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Two Division of the Autonomic Nervous System: 

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Two Division of the Autonomic Nervous System: 

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1) Sympathetic Nervous System (adrenergic)
2) Parasympathetic Nervous System (cholingergic)

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- Neurotransmitters:

- 1) Acetylcholine (ACH) is released at ganglia,
- 2) Norepinephrine (NE) is released at postganglionic nerve endings

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-Receptors- (Four Types) :

1) Alpha- 1: located on glands, smooth muscle, eyes, most arteries, veins
2) Alpha-2: located on adrenergic nerve endings
3) Beta-1: located on the heart
4) Beta-2: located on smooth muscle, lungs, uterus, skeletal muscles arteries, coronary arteries

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- End Organ Responses

1) Alpha-1:
-On most arteries and veins, causes vasoconstriction (increases blood pressure)
-On eyes, dilates the pupils (mydriasis)
2) Alpha-2:
-On adrenergic nerve endings, causes vasodilation (decreases blood pressure)
3) Beta-1:
-On the heart, causes increased force of contraction (inotropic), increased heart rate (chronotropic), and increased conduction (dromotropic)
4) Beta-2:
-On bronchiolar smooth muscle, causes muscle relaxation and bronchodilation
-On uterus, causes uterine relaxation
-On coronary and skeletal muscle blood vessels, causes relaxation of blood vessels and vasodilation

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- Drug Classifications:

1) Alpha-1 Adrenergic Agonists:
- alpha-1 receptor is stimulated
- contraction of smooth muscle, blood vessels constrict, increases BP
- vasoconstriction of nasal passages --> decongestant effect
2) Adrenergic Agonists:
- stimulates all alpha and beta receptors, an exception
- vasopressor- vasoconstriction, increases BP
- cardiac stimulant
- bronchodilator
3) Alpha-1 Adrenergic Blockers:
- binds to alpha-1 receptors and blocks them
- relaxation of smooth muscle
- vasodilation of blood vessels, decreases BP
4) Beta-1 Adrenergic Agonists:
- low-dose: stimulates dopaminergic (d-1) receptors in kidneys causing vasodilation and increased renal blood flow
- moderate-dose: stimulates beta-1 receptors-heart, increases force of contraction
- high-does: stimulates alpha-1 receptors causing vasoconstriction --> increase in blood pressure
5) Beta-2 Adrenergic Agonists:
- stimulate Beta-2 receptors
- relaxation of smooth muscle of the lungs--> bronchodilation
- relaxation of smooth muscle of uterus
6) Beta Blockers (two Types):
1) Selective:
- beta-1 receptor is blocked (antagonizes effects of NE and EPI)
- decreases force of contraction (negative inotropic) , decreases cardiac output
- decreases HR (negative chronotropic)
- decreases conduction (negative dromotropic)
- decrease in cardiac output also decreases BP
2) Non-Selective:
- block beta-1 and beta-2 receptors
- decreases force of contraction (negative inotropic), decreases cardiac output
- decreases HR (negative chronotropic)
- decreases conduction (negative dromotropic)
- decrease in cardiac output also decreases BP
- can cause bronchoconstriction

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- Specific Drug Examples:

1) Alpha-1 Adrenergic Agonists:
- ephedrine
- phenylephrine (Neo-Synephrine®)
2) Adrenergic Agonists:
- epinephrine (Adrenaline®)
3) Alpha-1 Adrenergic Blockers:
- prazosin (Minipressor®)
- terazosin (Hytrin®)
- doxazosin (Cardura®)
4) Beta-1 Adrenergic Agonists:
- dobutamine
5) Beta-2 Adrenergic Agonists:
- formoterol (Foradil®)
- albuterol (Proventil®, Ventolin®)
- terbutaline (Brethine®)
6) Beta Blockers -(Two Types):
1) Nonselective:
- nadolol (Corgard®)
- propanolol (Inderal®)
- timolol (Blocadren®)
2) Selective:
- atenolol (Tenormin®)
- metoprolol (Lopressor®)

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- Neurotransmitter:

1) Acetylcholine (ACH) - released at ganglia AND postganglionic nerve endings

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-Receptors- Two Types:

1) Muscarinic:
- located at cell membranes of visceral organs and glands
2) Nicotinic - Two Types:
a)Nicotinic-Nerve (Nn) -located at both parasympathetic and sympathetic ganglia
b)Nicotinic-muscle (Nm)- located on cell membranes of skeletal muscles (somatic)

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- End Organ Responses:

1) Heart: decreases heart rate and AV conduction, slight decrease in contractility
2) Intestines, GI motility, and secretions: Increased digestion, increased GI secretions
3) Postganglionic Neurotransmitter: Acetylcholine (ACH) released
4) Pupil of the Eye: constriction (miosis)
5) Respiratory passages, lower: bronchoconstriction
6)  Urinary bladder and Sphincter: increased urination

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- Drug Classifications:

1) Direct Acting Cholinergic Agonists:
- directly stimulate/bind to the muscarinic receptors in the parasympathetic division
- mimics ACH
2) Indirect Acting Cholinergic Agents:
- inhibit acetylcholinesterase, the enzyme that destroys ACH in the synapse
- increases ACH
3) Anticholinergics:
- bind to a cholinergic receptor
- acts as a blocking drug; competitive antagonism

- Receptors interacted with:
- Action that occurs:

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- Specific Drug Examples:

1) Direct Acting Cholinergic Agonist:
- acetylcholine
- pilocarpine (Pilocar®)
- bethanechol (Urelcholine®)

2) Indirect Acting Cholinergic Agents:
- neostigmine (Prostigmin®)

3) Anticholinergics:
- atropine
- dicyclomine (Bentyl®)

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1) Hitner, . Pharmacology: An Introduction with Additional Material. Available from: Yuzu Reader, (8th Edition). McGraw-Hill Learning Solutions, 2021. https://yuzu.vitalsource.com/reader/books/9781266131400/epubcfi/6/40[%3Bvnd.vst.idref%3Dchapter06]!/4/2/32/10/8/1:345[tio%2Cn.]

2) Tammie Peterson, TP. (2023, February 13). Unit 2 Autonomic Nervous System [Powerpoint slides]. Pharmacology, Austin Community College. https://app.vidgrid.com/view/PkCL3p3jcKzV/?sr=8k73XD