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1: sympathetic division and the parasympathetic division

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1: sympathetic division and the parasympathetic division

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The sympathetic nervous system (Adrenergic) is the fight-or-flight response
The parasympathetic nervous system (cholingergic) is the rest and digest

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Acetylcholine (ACH)
Norepinephrine (NE)
Epinephrine (EPI)
Dopamine (DA)

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Acetylcholine (ACH)

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Adrenal Medulla: Release or epinephrine
Arteries: Vasoconstriction (exceptions: coronary arteries and arteries to skeletal muscle which are dilated)
Heart: Increase HR and AV conduction
Intestines, GI motility, and secretions: Decreased
Postganglionic neurotransmitter: Norepinephrine released
Pupil of the eye: Dilation (mydriasis)
Respiratory passages, lower: Bronchodilation
Urinary Bladder: Relaxation
Urinary Sphincter: Contraction

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Adrenal Medulla: -
Arteries: Most arteries are not supplied by Parasympathetic nerves
Heart: Decrease HR and AV conduction, slight decrease in contractility
Intestines, GI Motility, and Secretions: Increased
Postganglionic neurotransmitter: Acetylcholine released
Pupil of the eye: Constriction (miosis)
Respiratory passages, lower: Bronchoconstriction
Urinary Bladder: Constriction
Urinary sphincter: Relaxation

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Alpha-1 Adrenergic Agonist: Alpha-1 receptor is stimulated:
Contraction of smooth muscle, blood vessels constrict, increase BP, vasoconstriction of nasal passages- decongestant effect
DRUGS:
ephedrine- increases BP
phenylephrine (Neo-Synephrine®)

Adrenergic Agonist: Stimulates all alpha and beta receptors, an exception. Vasopressor- vasoconstriction, increases BP, cardiac stimulant, Bronchodilator
DRUGS:
epinephrine (Adrenalin®)

Alpha-1 Adrenergic Blocking Drugs: Binds to alpha-1 receptors and blocks them, Relaxation of smooth muscle, Vasodilation of blood vessels, Decrease BP, Relaxes smooth muscle of ureters and increases urine flow
DRUGS:
prazosin: (Minipress®)-hypertension
terazosin (Hytrin®)-hypertension, benign prostatic hyperplasia
Doxazosin (Cardura®)-hypertension benign prostatic hyperplasia

Beta Adrenergic Agonist-
Beta-1:
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 and cardiac output

High dose- stimulates alpha-1 receptors causing vasoconstriction  increase in blood pressure
DRUGS:

dobutamine

Beta-2:
stimulates beta 2 receptors

relaxation of the smooth muscle of the lungs- bronchodilation

relaxation of the smooth muscle of the uterus
DRUGS:
albuterol (Proventil®, Ventolin®)-bronchodilator

terbutaline (Brethine®)-bronchodilator, uterine relaxant

formoterol (Foradil®)-bronchodilator

salmeterol (Serevent®)-bronchodilator

Beta- Adrenergic Blocking Drugs-
Selective Beta-1 Blockers:
beta-1 receptor is blocked (antagonizes beta-1 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

DRUGS:
atenolol (Tenormin®)

metoprolol (Lopressor®)

Non-selective Beta Blockers:
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

DRUGS:
nadolol (Corgard®)

propanolol (Inderal®)
timolol (Blocadren®)

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Cholinergics/Parasympathomimetics:
Direct –Acting Cholinergic Agonists-
directly stimulate/bind to the muscarinic receptors in the parasympathetic division

mimics ACH

DRUGS:
acetylcholine-used for miosis, cataract and other eye surgeries

MOA: pupil constriction

pilocarpine (Pilocar® )-used for glaucoma

MOA: pupil constriction; decreases amount of fluid in eye; decreases  intraocular pressure

bethanechol (Urecholine®)-used for urinary retention and ileus/intestinal stasis
MOA: stimulates muscarinic receptors of bladder and GI tract to prevent constipation and urinary retention post-op                                              and in the elderly

Indirect –Acting Cholinergic Agonists-
inhibit acetylcholinesterase, the enzyme that destroys ACH in the synapse

increases ACH
DRUGS:
neostigmine (Prostigmin®)

Cholinergics/Parasympathomimetics:
Direct –Acting Cholinergic Agonists-
directly stimulate/bind to the muscarinic receptors in the parasympathetic division

mimics ACH
DRUGS:

acetylcholine-used for miosis, cataract and other eye surgeries

MOA: pupil constriction

pilocarpine (Pilocar® )-used for glaucoma

MOA: pupil constriction; decreases amount of fluid in eye; decreases  intraocular pressure

bethanechol (Urecholine®)-used for urinary retention and ileus/intestinal stasis

MOA: stimulates muscarinic receptors of bladder and GI tract to prevent constipation and urinary retention post-op                                              and in the elderly

Indirect –Acting Cholinergic Agonists
inhibit acetylcholinesterase, the enzyme that destroys ACH in the synapse

increases ACH
DRUGS:
neostigmine (Prostigmin®)

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Unit 2 ANS Part 1 and Part 2 PowerPoints

https://acconline.austincc.edu/bbcswebdav/pid-22461055-dt-content-rid-98132924_1/xid-98132924_1

https://acconline.austincc.edu/bbcswebdav/pid-22461055-dt-content-rid-98132925_1/xid-98132925_1