• Cholinerge vezels zijn gelokaliseerd in zowel para- als sympathicus
o Sympathicus:
§ Postsynaptische nicotinereceptoren
§ Uitz: muscarinereceptoren op zweetklieren
o Parasympathicus:
§ Postsynaptische nicotinereceptoren
§ Muscarine receptoren
o Neuromusculaire junctie
§ Alleen nicotinereceptoren
• Somatische nicotinereceptoren verschillen van ganglionaire nicotine receptoren
SYNTHESE ACH
• Choline is precursor
o Via acetylCoA → aanmaak ACH
• Afgebroken via acetylcholineesterasen
VERSCHILLENDE CHOLINERGE RECEPTOREN
• Nicotine receptor
o Ionkanaal → heel snelle werking
• Muscarine receptor
o G-proteïne gekoppeld → wat tragere werking
o Simulerend type: via PLC, IP3 en Ca-vrijstelling
o Inhiberend type: via inhibitie adenylaatcyclase → cAMP naar beneden
,STIMULATIE VAN PARASYMPATISCH ZS (endogene effecten)
- M conctrictor pupillae Contractie → miosis, ↓ intra-oculaire druk
- M ciliaris
Contractie → bolle lens, accommodatie
MUSCARINE AGONISTEN
→ selectieve stimulatie van muscarinereceptoren
PILOCARPINE (oogdruppels)
BETHANECHOL
Effecten:
• ↓ hartritme en ↓ contractiekracht
o Verlaagde cardiac output
• VD in bloedvaten
o Via muscarine receptoren op endotheelcellen → NO-vrijstelling ↑
o Via muscarine receptoren op postganglionaire sympathische neuronen → NOR-
vrijstelling ↓
• Glaucoom: aandoening met te veel kamervocht
o Pilocarpine oogdruppels → daling IOP
• Blaas atonie/paralytische ileum: paralyse blaas/darmen na chirurgie
o PS stimulatie → motiliteit in blaaswand/darmwand activeren
• Droge mond
o Na radiotherapie/chirurgie indien PS beschadigd
o Sjöger syndroom: auto-immune aandoening waar traan- en speekselsecretie
verstoord is
MUSCARINE ANTAGONISTEN
→ competitieve antagonisten van muscarine receptor, meestal niet-selectief
ATROPINE
SCOPOLAMINE = HYOSCINE
BUTYLHYOSCINE BROMIDE
Effecten
• ↑ hartritme
• Onveranderde BD
o Geen cholinerge innervatie in weerstandsvaten
• Relaxatie gladde spiercellen
o Niet op bloedvaten
o Bronchodilatatie
• ↓ secretie exocriene klieren
• Mydriasis, ↑ IOP, verlies accommodatie
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