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Two Divisions of the Autonomic  Nervous System

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Two Divisions of the Autonomic  Nervous System

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1. Sympathetic Nervous System
-Also called the Adrenergic System

2. Parasympathetic Nervous System
-Also called the Cholinergic Systm

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The Neurotransmitters for the Sympathetic Nervous System

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The Neurotransmitters for the Sympathetic Nervous System

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Acetylcholine (ACH): cholinergic

NT released at ganglia from presynaptic nerve endings

Norepinephrine (NE): adrenergic

NT released at postganglionic nerve endings by adrenal medulla & neurons

Epinephrine (EPI): adrenergic

released by the adrenal medulla and acts on adrenergic receptors

Dopamine (DA):

released by the adrenal medulla

acts on dopamine receptors

stimulated by many receptors like; alpha, beta, dopaminergic

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Neurotransmitters for the Parasympathetic Nervous System

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Neurotransmitters for the Parasympathetic Nervous System

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Acetylcholine (ACH)

released at ganglia and postganglionic nerve endings

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Receptors of the Sympathetic Nervous System

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Receptors of the Sympathetic Nervous System

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Alpha-1: found on glands, smooth muscles, eyes, most arteries & veins

Alpha-2*: relaxation/inhibition of parasympathetic response

Beta-1: located on heart

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

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Receptors of The Parasympathetic Nervous System

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Receptors of The Parasympathetic Nervous System

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Muscarinic: on cardiac, smooth muscle, & glands

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

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

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The End Organ Responses When Each Sympathetic Nervous System Transmitter is Stimulated

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The End Organ Responses When Each Sympathetic Nervous System Transmitter is Stimulated

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Adrenal Medulla: releases epinephrine and some norepinephrine

Arteries: vasoconstriction except for the coronary and skeletal muscle arteries

Heart: increases HR, AV conduction, and contractility

Postganglionic neurotransmitter: releases norepinephrine

Pupil: becomes dilated; mydriasis

Respiratory Passages: become dilated; bronchodilation

Urinary Bladder: relax

Urinary Sphincter: contracts which decreases urination

GI: decreases digestion, slows motility and secretions

Alpha-1:
-causes smooth muscle contraction & vasoconstriction, which increases BP
-also causes mydriasis of the eye

Alpha-2:
-decreases smooth muscle contraction, which decreases BP and vasodilation

Beta-1:
-increases force of contraction of heart, increases HR, and increases conduction

Beta-2:
-causes smooth muscles, uterine, coronary arteries, and skeletal muscle blood vessels to relax
-causes bronchoconstriction and vasodilation

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The End Organ Responses of The Parasympathetic Nervous System

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The End Organ Responses of The Parasympathetic Nervous System

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Heart: causes a decrease in HR and AV conduction, and a slight decrease in contractibility

GI: GI motility, digestion, and secretions are increased

Postganglionic neurotransmitter: releases acetylcholine

Pupil: constriction of pupil; miosis

Respiratory passages: causes constriction; bronchoconstriction

Urinary bladder: contracts

Urinary sphincter: relaxes, causes increased urination

Muscarinic:
-decreased HR
-causes bronchoconstriction and pupillary constriction
-increases digestion, GI secretions, and urination

Nicotinic 1 (Nn):
-contraction of muscles

Nicotinic 2 (Nm):
-contraction of muscles

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The Sympathetic Nervous System Drug Classifications

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The Sympathetic Nervous System Drug Classifications

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Alpha-1 Adrenergic Agonists
-alpha-1 receptor is stimulated
-causes contractions of smooth muscle, constriction of blood vessels, vasoconstriction of nasal passages, and increased BP
Drugs:
-ephedrine
-phenylephrine (Neo-Synephrine®)

Adrenergic Agonists
-all alpha and beta receptors are stimulated
-causes vasoconstriction, increased BP, and is a bronchodilator
Drugs:
-epinephrine (Adrenalin®)

Alpha-1 Adrenergic Blocking Drugs
-alpha-1 receptor is blocked
-causes relaxation of smooth muscle, vasodilation of blood vessels, decreases BP, relaxation of smooth muscle of ureters, and increases urine flow
Drugs:
-prazosin (Minipress®)
-terazosin (Hytrin®)
-doxazosin (Cardura®)

Beta-1 Adrenergic Agonists
-low dose: dopaminergic (d-1) receptors are stimulated
-causes vasodilation and increased renal blood flow of          kidneys
-moderate dose: beta-1 receptors are stimulated
-causes increased force of contraction and cardiac output
-high dose: alpha-1 receptors are stimulated
-causes vasoconstriction and increased BP
Drugs:
-albuterol (Proventil®, Ventolin®)
-terbutaline (Brethine®)
-formoterol (Foradil®)
-salmeterol (Serevent®)

Selective Beta-1 Blockers
-beta-1 receptor is blocked
-causes decreased force of contraction, cardiac output, HR, BP, and conduction
Drugs:
-atenolol (Tenormin®)
-metoprolol (Lopressor®)

Non-selective Beta Blockers
-beta-1 and beta-2 receptors are blocked
-causes decreased force of contraction, cardiac output, HR, BP, conduction, and can cause bronchoconstriction
Drugs:
-nadolol (Corgard®)
-propranolol (Inderal®)
-timolol (Blocadren®)

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The Parasympathetic Nervous System Drug Classification

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The Parasympathetic Nervous System Drug Classification

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Direct-Acting Cholinergic Agonists
-muscarinic receptor is stimulated
-mimics ACH
Drugs:
-acetylcholine
-causes pupil constriction
-pilocarpine (Pilocar®)
-causes pupil constriction, decreases amount of fluid in eye, and decreases intraocular pressure
-bethanechol (Urecholine®)
-causes stimulation of receptors of blader and GI tract to prevent constipation and urinary retention

Indirect-Acting Cholinergic Agonists
-inhibit acetylcholine
Drugs:
-neostigmine (Prostigmin)
-used for urinary retention & intestinal stasis, as a reversal of anticholinergic-rocuronium bromide, as a treatment for myasthenia gravis
-physostigmine (Eserine®)
-used as an antidote for an overdose of anticholinergics

Anticholinergics/Parasympatholytics
-binds to and blocks cholinergic receptors
Drugs:
atropine:
-causes increased HR, decreased vagus nerve activity, slows digestion and urination, and mydriasis
dicyclomine (Bentyl®)
-causes a decrease in GI secretions and motility
ipratropium bromide (Atrovent®)
-causes bronchodilation