1. sso pendahuluan maret 2008i

7/26/2019 1. SSO Pendahuluan Maret 2008i

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PENDAHULUAN

SUSUNAN SYARAFOTONOM

Prof.Dr.dr.Jazanul Anwar SpFK

Departemen Farmakologi dan Terapetik

Universitas Sumatera Utara

1



2



Nervous System

Central Nervous System Peripheral Nervous System

Autonomic Nervous System Somatic Nervous System

Sympathetic Nervous System Parasympathetic Nervous System

3



4



5



NA

NA = noradrenaline

6



TYROSINE DOPA NA

2

2

1

1

3

Adrenalin

MAO COMT

NA NA

Syaraf pasca anlion si!pa"i#

7



Tyrosine

Tyrosine hydroxylase ↓

DOPA

DOPA carboxylase ↓Dopamine

Dopamine β hydroxylase ↓

!oradrenalineP!"T ↓

Adrenaline

Prod$c"ion of Noradrenalin

#



Or$anisasi sis%em simpa%i&

Figure 16.3'



Pola $!$! s"i!$lasi sis"e! si!pa"i#

( %& Menin#a"#an #eseiaan !en"al( '& Mena!(a) #ecepa"an !e"a(oils!e

( *& Men$rani f$nsi pencernaan dan penel$aran $rin

( +& Mena#"if#an cadanan enersi

( ,& Mena!(a) #ecepa"an pernafasan dan !endila"asisal$ran pernafasan

( -& Mena!(a)#an deny$" .an"$n dan "e#anan dara)

( /& Mena#"if#an #elen.ar #erina"

)*n$si +aal sis%em simpa%i&

1,



( A&%i-asi simpa%i& dalam keadaan krisis a&an meliba%

sel*r*h sis%em simpa%i&. /al ini di&endali&an oleh p*sa%p*sa% simpa%i&yan$ %erdapa% didalam hipotalamus.

( Per*bahanper*bahan yan$ dirasa&an adalah0

( 1. Peningkatan kewaspadaan melal*i a&%i-asi

sis%em re%i&*ler0

menyebab&an perasaan “on edge”

( 2. Perasaan bertenaga dan euphoria dan diser%ai

perasaan mengabaikan rasa takut dan

%emporer tidak sensitif terhadap nyeri

A&%i-asi simpa%i&

11



*& 0er"a!(a) a#"i1i"as pada p$sa"2p$sa"

#ardio1as#$ler dan pernafasan dari pons dan

!ed$la o(lona"a yan !enye(a(#an

penin#a"an3

Te#anan dara)

4edala!an pernafasan

+& Penin#a"an "on$s o"o" secara $!$!

