# data[].attributes.body
"Fight or Flight"
Adrenergic

Parasympathetic Nervous System
"Rest and Digest"
Cholinergic

# data[].attributes.body
*Acetylcholine (ACh): released at ganglia from presynaptic nerve.

*Norepinephrine (NE): released at post ganglionic nerve endings. Released by adrenal medulla and post synaptic neurons.

*Epinephrine (EPI): released by adrenal medulla.

*Dopamine (DA):  precursor to NE found in the CNS, specifically the brain.

Parasympathetic Nervous System (PSNS)

*Acetylcholine (ACh):  released at the ganglia from presynaptic nerves, and at the post ganglionic nerve endings.

# data[].attributes.body
Sympathetic Nervous System

Adrenergic Receptors:

*Alpha 1

location: smooth muscle, glands, eyes, most arteries and veins.

stimulated by NE & EPI

*beta 1

location: heart.

stimulated by NE and EPI (stronger effect by EPI)

*beta 2

location: lungs, uterus, skeletal muscle arteries, coronary arteries, smooth muscle.

stimulated by EPI ONLY

Parasympathetic Nervous System

Cholinergic Receptors:

*Muscarinic

location: cardiac and smooth muscle, glands at postganglionic nerve endings.

*Nicotinic 1 (Nn)

location: ganglia of parasympathetic and sympathetic nerves.

*Nicotinic 2 (Nm)

location: in the somatic nervous system at the neuromuscular junction (NMJ) of skeletal muscles.

all cholinergic receptors stimulated by ACh

# data[].attributes.body
Sympathetic Organ Response

*Adrenal Medulla: releases EPI
*Arteries: vasoconstriction
(EXCEPTION: coronary and skeletal muscle arteries DILATE!)
*Heart: + chronotrope (heart rate) + inotrope (contractility)
+ dromotrope (AV conduction)
*GI: decreased secretions and motility
*Eye: pupil dilation= Mydriasis
*Lungs: bronchodilation
*Urinary Bladder: relaxation of smooth muscle
*Urinary Sphincter: contraction of smooth muscle.

Parasympathetic Organ Response

*Adrenal Medulla: no effect
*Arteries: (NO effect because not supplied by parasympathetic nerves)
*Heart: decrease heartrate, contractility, and AV conduction.
*GI: increased secretions and motility.
*Eye: constriction of pupil= Miosis
*Lungs: bronchoconstriction
*Urinary Bladder: contraction
*Urinary Sphincter: relaxation= urination

# data[].attributes.body
Parasympathomimetics
Drugs that mimic the PSNS
Also called:
Cholinergics - Agonists

Direct Acting Cholinergic Agonists
*bind to and stimulate muscarinic receptors. Mimic ACH
Drugs:
acetylcholine
pilocarpine (Pilocar®)
*pupil constriction, decrease intraocular fluid and pressure
bethanechol (Urecholine®)
*stimulates urination and peristalsis

Indirect Acting Cholinergic Agonists
*blocks AChE from breaking down acetylcholine = increases ACh in the synapse at muscarinic, and nicotinic 1and 2 receptor locations.
Drugs:
neostigmine (Prostigmine®)
physostigmine (Eserine®)
*antidote to anticholinergics at Nm receptors that cause muscle paralysis
*treat Myasthenia Gravis
note: all indirect cholinergic agonist end in "STIGMINE"

Parasympatholytics
Drugs that bind to cholinergic receptors and block ACh.

Anticholinergics
*competitive antagonism = binds and competes with other substances for action.
Drugs:
atropine (Belladonna plant)
*antidote for cholinergic poisoning. Reverses SLUDGE. Used for pre-op.
dicyclomine (Bentyl®)
*food poisoning treatment slows GI secretions and motility
ipratropium bromide (Atrovent®)
*causes bronchodilation

# data[].attributes.body
Sympathomimetics
Drugs that mimic the SNS.
Also called:
Adrenergics - Agonists

Alpha 1 Adrenergic Agonist
*stimulates alpha 1 receptor
*vasoconstriction, smooth muscle contraction, increase BP, decongestant effect in nasal passages.
Drugs:
ephedrine
phenylephrine (Neo-Synephrine®)

Adrenergic Agonist
-stimulates ALL alpha and beta receptors.
* vasoconstriction: alpha 1
* cardiac stimulation: beta 1
* bronchodilation: beta 2
Drug:
epinephrine (Adrenalin®)

Beta 1 Adrenergic Agonist
* stimulates beta 1 receptors; increases HR, FOC, and conduction...increases CO.
Drug:
dobutamine

Beta 2 Adrenergic Agonist
*stimulates beta 2 receptors
*bronchodilation
*relaxation of smooth muscle of uterus
Drugs:
albuterol (Proventil®, Ventolin®)
formoterol (Foradil®)
salmeterol (Serevent®)
terbutaline (Brethine®)

Sympatholytics
Drugs that work against the SNS.
Also called:
Adrenergic Blockers/ Antagonists

Alpha 1 Adrenergic Blocker
-binds to and blocks alpha 1 receptors.
*relaxation smooth muscle
*vasodilation of blood vessels = decrease BP
*relax smooth muscle of ureters = increase urine output
Drugs:
prazosin (Minipress®)
terazosin (Hytrin®)
doxazosin (Cardura®)
note: all alpha 1 blockers end in "AZOSIN"

Selective Beta 1 Blocker
*beta 1 receptor blocked ONLY
*decreases HR, FOC, conduction
( neg. chronotrope neg. inotrope neg. dromotrope) = decreases BP)
Drugs:
atenolol (Tenormin®)
metoprolol (Lopressor®)

Non-Selective Beta Blocker
*blocks BOTH beta 1 and beta 2 receptors.
*decrease HR, FOC, conduction = decrease BP.
*ALSO causes bronchoconstriction
Drugs:
nadolol (Corgard®)
propanolol (Inderal®)
timolol (Blocadren®)
note: all beta blockers end in "OLOL"