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Structure of acetylcholine (ACh). 11.2 Acetylcholine in the Autonomic Nervous System. In the autonomic nervous system, acetylcholine (ACh) is the neurotransmitter in the preganglionic sympathetic and parasympathetic neurons. These are shown in Figure 11.2 as the red ACh in the ganglion.nhibitors of acetylcholinesterase are the most effective means to elevate acetylcholine either at cholinergic neurons or at the neuromuscular junction. These drugs are used to treat Alzheimer's disease, myasthenia gravis and in many other situations where the elevation of cholinergic neurotransmission is desired.