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- Released at the ganglia and the postganglionic nerve endings.
- Cholinergic receptors: act in the cardiac and smooth muscle membrane sites.

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Neurotransmitter: ACH and Norepinephrine (NE)

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Neurotransmitter: ACH and Norepinephrine (NE)

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- ACH released at the ganglia and NE released at the postganglionic nerve endings.
- Adrenergic receptors: act in the cardiac and smooth muscle membrane sites.

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Eye
- constricts pupil

Lacrimal Gland
- Produce tears

Mouth
- Parotid gland and Salivary gland: produce saliva

Bronchi
- constricts

Heart
- decreases heart rate

Stomach:
- digestion

Intestines/ GI motility/ secretions:
- Increased

Urinary Bladder:
- contraction

Urinary Sphincter:
- Relaxation

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Eye
- dilates pupil

Adrenal Medulla
- Release of epinephrine

Arteries
- Vasoconstriction

Bronchi
- relaxes

Heart
- Increase heart rate

Intestines/ GI motility/ Secretion
- decreased

Urinary Bladder
- relaxation

Urinary Sphincter
- contraction

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Parasympathomimetic:
- Receptor: cholinergic (muscarinic)
- Agonist
- direct or in-direct
- direct acting drugs bind to muscarine receptors, producing effects similar to those of ACH

Drug examples:
direct
Acetylcholine (Miochol-E)
Bethanechol (Urecholine)
Carbachol (Isopto carbachol)
Pilocarpine (Isopto carpine)
indirect
Ambenonium (Mytelase)
Demecarium (Humorsol)
Echothiophate (Phospholine)
Edrophonium (Tensilon)
Neostigmine (Prostigmin)
Physostigmine (generic)
Pyridostigmine (Mestinon)
Donepezil (Aricept)
Galantamine (Razadyne)
Rivastigmine (Exelon)

Parasympholytic:
- Receptor: Muscarinic
- Antagonist
- Bind to muscarinic receptor, acting as an antagonist competitive of ACH.

Drug examples:
Atropine (generic)
Atropine (Isopto atropine)
Darifenacin (Enablex)
Dicyclomine (Bentyl)
Flavoxate (Urispas)
Glycopyrrolate (Robinul)
Hyoscyamine (Anaspaz)
Ipratropium (Atrovent)
Methscopolamine (Pamine)
Oxybutynin (Ditropan, Detropan XL) (Oxytrol, OTC)
Propantheline (Pro-Banthine)
Scopolamine (generic) (Transderm scop)
Solifenacin (Vesicare)
Tiotropium (Spiriva)
Tolterodine (Detrol, Detrol LA)
Trospium (Sanctura)

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Sympathomimetics:
- Receptor: Alpha 1- mediated smooth muscle (vasoconstriction), increased blood pressure
Alpha 2- negative feedback effect to decrease release of NE
Beta 1- cardiac stimulation; increased heart rate and force of contraction
Beta 2- bronchodilation, and increased blood flow to the heart and skeletal muscle
- Agonist

Drug examples:
Metaraminol (Aramine)
Phenylephrine (Neo-synephrine)
Dopamine (Intropin)
Albuterol (Proventil)

Sympatholytic:
- Receptor: Alpha 1- relaxation of alpha-1 mediated smooth muscle (vasodilation), decreased blood pressure
Beta 1- decreased cardiac function; decreased heart rate and force of contraction
Beta 2- beta-2-mediated smooth muscle contraction (nontherapeutic)
Adrenergic nerve endings- Interferes with synthesis and/or release of NE from nerve ending, decreases all sympathetic activity, lowers blood pressure and cardiac function
- Antagonist

Drug examples:
Alfuzosin (Uroxatral)
Doxazosin (Cardura)
Phenoxybenzamine (Dibenzyline)
Prazosin (Minipress)
Silodosin (Rapaflow)
Tamsulosin (Flomax)
Terazosin (Hytrin)
Carvedilol (Coreg)
Acebutolol (Sectral)

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Pharmacology Textbook: An Introduction
Hitner, Henry; Nagle, Barbara