For myasthenia gravis & ileus
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Physostigmine
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(X) BBB; For glaucoma and for treatment of belladonna poisoning
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Pyridostigmine
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Myasthenia gravis
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Ambenonium
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Myasthenia gravis
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Slow Reversible
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Echothiophate
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Glaucoma
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Organophosphate insecticides, nerve gases DFP
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N/A
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General (SLUDE)
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Salivation, Lacrimation, Urination, Diarrhea, Emesis
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Muscarinic (SLUGBAM)
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Salivation/Sz, Lacrimation, Urination, GI distress (D/V), Bronchoconstriction, Abd. cramps, Miosis
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Nicotinic (MTWThF)
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Mydriasis, Tachycardia, Weakness (musc. paralysis), hyperTHermia, Fasciculation
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Muscarinic (SLUGBAM)
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Salivation/Sz, Lacrimation, Urination, GI distress (D/V), Bronchoconstriction, Abd. cramps, Miosis
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