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1. Two Divisions of the Autonomic Nervous System and Their Alternate Names

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1. Two Divisions of the Autonomic Nervous System and Their Alternate Names

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-Sympathetic Nervous System, or adrenergic
-Parasympathetic Nervous System, or cholinergic

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2. Neurotransmitters of the sympathetic and parasympathetic nervous systems

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2. Neurotransmitters of the sympathetic and parasympathetic nervous systems

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-Sympathetic: Acetylcholine (ACH), Norepinephrine (NE), Epinephrine (EPI), Dopamine (DA)

-Parasympathetic: Acetylcholine (ACH)

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5. End organ responses that occur when each transmitter is stimulated

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5. End organ responses that occur when each transmitter is stimulated

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Sympathetic

Adrenal medulla: releases epinephrine

Arteries: vasoconstriction except for coronary and skeletal which are vasodilated

Heart: increases heart rate, contractility, and atrioventricular conduction

Intestinal/GI: decreased motility and secretion

Postganglionic transmitter: norepinephrine is released

Pupils: mydriasis or dilation

Lower respiratory passages: bronchodilation

Urinary bladder: relaxation

Urinary sphincter: contraction

Parasympathetic

Heart: decreased heart rate, atrioventricular conduction, and slight decrease of contractility

Intestinal/GI: decreased motility and secretion

Postganglionic neurotransmitter: acetylcholine released

Pupil: miosis or constriction

Lower respiratory passages: bronchoconstriction

Urinary bladder: contraction

Urinary sphincter: relaxation

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6. Drug classifications of the autonomic nervous system

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6. Drug classifications of the autonomic nervous system

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Sympathetic

Alpha-1 adrenergic agonists interact with alpha 1 receptors to allow the  contraction of smooth muscle, constriction of blood vessels which causes an increase in blood pressure, and vasoconstriction of nasal passages to produce a decongestant effect

Adrenergic agonists stimulate all alpha and beta receptors to allow for bronchodilation and vasoconstriction

Alpha-1 adrenergic blocking drugs function by binding to alpha 1 receptors and block them for relaxation of the smooth muscle, vasodilation of blood vessels which ultimately decreases blood pressure, and causes relaxation of the smooth muscle in the ureters to increase urination

Beta 1 adrenergic agonists affect various receptors depending on the dosage

Low doses of Beta 1 adrenergic agonists stimulate dopaminergic receptors found in the kidneys which causes vasodilation for increase renal blood flow

Moderate dose of Beta 1 adrenergic agonists stimulate beta 1 receptors in the heart to allow for  stronger force of contraction and cardiac output

High doses of Beta 1 adrenergic agonists stimulates alpha-1 receptors causing vasoconstriction and an increase in blood pressure

Beta-2 Adrenergic Agonists stimulate beta 2 receptors and cause relaxation of the smooth muscle of the lungs, bronchodilation, and relaxation of the smooth muscle of the uterus

Selective beta-1 blockers interact with beta 1 receptors by blocking them to decrease force of contraction and cardiac output, decrease heart rate, decrease conduction, and decrease blood pressure

Non-selective beta blockers block beta 1 and beta 2 receptors to allow for bronchoconstriction, decreased heart rate, decrease conduction, decreased cardiac output, and decreased force of contraction

Parasympathetic

Direct-acting cholinergic agonists directly binds to muscarinic receptors and mimic acetylcholine

Indirect –Acting Cholinergic Agonists inhibit acetylcholinesterase, the enzyme that destroys acetylcholine in the synapse which cause an increase in acetylcholine

Anticholinergics or Parasympatholytics bind to a cholinergic receptor and act as a blocking drug

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7. Specific drug examples of each drug classification in the autonomic nervous system

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7. Specific drug examples of each drug classification in the autonomic nervous system

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Sympathetic

Alpha-1 adrenergic agonists

ephedrine

phenylephrine (Neo-Synephrine®)

Adrenergic agonists

epinephrine (Adrenalin®)

Alpha-1 adrenergic blocking drugs

prazosin (Minipress®)

terazosin (Hytrin®)

doxazosin (Cardura®)-HTN, BPH

Beta 1 adrenergic agonists

dobutamine

Beta-2 Adrenergic Agonists

albuterol (Proventil®, Ventolin®)

terbutaline (Brethine®)

formoterol (Foradil®)

salmeterol (Serevent®)

Selective beta-1 blocker

atenolol (Tenormin®)

metoprolol (Lopressor®)

Non-selective beta blockers

nadolol (Corgard®)

propranolol (Inderal®)

timolol (Blocadren®)

Parasympathetic

Direct-acting cholinergic agonists

acetylcholine

pilocarpine (Pilocar®)

bethanechol (Urecholine®)

Indirect –Acting Cholinergic Agonists

neostigmine (Prostigmin®)

Anticholinergics or Parasympatholytics

atropine

dicyclomine (Bentyl®)

ipratropium bromide (Atrovent®)

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3. Location where each neurotransmitter is released in the autonomic nervous system

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3. Location where each neurotransmitter is released in the autonomic nervous system

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Sympathetic

Acetylcholine is released at the ganglia of presynaptic nerve endings

Norepinephrine is released at postganglionic nerve endings

Epinephrine is released at the adrenal medulla

Dopamine is released at the presynaptic nerve endings

Parasympathetic

Acetylcholine is released at the ganglia of presynaptic nerve endings

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4. Receptors of the sympathetic and parasympathetic nervous systems and their main locations

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4. Receptors of the sympathetic and parasympathetic nervous systems and their main locations

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sympathetic/adrenergic

Alpha 1: located on smooth muscles, eyes, glands,  and most arteries/veins

Alpha 2: located on presynaptic nerve endings as well as postganglionic nerve endings

Beta 1: located on the heart

Beta 2: located on smooth muscle, lungs, uterus, skeletal muscle arteries, and coronary arteries

parasympathetic/cholinergic

Muscarinic: located on the cardiac, smooth muscle, and glands

Nicotinic 1 (Nn): located at ganglia of parasympathetic nerves and sympathetic nerves

Nicotinic 2 (Nm): located at the neuromuscular junction of skeletal muscle

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Rogers, Kara. "epinephrine". Encyclopedia Britannica, 11 May. 2020, https://www.britannica.com/science/epinephrine. Accessed 20 June 2022.

Hitner. Pharmacology: An Introduction with Additional Material. McGraw-Hill Learning Solutions, 2021. [Yuzu Reader].

Conrad, Brian. “The Role of Dopamine as a Neurotransmitter in the Human Brain.” Enzo Life Sciences, 31 May 2021, www.enzolifesciences.com/science-center/technotes/2018/november/the-role-of-dopamine-as-a-neurotransmitter-in-the-human-brain/.