obat simpatik
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OBAT SIMPATIS
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POKOK BAHASAN
• PENGANTAR OBAT OTOMOM
• OBAT AGONIS KOLINERGIK
• OBAT ANTAGONIS KOLINERGIK
• OBAT ADRENERGIK
• OBAT ANTAGONIS ADRENERGIK
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PENGANTAR
• DEFINISI
• meniru, modifikasi, aktivitas SSO
• mei!uti "
• sistem saraf otonom #anatomi$• %at kimia&i #neurotransmiter$
• or'an efektor #efek o(at$
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Sistem saraf
Sistem Saraf Te!i Sistem Saraf Pusat
Divisi efferen Divisi afferen
#sensorik$
Sistem Saraf Otonom Sistem Saraf Somatik#motorik$
Saraf Parasimfatis Saraf Simfatis
Anatomi
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NE)ROTRANS*ITER
RESEPTOR
EFEK OBAT
SINTESIS TRANSPORTASI
IKATAN
DEGRADASI
KHASIAT K+INIK
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ANTIADRENERGIK
SIMPATOLITIK
α & β
Selektif & non-selektif
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S)**ARIES
Struture of t-e Autonomi NS
* two ne!ons" #!e$an$lioni% an #ost$an$lioni%'
* s(na#se in atonomi% $an$lia'
* ea%) #!e$an$lioni% ne!on is %onne%te wit) ei$)t" nine o! #to + #ost$an$lioni% ne!ons'* T)e atonomi% $an$lia a!e also mini - inte$!atin$ %ente!s'
* T)e( !e%ei,e in#t f!om t)e #e!i#)e!( an molate t)e ot$oin$ !es#onses'
. Intrinsi neurons serete do!amine t-at is in-i(itor/0
T-e autonomi si'nas are transmitted to t-e (od/ t-rou'-
. t-e s/m!at-eti nervous s/stem #t-oraoum(ar s/stem, fi'-t and fi'-t division$
. t-e !aras/m!at-eti nervous s/stem #raniosara s/stem, rest and di'est division$
. Some aut-ors distin'uis- aso t-e enteri s/stem0
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S1*PATHETI2 S1STE*
* T)e %ell oies in t)e inte!meiolate!al )o!ns of t)e t)o!a%i% an lma! s#inal %o!'
* T)e m(elinate slowl( %on%tin$ . fie!s /#!e$an$lioni%0 t)!o$) t)e $!a( !ami %ommni%antes
#ass into t)e ,ent!al !oots an to t)e s(m#at)eti% $an$lia /#a!a,e!te!al %)ain $an$lia0'
* !ost'an'ioni neuron /etween t)e s(m#at)eti% $an$lia an t)e ta!$et o!$ans0' - mostl(
nm(elinate 1 fie!s" en on t)e ,is%e!al ne!ons'
* T)e !araverte(ra s/m!at-eti -ains of t)e $an$lia lie on ot) sies of t)e s#inal %olmn'
* T)e!e a!e also two !reverte(ra 'an'ia t)e eia 'an'ion an t)e -/!o'astri 'an'ion'* T)e fie!s f!om t)ese $an$lia !ea%) t)e inne! o!$ans t)!o$) t)e #le2ses on t)e s!fa%e of t)e
loo ,essels' Ot)e! a2ons f!om t)e s(m#at)eti% $an$lia !eente! t)e s#inal %o! an !ea%) t)e ta!$et
o!$ans t)!o$) t)e s#inal ne!,es'
* a%ti,e in eme!$en%( sitations3
- )ea!t eat is a%%ele!ate"
- e(e ##ils a!e ilate"
- loo #!ess!e !aises"
- loo ,essels in t)e skin a!e %onst!i%te"
- loo $l%ose in%!eases"
- t)e state of a!osal is in%e'
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Adrener'i ree!tors
- T)e ne!,e fie!s o not fo!m fi!m 4n%tions on t)e ta!$et
o!$ans'
- Ne!ot!ansmitte!s a!e se%!ete f!om t)e ,a!i%osities alon$ t)e
ne!,e fie!s'
- all a!e linke to G #!oteins'
- istin$is)e ( t)ei! sensiti,it( to e#ine#)!ine"
no!e#ine#)!ine an t)e !$ iso#!ote!enol'
- no!e#ine#)!ine a%ti,ates mo!e al#)a !e%e#to!s" e#ine#)!inea%ti,ates mo!e eta !e%e#to!s
