| **Day** | **Topic** |

| Day 1 | Introduction to Pharmacology – Definitions, Branches, Scope |

| Day 2 | Routes of Drug Administration |

| Day 3 | Pharmacokinetics – Absorption & Distribution |
| Day 4 | Pharmacokinetics – Metabolism & Excretion |
| Day 5 | Pharmacodynamics – Drug-Receptor Interaction |
| Day 6 | Factors Modifying Drug Action |
| Day 7 | Adverse Drug Reactions & Drug Interactions |
| Day 8 | Introduction to ANS – Divisions & Neurotransmitters |
| Day 9 | Cholinergic Drugs (Direct & Indirect) |
| Day 10 | Anticholinergic Drugs |
| Day 11 | Adrenergic Agonists |
| Day 12 | Adrenergic Blockers (Alpha & Beta Blockers) |
| Day 13 | Ganglionic & Neuromuscular Blockers |
| Day 14 | CNS Overview + Review Week 2 Topics |
| Day 15 | Sedatives & Hypnotics |
| Day 16 | Antiepileptic Drugs |
| Day 17 | Antipsychotics & Antidepressants |
| Day 18 | Opioid Analgesics & Antagonists |
| Day 19 | General & Local Anesthetics |
| Day 20 | Antiparkinsonian & Alzheimer Drugs |
| Day 21 | Week 3 Revision + Practice MCQs |
| Day 22 | Drugs Acting on CVS – Antihypertensives |
| Day 23 | Antianginal & Heart Failure Drugs |
| Day 24 | Diuretics |
| Day 25 | Anticoagulants & Antiplatelet Drugs |
| Day 26 | Drugs for Respiratory System – Asthma, Cough |
| Day 27 | Antibiotics – Classification & Mechanism |
| Day 28 | Antifungal, Antiviral & Antitubercular Drugs |
| Day 29 | Chemotherapy of Cancer + Immunosuppressants |
| Day 30 | Revision Day – Quick Recap of All Systems |

Here are **detailed pharmacology notes** on the topic **”Introduction to

Autonomic Nervous System (ANS) – Divisions & Neurotransmitters”**
based on both **Lippincott’s Illustrated Reviews** and **Katzung Basic &
Clinical Pharmacology**:

## 📘 **Introduction to Autonomic Nervous System (ANS)**

**References:**

* Lippincott: Ch. 3 – Autonomic Nervous System

* Katzung: Ch. 6 – Introduction to Autonomic Pharmacology

### 🧠 **Definition of ANS:**

The **Autonomic Nervous System (ANS)** is a division of the peripheral

nervous system that **regulates involuntary physiological functions**
such as heart rate, blood pressure, digestion, respiration, and glandular
secretion.

It operates **subconsciously** and controls **visceral organs**, **smooth

muscles**, **cardiac muscles**, and **glands**.

### 🔹 **Divisions of the ANS**

According to **Lippincott** and **Katzung**, the ANS is divided into:

| Division | Origin | Function

| Major Neurotransmitter |

| -------------------------- | ----------------------------------------- |
---------------------------------- | ---------------------------------------- |

| **Sympathetic (SNS)** | Thoracolumbar (T1–L2) | “Fight

or Flight” | Ach (preganglionic), NE (postganglionic) |

| **Parasympathetic (PNS)** | Craniosacral (CN III, VII, IX, X + S2–S4) |

“Rest and Digest” | Ach (both pre and postganglionic) |

| **Enteric Nervous System** | GI tract (intrinsic plexuses) |

Independent control of GI function | Ach, 5-HT, dopamine |
### ⚙️**Functional Differences** (Lippincott & Katzung):

| Feature | Sympathetic (SNS) | Parasympathetic (PNS) |

| Heart rate | Increases | Decreases |

| Bronchi | Dilates | Constricts |

| Pupils | Dilates (mydriasis) | Constricts (miosis) |

| GI Motility | Decreases | Increases |

| Bladder | Relaxes (urine retention) | Contracts (urination) |

| Glands (saliva, sweat) | ↓ saliva, ↑ sweat | ↑ saliva |

### 🔗 **Anatomical Pathways**

**Preganglionic neurons** originate in CNS → Synapse in **autonomic

ganglia** → **Postganglionic neurons** project to target organs.

* **SNS**: Short preganglionic, long postganglionic fibers.

* **PNS**: Long preganglionic, short postganglionic fibers.

### 💬 **Neurotransmitters of ANS**

#### 🔸 **1. Acetylcholine (Ach)**

 Released by:

* All **preganglionic neurons** (both SNS & PNS)

 * All **postganglionic PNS neurons**

* **Postganglionic sympathetic neurons to sweat glands**

#### 🔸 **2. Norepinephrine (NE)**

 Released by:

* Most **postganglionic sympathetic neurons**

* Acts on **adrenergic receptors** (α1, α2, β1, β2)

#### 🔸 **3. Epinephrine (EPI)**

 Secreted by **adrenal medulla** (modified sympathetic ganglion)

into bloodstream

#### 🔸 **4. Dopamine**

 Found in some **renal blood vessels** (sympathetic innervation)

