Pharmacology of Drugs Acting on ANS an Overview

It's important for a Healthcare professional to have a sound knowledge about the Drugs. This overview of 'Pharmacology of Drugs Acting on ANS' is our approach to make it easy for healthcare professionals to remember these drugs.

Drugs Acting on Autonomic Nervous System (ANS): Drugs that produce their primary therapeutic effect by Mimicking or altering the functions of the ANS.

    Cholinergic Drugs (Cholinomimetic, Parasympathomimetic)


    1. Cholinergic Agonists

    • Choline Esters

      • Acetylcholine, Methacholine, Carbachol, Bethanechol.

    • Alkaloids

      • Muscarine, Pilocarpine, Arecoline.


    2. Anticholinesterases

    • Reversible

      • Carbamates

        • Physostigmine (Eserine), Neostigmine, Pyridostigmine, Edrophonium, Rivastigmine, Donepezil, Galantamine.

      • Acridine

        • Tacrine.

    • Irreversible

      • Carbamates

        • Cararyl, Propoxur.


    • Organophosphates

      • Dyflos (DFP), Echothiophate, Malathion, Tabun, Sarin, Soman.


    Anticholinergic Drugs (Muscarinic Antagonists, Atropinic Drugs, Parasympatholytics)


    1. Natural Alkaloids

    • Atropine, Hyoscine (Scopolamine).


    2. Semi Synthetic Derivatives

    • Atropine methonitrate, Homatropine, Hyoscine butyl bromide, Ipratropium bromide, Tiotropium bromide.


    3. Synthetic Compounds

    • Antisecretory-Antispasmodics

      • Quaternary Compounds

        • Propantheline, Oxyphenonium, Clidinium, Pipenzolate methyl bromide, Isopropamide, Glycopyrrolate.

      • Tertiary Amines

        • Dicyclomine, Valethamate, Pirenzepine.

    • Mydriatics

      • Cyclopentolate, Tropicamide.

    • Vasicoselective

      • Oxybutynin, Flavoxate, Tolterodine.

    • Antiparkinsonian

      • Trihexyphenidyl (Benzhexol), Procyclidine, Biperiden.


    Ganglionic Stimulants & Blocking Agents


    1. Ganglionic Stimulants

    • Selective Nicotinic Agonists

      • Nicotine (small dose), Lobeline, Dimethyl phenyl piperazinium (DMPP), Tetramethylammonium (TMA), Varenicline.

    • Nonselective/Muscarinic Agonists

      • Acetylcholine, Carbachol, Pilocarpine, Anticholinesterases.


    2. Ganglionic Blocking Agents

    • Competitive Blockers

      • Quaternary Ammonium Compounds

        • Hexamethonium, Pentolinium.

      • Amines

        • Mecamylamine, Pempidine. 

      • Mono Sulfonium Compounds

        • Trimethaphan-camphorsulfonate.

    • Persistent Depolarizing Blockers

      • Nicotine (large dose), Anticholinesterases (large dose).


    Adrenergic Drugs (Sympathomimetics, Adrenergic Agonists)


    1. Pressor Agents

    • Noradrenaline (Norepinephrine), Ephedrine, Dopamine, Phenylephrine, Methoxamine, Mephentermine.


    2. Cardiac Stimulants

    • Adrenaline, Isoprenaline, Dobutamine.


    3. Bronchodilators

    • Isoprenaline, Salbutamol (Albuterol), Terbutaline, Salmeterol, Formoterol, Bambuterol.


    4. Nasal Decongestants

    • Xylometazoline, Oxymetazoline, Naphazoline, Phenylephrine, Phenylpropanolamine, Pseudoephedrine.


    5. CNS Stimulants

    • Amphetamine, Dexamphetamine, Methamphetamine, Methylphenidate. 


    6. Anorectics

    • Amphetamine, Fenfluramine, Dexafenfluramine, Sibutramine.


    7. Uterine Relaxants

    • Ritodrine, Isoxsuprine, Salbutamol, Terbutaline.


    Anti-Adrenergic Drugs (Sympatholytics, Sympathoplegic, Adrenergic Antagonists)


    1. α Adrenergic Blocking Agents

    • Non Equilibrium Type

      • β Halo Alkylamine

        • Phenoxybenzamine.

    • Equilibrium Type (Competitive Antagonists)

      • Non Selective

        • Ergot Alkaloids

          • Ergotamine, Ergotoxine.

        • Hydrogenated Ergot Alkaloids

          • Dihydroergotamine (DHE), Dihydroergotoxine (Co Dergocrine).

        • Imidazoline

          • Phentolamine.

        • Miscellaneous

          • Chlorpromazine.

      • α-1 Selective

        • Prazosin, Terazosin, Doxazosin, Alfuzosin, Tamsulosin.

      • α-2 Selective

        • Yohimbine.


    2. β Adrenergic Blockers 

    • Non Selective (β1 + β2)

      • Without Intrinsic Sympathomimetic Activity (ISA)

        • Propranolol, Sotalol, Timolol.

      • With ISA

        • Pindolol.

      • With α Blocking Property

        • Labetalol, Carvedilol.

    • Cardio Selective (β1)

      • Metoprolol, Atenolol, Acebutolol, Bisoprolol, Esmolol, Betaxolol, Celiprolol, Nebivolol.


    Topical Drugs for Glaucoma


    1. Beta Adrenergic Blockers

    • Timol, Betaxolol, Levobunolol, Carteolol.


    2. Alpha Adrenergic Blockers

    • Dipivefrine, Apraclonidine, Brimonidine.

    3. Prostaglandin Analogues

    • Latanoprost, Travoprost, Bimatoprost.


    4. Carbonic Anhydrase Inhibitors

    • Dorzolamide, Brinzolamide.


    5. Mitotics

    • Pilocarpine, Physostigmine, Echothiophate.


    This ends our overview on Pharmacology of Drugs Acting on ANS.