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1. Alpha-1 Adrenergic Agonists: brand/generic - Neo-Synephrine®/phenylephrine; ephedrine

2. Adrenergic Agonists: brand/generic - Adrenalin®/epinephrine

3.  Alpha-1 Adrenergic Blocking Drugs: brand/generic - Minipress®/prazosin; Hytrin®/terazosin; Cardura®/doxazosin

4. Beta-1 Adrenergic Agonists: brand/generic - dobutamine

5. Beta-2 Adrenergic Agonists: brand/generic - Foradin®/formoterol; Proventil®/Ventolin®/albuterol; Brethine®/terbutaline

6. Selective Beta-1 Blockers: brand/generic - Tenormin®; atenolol; Lopressor®/metoprolol

7. Non-selective Beta Blockers: brand/generic - Corgard®/nadolol; Inderol®/propranolol; Blocadren®/timolol

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This is also known as the Adrenergic System; "fight, fright, flight"

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This is also known as the Cholinergic System; "rest and digest"

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1. Acetylcholine (ACH): neurotransmitter is released at ganglia from presynaptic nerve endings

2. Norepinephrine (NE): neurotransmitter is released at the postganglionic nerve endings; synthesized from dopamine; released by adrenal medulla and neurons

3. Epinephrine (EPI): acts on adrenergic receptors; produced by the adrenal medulla

4. Dopamine (DA): sympathetic and CNS transmitter; precursor to NE; stimulates many receptors (alpha, beta, dopaminergic); different actions based on dose given

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Acetylcholine (ACH): neurotransmitter is released at ganglia and postganglionic nerve endings

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1. Acetylcholine (ACH)

2. Norepinephrine (NE)

3. Epinephrine (EPI)

4. Dopamine (DA)

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Acetylcholine (ACH)

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1. Alpha-1: found predominantly on smooth muscle membranes of arteries, veins, and sphincters of the urinary and gastrointestinal tract

2. Alpha-2: located on adrenergic nerve endings

3. Beta-1: found on both cardiac and some smooth muscle membranes

4. Beta-2: located in the smooth muscle of coronary and skeletal muscle, blood vessels and bronchodilation

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1. Muscarinic: located on cardiac, smooth muscle, and glands

2. Nicotinic 1 (Nn): found at ganglia of parasympathetic nerves and sympathetic nerves (synapse area)

3. Nicotinic 2 (Nm): neuromuscular junction of skeletal muscles

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1. Adrenal medulla: release of epinephrine

2. Arteries: increased blood pressure; vasoconstriction with exception to the coronary arteries and arteries to skeletal muscles (which are dilated)

3. Heart: increases heart rate and AV contraction; also increases contractility

4. Intestines, GI motility, and secretions: decreased to perfuse heart and getting more oxygen in

5. Postganglionic neurotransmitter: norepinephrine released

6. Pupils of the Eye: dilation (mydriasis) - more light to get in to see better

7. Respiratory passages, lower: bronchodilation - airways open for more oxygen to come in

8. Urinary bladder: relaxation, decrease urination

9. Urinary sphincter: contraction

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1. Adrenal medulla: no parasympathetic effect

2. Arteries: most arteries are not supplied by parasympathetic nerves

3. Heart: decreases heart rate and AV conduction, slight decrease in contractility

4. Intestines, GI motility, and secretions: increased

5. Postganglionic neurotransmitter: Acetylcholine released at post ganglionic nerve ending

6. Pupil of the eye: Constriction (miosis)

7. Respiratory passage, lower: bronchoconstriction

8. Urinary bladder: contraction, increase urination

9. Urinary sphincter: relaxation

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1. Alpha-1 Adrenergic Agonists (Sympathomimetic): receptors - Alpha-1 receptor stimulated; MOA - contraction of smooth muscles, blood vessels constrict, and increased BP, vasoconstriction of nasal passages provide a decongestive effect

2. Adrenergic Agonists (Sympathomimetic): receptors - stimulates alpha and beta receptors (an exception); MOA - vasopressor/vasoconstriction (increases BP), cardiac stimulant (increases beta receptors), bronchodilator (simulates beta receptors)

3. Alpha-1 Adrenergic Blocking Drugs (Sympatholytic): receptors - binds to Alpha-1 receptors; MOA - blocks Alpha-1 receptors after binding to them, relaxation of smooth muscle, vasodilation of blood vessels (decreases blood pressure), relaxes smooth muscle of ureters and increases blood flow

4. Beta-1 Adrenergic Agonists [Beta Adrenergic Agonists] (Sympathomimetic): receptors - stimulates Beta-1 receptors; MOA low dose - stimulates (d1) receptors in kidneys causing vasodilation and increased renal blood flow; MOA moderate dose - stimulates Beta-1 receptors in heart, increased force of contraction and cardiac output; MOA high dose - simulates Alpha-1 receptors causing vasoconstriction which increases blood pressure

5. Beta-2 Adrenergic Agonists [Beta Adrenergic Agonists](Sympathomimetic): receptors - stimulates Beta-2 receptors; MOA - relaxation of the smooth muscle of the lungs causes bronchodilation, relaxation of the smooth muscle of the uterus

6. Selective Beta-1 Blockers [Beta-Adrenergic Blocking Drugs] (Sympatholytic): receptors - binds to Beta-1 receptor; MOA - blocks Beta-1 receptor after binding to them (antagonizes Beta-1 effects of NE and EPI), decreases force of contraction (negative inotropic) therefore decreasing cardiac output, decreases heart rate (negative chronotropic), decreases conduction (negative dromotropic), decrease in cardiac output which also decreases blood pressure

7. Non-selective Beta Blockers [Beta-Adrenergic Blocking Drugs] (Sympatholytic): receptors - binds to Beta-1 and Beta-2 receptors; MOA - blocks Beta-1 and Beta-2 receptors after binding to them, decreases force of contraction (negative inotropic) therefore decreasing cardiac output, decreases heart rate (negative chronotropic), decreases conduction (negative dromotropic), decrease in cardiac output also decreases blood pressure, can also cause bronchoconstriction

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1. Direct-Acting Cholinergic Agonists: receptors - muscarinic; MOA - binds to the muscarinic receptors in the parasympathetic division to mimic ACH

2. Indirect-Acting Cholinergic Antagonists (Anticholinesterase): receptors - cholinergic receptor sites; MOA - inhibits acetylcholinesterase (the enzyme that destroys ACH in the synapse) therefore increasing ACH

3. Anticholinergics/Parasympatholytics:  receptors - cholinergic receptor; MOA - binds to the cholinergic receptor to acts as a blocking drug therefore creating competitive antagonism

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1. Direct-Acting Cholinergic Agonist: brand/generic - acetylcholine; Pilocar®/pilocarpine; Urecholine®/bethanechol

2. Indirect-Acting Cholinergic Antagonists: brand/generic - Prostigmin®/neostigmine

3. Anticholinergics/Parasympatholytics: brand/generic - atropine; Bentyl®/dicyclomine