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Voluntary Control from cerebral cortex

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Brain and Spinal Cord

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Afferent and Efferent Nerves

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Involuntary control & Autorhythmicity

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Adrenergic System
"Fight or Flight" response

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Cholinergic System
Rest and Digest

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Short pre-ganglionic neuron (far from effector organ) and long post ganglionic neuron
Acetylcholine NT and nicotinic 1 or Nm receptor at ganglion
Norepinephrine NT and adrenergic receptor at post ganglionic nerve endings

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Long pre-ganglionic neuron and short post ganglionic neuron
Acetylcholine NT and nicotinic (Nn) receptor at ganglion
Acetylcholine NT and cholinergic (muscarinic receptor) at receptor

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Heart: Decreased HR, conduction, and contractility
Eyes: Miosis
Respiratory: bronchoconstriction
GI: increased digestion and increased defecation
Renal: urinary bladder contraction and urinary sphincter relaxation, increased urination

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Blood Vessels: vasoconstriction (dilation of skeletal muscle and coronary arteries)
Heart: Increased HR, contractility, and conduction
Eyes: mydriasis
Respiratory: bronchodilation
GI: decreased digestion, GI motility, and secretions
Renal: relaxation of urinary bladder and urinary sphincter contraction

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Drugs that mimic the parasympathetic system

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Drugs that work against parasympathetic system
bind to cholinergic receptor
act as a blocking drug; competitive antagonism

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MOA: directly stimulate/bind to the muscarinic receptors in the parasympathetic division
mimic ACH

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-used for miosis, cataract and other eye surgeries
MOA: pupil constriction

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-used for glaucoma
MOA: pupil constriction; decreases amount of fluid in eye, decreases IOP

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-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 elderly

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MOA: inhibit acetylcholinesterase

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Uses: urinary retention and intestinal stasis/ileus, reversal of anticholinergic-rocuronium bromide (Zemuron) with respiratory paralysis from anesthesia by increasing ACH at the nicotinic 2 (Nm) receptors on skeletal muscle, treatment for myasthenia gravis

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Antidote for cholinergic poisoning
-increase HR, decreases vagus nerve activity
-pre-op  med-slows digestion and urination
-mydriasis

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-used for GI disorders (ulcers, colitis, IBS)
-decreases GI secretions and motility

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bronchodilation

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drugs that mimic the sympathetic system

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drugs that work against the sympathetic system

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MOA: alpha-1 receptor is stimulated
contraction of smooth muscle, blood vessels constrict, increases BP
vasoconstriction of nasal passages (decongestant effect)

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Increases BP

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Increases BP
Nasal decongestant

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MOA: Stimulates all alpha and beta receptors
Vasopressor: vasoconstriction, increases BP
Cardiac stimulant
Bronchodilator

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Uses: severe allergic reactions/anaphylaxis, shock, cardiac arrythmias

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MOA: binds to Alpha-1 receptors and blocks them
relaxation of smooth muscle
vasodilation of blood vessels (decreases BP)
relaxes smooth muscle of ureters and increases urine flow

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Uses: hyptertension

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Uses: Hypertension and Benign prostatic hyperplasia

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Hypertension and Benign prostatic hyperplasia

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Low Dose: Vasodilation and increased renal blood flow
Moderate dose- increase force of contraction and cardiac output
High Dose- increase blood pressure

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Uses: treatment of shock, increased blood pressure, increase heart function

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MOA: stimulates beta 2 receptors
brochodilation
uterine relaxant

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Uses: Bronchodilator

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Uses: bronchodilator and uterine relaxant

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Uses: bronchodilator

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Uses: bronchodilator

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MOA: beta-1 receptor is blocked
decreases force of contraction, HR, conduction, and cardiac output

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MOA: block beta-1 and beta-2 receptors
Decrease force of contraction, HR, conduction, cardiac output, BP
brochoconstriction