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NE)ROTRANS*ITTERS OF THE A)TONO*I2 S1STE*
* A%et(l%)oline an no!e#ine#)!ine a!e t)e #!ima!( atonomi% ne!ot!ansmitte!s'
* All #!e$an$lioni% fie!s a!e -oiner'i
* T)e #ost$an$lioni% fie!s of t)e #a!as(m#at)eti% s(stem a!e also %)oline!$i%'
* Most #ost$an$lioni% fie!s of t)e s(m#at)eti% s(stem a!eadrener'i
* Some atonomi% ne!ons a!e non-a!ene!$i%" non-%)oline!$i%'
- Do#amine is se%!ete in t)e s(m#at)eti% $an$lia an
- GnR5"
- 6IP /,asoa%ti,e intestinal #e#tie0"- somatostatin"
- sstan%e P"
- aenosine"
- nit!i% o2ie"
- ne!o#e#tie 7
- Some #!e$an$lioni% ne!ons %o-se%!ete #ol(#e#ties alon$ wit) a%et(l%)oline
T-e res!onses !rodued (/ t-e !ost'an'ioni neurons"
* fast EPSP8s $ene!atin$ t)e a%tion #otentials" #!o%e ( a%et(l%)oline9
* slow IPSP8s" #!oal( #!o%e ( o#amine
* slow EPSP8s9
* late slow EPSP8s lastin$ mintes'
A!-a ree!tors
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A!-a ree!tors
* in%!ease int!a%ellla! %al%im le,els ( o#enin$ %al%im %)annels in
t)e %ell mem!ane" ( !eleasin$ %al%im f!om int!a%ellla! sto!es" o!
ot)'. 34 ree!tors are t-e most ommon adrener'i ree!tors0
5 dominate in saivar/ 'ands and in t-e vasuar smoot- muse
5 indue ontration of arterioes, uterus, (ron-ioes, s!-inters of
t-e urinar/ (adder and GI trat, vas efferens and musuus diator
!u!iae0
5 res!ond stron'/ to nore!ine!-rine and on/ &eak/ to
e!ine!-rine0
5 t-rou'- t-e G !roteins, t-e/ ativate !-os!-oi!ase 20 &-i-
ata/%es t-e i(eration of dia/'/ero &-i- auses a reease ofaium ions0
. 36 ree!tors are ess ommon, our in t-e 2NS, kidne/s, uterus,
!arotid 'and, !anreas, mast es and t-rom(o/tes, GI trat0 N
5 nore!ine!-rine in-i(its aden//ase0
Beta ree!tors- a%ti,ate %(%li% AMP an t!i$$e! #)os#)o!(lation of %ellla! #!oteins
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- a%ti,ate %(%li% AMP an t!i$$e! #)os#)o!(lation of %ellla! #!oteins'
* 74 ree!tors are !rominent in t-e -eart0 T-e/ an raise t-e eve of
intraeuar aium0 T-e me-anism of ation invoves G !roteins0
T-e/ are ou!ed to t-e aden//ase05 In t-e SA node, t-e/ inrease t-e -eart rate0
5 In t-e A8 node, t-e/ inrease ondution veoit/0
5 In t-e -eart muse, t-e/ inrease ontratiit/0
5 In t-e kidne/, t-e/ inrease t-e seretion of renin0
. 76 ree!tors are in t-e areas not innervated (/ t-e s/m!at-eti
nervous s/stem, in t-e vasuar smoot- muse of skeeta muses, in
t-e &as of GI trat and in t-e (ro-ioes0
5 T-e/ are sensitive to different ate-oamines0
5 ativate G !roteins,5 stimuate aden/ /as
5 derease t-e eve of aium in t-e es0
5 ause t-e vasodiation and diatation of (ron-i,
5 stimuation of insuin reease,
5 inrease in i o sis and oneo enesis0
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DISORDERS OF THE A)TONO*I2 NER8O)S S1STE*
T)e( a!e !elati,el( !a!e
* i!e%t ama$e to t)e )(#ot)alams ma( %ase ano!malities in wate!
alan%e o! tem#e!at!e !e$lation'
* $ene!ali:e s(m#at)eti% (sfn%tion ma( !eslt in %an%e! o! iaetes
mellits'
* in%ontinen%e of !ine
* im#oten%e
* w)en s(m#at)eti% ne!ons e$ene!ate" t)e!e is #!ima!( atonomi%fail!e' .t t)e!e is ene!,ation )(#e!sensiti,it('
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