2 !e!($a" pena!pilan !aca! "ean

,& Mo(ilisasi "enaa2"enaa cadanan

!ena!(a) li#oenolisis dan pe!(e(asan lipid

A&%i-asi simpa%i&

12



( %im*la%ion o+ sympa%he%ic di-ision has %o dis%inc%

res*l%s

elease o+ ace%ylcholine or a% speci+ic loca%ions

ecre%ion o+ and in%o $eneral circ*la%ion

( ympa%he%ic $an$lionic ne*rons end in %elodendria

s%*dded i%h 1aricosi"ies +illed i%h

ne*ro%ransmi%%er ranchin$ ne%or& %ha% resembles a s%rin$ o+ pearls

!e*ro%ransmi%%ers and

sympa%he%ic +*nc%ion

13



( "os% pos%$an$lionic +ibers are adreneric

elease

( a*ses -asocons%ric%ion

( A +e are0 C)olineric

( elease ace%ylcholine

%im*la%es sea% $land secre%ion

a*ses -asodila%ion Ni"ro5ideric

( elease ni%ric oxide

( a*ses immedia%e -asodila%ion



14



( 8++ec%s o+ sympa%he%ic s%im*la%ion res*l% primarily

+rom in%erac%ions i%h membrane recep%ors

sensi%i-e %o0

( To %ypes o+ recep%ors0

Alp)a recep"ors

0e"a recep"ors

( 9n $eneral s%im*la%es alpha recep%ors

( s%im*la%es bo%h alpha and be%a recep%ors



15



( o locali:ed sympa%he%ic ac%i-i%y a% -aricosi%ies

in-ol-es %he release o+ and %h*s a++ec%s alpha

recep%ors

( ;enerali:ed sympa%he%ic ac%i-i%y in-ol-es %he

release o+ by %he adrenal med*lla and %here+ore

a++ec%s bo%h alpha and be%a recep%ors



16



TYROSINE DOPA NA

2

2

1

1

3

Adrenalin

MAO COMT

NA NA

Syaraf pasca anlion si!pa"i#

17



( To %ypes o+ alpha recep%ors Alp)a2%

( /as an exci%in$ e++ec% on %he %ar$e% cell

)or example s%im*la%ion o+ alpha1 recep%ors on %he s*r+aces o+

smoo%h m*scle cells is responsible +or0

< ons%ric%ion o+ peripheral blood -essels< los*re o+ sphinc%ers alon$ di$es%i-e %rac%

Alpha recep%ors

1#



Alp)a2'

( es*l%s in loerin$ o+ cyclic-AMP le-els in %he

cy%oplasm

cA"P is an impor%an% messen$er %ha% can ac%i-a%e

or inac%i-a%e &ey en:ymes

( ;enerally has an inhibi%ory e++ec% on %he cell

( The presence o+ alpha2 recep%ors helps coordina%e

ac%i-i%ies be%een sympa%he%ic and parasympa%he%ic

di-isions

( =hen sympa%he%ic di-ision is ac%i-e binds %o

parasympa%he%ic ne*rom*sc*lar and ne*ro$land*lar

>*nc%ions

( This inhibi%s %heir ac%i-i%y

Alpha recep%ors

1'



Alp)a2'

( es*l%s in loerin$ o+ cyclicA"P le-els in %he cy%oplasm

cA"P is an impor%an% messen$er %ha% can ac%i-a%e or inac%i-a%e &ey

en:ymes


( The presence o+ alpha2 recep%ors helps coordina%e ac%i-i%ies

be%een sympa%he%ic and parasympa%he%ic di-isions( =hen sympa%he%ic di-ision is ac%i-e binds %o parasympa%he%ic

ne*rom*sc*lar and ne*ro$land*lar >*nc%ions


Alpha recep%ors

2,



Alp)a2'

( es*l%s in loerin$ o+ cyclicA"P le-els in %he cy%oplasm

cA"P is an impor%an% messen$er %ha% can ac%i-a%e or inac%i-a%e &ey

en:ymes


( The presence o+ alpha2 recep%ors helps coordina%e ac%i-i%ies

be%een sympa%he%ic and parasympa%he%ic di-isions( =hen sympa%he%ic di-ision is ac%i-e binds %o parasympa%he%ic

ne*rom*sc*lar and ne*ro$land*lar >*nc%ions


Alpha recep%ors

21



( There are %hree %ypes o+ be%a recep%ors b*% %o

primary %ypes

0e"a2%( es*l%s in an increase in me%abolic ac%i-i%y

( )or example s%im*la%ion o+ be%a1 recep%ors on s&ele%al m*scle

accelera%es %he me%abolic ac%i-i%ies o+ %he m*scle

( %im*la%ion o+ be%a1 recep%ors in %he hear% ca*ses an increase inhear% ra%e and in %he +orce o+ con%rac%ion