#### 🔸 **5. Others (Enteric System)**

 **Serotonin (5-HT)**, **Nitric oxide (NO)**, **VIP**, **Substance P**

### 🎯 **Receptor Types (Lippincott + Katzung)**

| **Receptor** | **Location** | **Response**

|
| **Muscarinic (M1–M5)** | Organs innervated by PNS | Smooth
muscle contraction, secretion |

| **Nicotinic (Nn, Nm)** | Ganglia (Nn), Skeletal muscle (Nm) | Ganglionic

transmission, muscle contraction |

| **Alpha-1 (α1)** | Blood vessels, eye, bladder | Vasoconstriction,

mydriasis |

| **Alpha-2 (α2)** | Presynaptic terminals | Inhibits NE release

|

| **Beta-1 (β1)** | Heart, kidney | ↑ Heart rate, ↑ renin

release |

| **Beta-2 (β2)** | Bronchi, uterus, skeletal muscle | Bronchodilation,

vasodilation |

| **Beta-3 (β3)** | Adipose tissue | Lipolysis

|

### 📦 **Drug Target Summary**

* **Cholinergic drugs**: Affect Ach action (e.g., pilocarpine, neostigmine)

* **Adrenergic drugs**: Affect NE/EPI action (e.g., epinephrine,

propranolol)

### ✅ **Key Points to Remember**

* **Sympathetic** prepares body for action (fight/flight)

* **Parasympathetic** conserves energy (rest/digest)

* **Ach** is universal at ganglia; **NE** is dominant in postganglionic

sympathetic

* Most organs have **dual innervation** (SNS & PNS)

* Drugs often target these pathways to treat cardiovascular, respiratory,

and GI disorders
Would you like a **PDF version** of this note or a summary table for quick
revision?

Here are detailed and exam-focused notes on **Cholinergic Drugs** (Day

9 topic) with reference to **Lippincott’s Illustrated Reviews:
Pharmacology** and **Katzung’s Basic & Clinical Pharmacology**.

## 💊 **Cholinergic Drugs (Parasympathomimetics)**

📚 **Referenced from:**

* Lippincott: Ch. 4 – Cholinergic Agonists

* Katzung: Ch. 8 – Cholinergic Agonists & Cholinesterase Inhibitors

### 🧠 **Definition**

Cholinergic drugs are agents that **mimic the action of acetylcholine

(Ach)** by stimulating **cholinergic receptors** (muscarinic or nicotinic).

They are also called **parasympathomimetics** because they simulate

the parasympathetic nervous system.

### 🔍 **Classification of Cholinergic Drugs**

#### 🔹 1. **Direct-Acting Cholinergic Agonists**

They bind directly to **muscarinic or nicotinic receptors** and activate
them.

| **Drug** | **Receptor** | **Uses** |

| Acetylcholine | M & N | Limited use (rapid breakdown) |

| Bethanechol | M (GI, bladder) | Urinary retention, atonic bladder |

| Pilocarpine | M (eye, glands) | Glaucoma, dry mouth (xerostomia) |

| Carbachol |M&N | Glaucoma (topical) |

| Methacholine | M | Bronchial challenge test |

#### 🔹 2. **Indirect-Acting Cholinergic Agonists (Anticholinesterases)**

They **inhibit acetylcholinesterase (AChE)** → ↑ Ach at synapses →

prolonged action.

##### 🧪 a. **Reversible AChE Inhibitors**

| **Drug** | **Use** |

| Neostigmine | Myasthenia gravis, reversal of NM block |

| Pyridostigmine | Long-term management of MG |

| Physostigmine | Anticholinergic poisoning (enters CNS) |

| Edrophonium | Diagnosis of myasthenia gravis (short-acting) |

| Donepezil, Rivastigmine | Alzheimer’s disease |

##### ☠️b. **Irreversible AChE Inhibitors (Organophosphates)**

| **Compound** | **Use/Toxicity** |
| Echothiophate | Chronic glaucoma (rare) |

| Parathion, Malathion | Insecticides (toxic) |

| Sarin, Tabun | Nerve gases (chemical warfare) |

🛑 **Antidote for poisoning:**

* **Atropine** (muscarinic blocker)

* **Pralidoxime (2-PAM)** (reactivates AChE)

### 🧬 **Receptor Specificity** (from Katzung)

| **Receptor** | **Effect** |

| M1 | CNS, glands – ↑ secretion |

| M2 | Heart – ↓ heart rate |

| M3 | Smooth muscles – bronchoconstriction, ↑ GI motility, ↑

secretions, miosis |

| Nn | Ganglia – autonomic transmission |

| Nm | NMJ – skeletal muscle contraction |

### ⚠️**Adverse Effects (Mnemonic: DUMBBELSS)**

From both **Lippincott & Katzung**:

| Effect | Description |

| **D** | Diarrhea |
| **U** | Urination |

| **M** | Miosis (pupil constriction) |

| **B** | Bradycardia |

| **B** | Bronchospasm |

| **E** | Emesis |

| **L** | Lacrimation |

| **S** | Salivation |

| **S** | Sweating |

### 🔄 **Clinical Applications**

* **Glaucoma:** Pilocarpine, Carbachol

* **Myasthenia Gravis:** Neostigmine, Pyridostigmine

* **Alzheimer’s Disease:** Donepezil, Rivastigmine

* **Non-obstructive Urinary Retention:** Bethanechol

* **Anticholinergic toxicity:** Physostigmine

* **Neuromuscular blockade reversal:** Neostigmine

### ✅ **Quick Review Table**

| **Type** | **Example Drugs** | **Main Use** |

| Direct Agonists | Bethanechol, Pilocarpine | Urinary retention,

Glaucoma |

| Reversible AChE inhibitors | Neostigmine, Donepezil | MG, Alzheimer’s

|

| Irreversible AChE inhibitors | Organophosphates | Pesticides, Nerve

agents |
Would you like this content in:

* 📄 **PDF format**

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* 🧠 **MCQs for practice** on cholinergic drugs?