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-Sympathetic Nervous System (Adrenergic Nervous System)

-Parasympathetic Nervous System (Cholinergic Nervous System)

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Neurotransmitters of the Sympathetic Nervous System:
-Acetylcholine
-Epinephrine
-Norepinephrine
-Dopamine

Neurotransmitters of the Parasympathetic Nervous System:
-Acetylcholine

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Locations Where Neurotransmitters are Released

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Locations Where Neurotransmitters are Released

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Sympathetic Nervous System:
-Aceytlcholine is released at the ganglia from presynaptic nerve endings
-Norepinephrine is released at the postganglionic nerve endings

Parasympathetic Nervous System:
-Aceythlcholine is released at the ganglia and at the postganglionic nerve endings

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Receptors of the Sympathetic Nervous System:
-Alpha 1 receptors located on smooth muscle, glands, eyes, and most arteries and veins
-Alpha 2 receptors located on adrenergic nerve endings
-Beta 1 receptors located on the heart
-Beta 2 receptors located on smooth muscle, lungs, uterus, coronary arteries, and skeletal muscle arteries

Receptors of the Parasympathetic Nervous System:
-Muscarinic receptors located on cardiac muscle, smooth muscle, and glands
-Nicotinic 1 receptors located at ganglia of sympathetic and parasympathetic nerves
-Nicotinic 2 receptors located at the neuromuscular junction of skeletal muscles

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Sympathetic Nervous System:
-Arteries: vasoconstriction, causing increased blood pressure (exceptions are coronary arteries and skeletal muscle arteries, which are dilated)
-Heart: increases heart rate, AV conduction, and contractility
-Intestines, GI motility, and secretion: decreased
-Pupil of the eye: dilation (mydriasis)
-Respiratory passages, lower: bronchodilation
-Urinary bladder: relaxation
-Urinary sphincter: contraction

Parasympathetic Nervous System:
-Heart: decreases heart rate and AV conduction, slight decrease in contractility
-Intestines, GI motility, and secretions: increased
-Pupil of the eye: constriction (miosis)
-Respiratory passages, lower: bronchoconstriction
-Urinary bladder: contraction
-Urinary sphincter: relaxation

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Drug Classifications of the Sympathetic Nervous System

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Drug Classifications of the Sympathetic Nervous System

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Alpha 1 Adregnergic Agonists:
-Alpha 1 receptors are stimulated
-Contraction of smooth muscle, blood vessels constrict, increased blood pressure
-Vasoconstriction of nasal passages, which leads to a decongestant effect

Adrenergic Agonists:
-All Beta and Alpha receptors are stimulated
-Vasoconstriction, which leads to increased blood pressure
-Cardiac stimulant
-Bronchodilation

Alpha 1 Adrenergic Blocking Drugs:
-Binds to Alpha 1 receptors and blocks them
-Relaxation of smooth muscles
-Vasodilation, which leads to decreased blood pressure
-Relaxes smooth muscle of ureters and increases urine flow

Beta 1 Adrenergic Agonists:
-Low dose stimulates Dopaminergic receptors in the kidneys, leading to vasodilation and increased renal blood flow
-Moderate dose stimulates Beta 1 receptors in heart, leading to an increase in force of contraction and cardiac output
-High dose stimulates Alpha 1 receptors, leading to vasoconstriction and increased blood pressure

Beta 2 Adrenergic Agonists:
-Beta 2 receptors are stimulated
-Relaxation of the smooth muscle of the lungs, which leads to bronchodilation
-Relaxation of the smooth muscle of the uterus

Selective Beta 1 Blockers:
-Bind to Beta 1 receptors and block them
-Decreases force of contraction, heart rate, conduction, and cardiac output
-Decrease in cardiac output decreases blood pressure

Non-Selective Beta Blockers:
-Bind to Beta 1 and Beta 2 receptors and block them
-Decreases force of contraction, heart rate, conduction, and cardiac output
-Decrease in cardiac output decreases blood pressure
-Can cause bronchoconstriction

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Drug Classifications of the Parasympathetic Nervous System

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Drug Classifications of the Parasympathetic Nervous System

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Direct Acting Cholinergic Agonists:
-Muscarinic receptors are stimulated
-Mimics the effects of acetylcholine

Indirect Acting Cholinergic Agents:
-Inhibit acetylcholinesterase, the enzyme that destroys acetylcholine in the synapse
-Increases acetylcholine

Anticholinergics:
-Bind to Muscarinic receptors
-Prevents acetylcholine from binding to receptors

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Alpha 1 Adrenergic Agonists:
-ephedrine
-phenylephrine (Neo-Synephrine®)

Andrenergic Agonists:
-epinephrine (Adrenalin®)

Alpha 1 Adrenergic Blockers:
-prazosin (Minipress®)
-terazosin (Hytrin®)
-doxazosin (Cardura®)

Beta 1 Adrenergic Agonists:
-dobutamine

Beta 2 Adrenergic Agonists:
-formoterol (Foradil®)
-albuterol (Proventil®, Ventolin®)
-terbutaline (Brethine®)

Selective Beta Blockers:
-atenolol (Tenormin®)
-metoprolol (Lopressor®)

Non-Selective Beta Blockers:
-nadolol (Corgard®)
-propranolol (Inderal®)
-timolol (Blocadren®)

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

Indirect Acting Cholinergic Agents:
-neostigmine (Prostigmin®)

Anticholinergics:
-atropine
-dicyclomine (Bentyl®)
-ipratropium bromide (Atrovent®)

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Hitner, H. Pharmacology: An Introduction with Additional Material. 5th ed. McGraw Hill, 2022.