( 0e"a (loc#ers are classes o+ dr*$s %ha% bloc& %he s%im*la%ion o+

be%a1 recep%ors

Th*s ca*sin$ a decrease in hear% ra%e and +orce o+ con%rac%ion

e%a recep%ors

22



0e"a2'( %im*la%ion o+ be%a2 recep%ors ca*ses inhibi%ion

( This %ri$$ers %he relaxa%ion o+ smoo%h m*scles alon$ %he

respira%ory %rac%

( As a res*l% %he diame%er o+ %he respira%ory passa$eays

increases

( This ma&es i% easier %o brea%h

( This response acco*n%s +or %he e++ec%i-eness o+

9nhalers *sed %o %rea% as%hma

8pipens *sed %o %rea% se-ere respira%ory a%%ac&s

e%a recep%ors

23



0e"a2'( %im*la%ion o+ be%a2 recep%ors ca*ses inhibi%ion

( This %ri$$ers %he relaxa%ion o+ smoo%h m*scles alon$ %he

respira%ory %rac%

( As a res*l% %he diame%er o+ %he respira%ory passa$eays

increases

( This ma&es i% easier %o brea%h

( This response acco*n%s +or %he e++ec%i-eness o+

9nhalers *sed %o %rea% as%hma

8pipens *sed %o %rea% se-ere respira%ory a%%ac&s

e%a recep%ors

24



0e"a2*( A %hird %ype

( *% no% considered a primary %ype

( )o*nd in adipose %iss*e

( %im*la%ion o+ be%a3 recep%ors leads %o lipolysis rea&don o+ %ri$lycerides s%oried i%hin adipocy%es

< )a%%y acids $enera%ed %hro*$h lipolysis are released in%o %he

circ*la%ion +or *se by o%her %iss*es

e%a recep%ors

25



Production o+ Ach

choline acetate Acetylcholine

Acetylcholine choline acetate

Acetylcholinesterase

26



Figure 16.7

)i$*re 16.7 The Or$ani:a%ion o+

%he Parasympa%he%ic Di-ision o+%he A!

27



Acetate

!holine

A!h

A!h A!h

N

"1

"2

"3

"#

"$

A!hE

Acetate !holine

Syaraf pasca anlion parasi!pa"i#

2#



( Pre$an$lionic +ibers lea-e %he brain as

cranial ner-es0 666 2 Oc$lo!o"or ner1e

( )ibers synapse in %he ciliary anlia

han$e %he diame%er o+ %he p*pil

han$e %he shape o+ %he lens %o +oc*s ima$es on %he re%ina

Or$ani:a%ion and ana%omy o+

%he parasympa%he%ic di-ision

2'



( Pola $!$! dari f$nsi syaraf parasi!pa"i#

( %& Men$rani #ecepa"an !e"a(olis!e

( '& Men$rani deny$" .an"$n dan "e#anan dara)&

( *& Mena!(a) se#resi l$da) dan #elen.ar sal$ran cerna

( +& Mena!(a) era#an dan aliran dara) sal$ran

cerna

( ,& Meransan penel$aran $rin dan defe#asi

)*n$si +aal Parasympa%he%i&

3,



76 2 Facial ner1e

( )ibers synapse in %he p"eryopala"ine ands$(!andi($lar $an$lia

( 9nner-a%es0

?acrimal $lands

mall $lands o+ %he nasal ca-i%y and pharynx *bmandib*lar sali-ary $land

*blin$*al sali-ary $land



31



68 2 9lossop)aryneal ner1e

( )ibers synapse in %he o%ic $an$lia

9nner-a%es %he paro%id sali-ary $land 8 2 7a$s ner1e

( )ibers synapse in %he in%ram*ral $an$lia

Tar$e%s -isceral or$ans o+0

< !ec&

< Thoracic ca-i%y

< Abdominal ca-i%y

( acral ne*rons @2 4 +orm %he pel1ic ner1es



32



Figure 16.8

)i$*re 16.# The Dis%rib*%ion o+

Parasympa%he%ic 9nner-a%ion

33



( 8++ec%s prod*ced by %he parasympa%he%ic

di-ision ons%ric%ion o+ p*pils

)oc*sin$ o+ %he lenses o+ %he eye on nearby

ob>ec%s ecre%ion by n*mero*s di$es%i-e $lands

ecre%ion o+ hormones %ha% promo%e absorp%ion

and *se o+ n*%rien%s

han$es in blood +lo and $land*lar ac%i-i%y

associa%ed i%h sex*al aro*sal

9ncrease in smoo%h m*scle ac%i-i%y alon$ %he

di$es%i-e %rac%

Parasympa%he%ic ac%i-a%ion

34



%im*la%ion and coordina%ion o+ de+eca%ion

on%rac%ion o+ %he *rinary bladder d*rin$

*rina%ion

ons%ric%ion o+ %he respira%ory passa$eays

ed*c%ion in hear% ra%e and +orce o+ con%rac%ion

ex*al aro*sal and %he s%im*la%ion o+ sex*al

$lands in bo%h $enders

Parasympa%he%ic ac%i-a%ion

35



( These +*nc%ions cen%er on0

elaxa%ion

)ood processin$

8ner$y absorp%ion

( Parasympa%he%ic sys%em has been called

%he ana(olic sys"e!

9%s s%im*la%ion leads %o a $eneral increase in %he

n*%rien% con%en% o+ %he blood

This s*ppor%s body processes and crea%es

ener$y reser-es

A4T67AS6 PARAS6MPAT64

36



( Dr*$s may be $i-en %o co*n%erac% or red*ce

symp%oms ca*sed or a$$ra-a%ed by

a*%onomic ac%i-i%ies

( Dr*$s are called !i!e"ic i+ %he mimic %he

ac%i-i%y o+ one o+ %he normal a*%onomic

ne*ro%ransmi%%ers

( Dr*$s %ha% red*ce %he e++ec%s o+ s%im*la%ion

by &eepin$ %he ne*ro%ransmi%%er +roma++ec%in$ %he pos%synap%ic membranes are

&non as (loc#in aen"s

ys%em )*nc%ion

37



( "ime%ic dr*$s o+%en ha-e ad-an%a$es o-er na%*ral

ne*ro%ransmi%%ers

)or ins%ance i%h and 0( "*s% be adminis%ered in%o %he bloods%ream

( 8++ec%s are shor%li-ed

=i%h sy!pa")o!i!e"ic dr*$s0

( They may s*r-i-e oral adminis%ra%ion 8n%eric coa%in$

( Prod*ce lon$erlas%in$ e++ec%s

*s%ained release

( "ore speci+ic ac%ion

"odi+yin$ A*%onomic !er-o*s

ys%em )*nc%ion

3#



( 8xamples incl*de0

Dr*$s inhaled %o dila%e %he respira%ory passa$eays

Drops %o dila%e %he p*pils

( Sy!pa")e"ic (loc#in aen"s (symp tholyt cs: bind%o %he recep%or si%es and pre-en% a normal response %o %hepresence o+0

!e*ro%ransmi%%ers

ympa%homime%ic dr*$s


ys%em )*nc%ion

3'



( Alphabloc&ers elimina%e peripheral

-asocons%ric%ion Bs*ally accompanies sympa%he%ic s%im*la%ion

( e%abloc&ers are e++ec%i-e +or %rea%in$0

hronic hi$h blood press*re O%her +orms o+ cardio-asc*lar disease


ys%em )*nc%ion

4,

+



( Parasy!pa")o!i!e"ic dr$s may be *sed

%o mimic ac%i-i%y o+ %he parasympa%he%ic

ner-e +ibers

*ch as %o increase ac%i-i%y alon$ %he di$es%i-e

%rac% and %o enco*ra$e de+eca%ion

( Parasy!pa")e"ic (loc#in aen"s %ar$e%

%he m*scarinic recep%ors o+ ne*rom*sc*laror ne*ro$land*lar >*nc%ions

O+%en *sed %o con%rol diarrhea and crampin$

associa%ed i%h +ood poisonin$


ys%em )*nc%ion

41



( /i$her order +*nc%ions share %he +olloin$ %hreecharac%eris%ics0 Are per+ormed by %he cerebral cor%ex and in-ol-e

complex in%erac%ions 9n-ol-e conscio*s and *nconscio*s in+orma%ion

processin$ Are s*b>ec% %o modi+ica%ion and ad>*s%men% o-er %ime

/i$her order +*nc%ions

1. sso pendahuluan maret 2008i

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