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Acetylcholine (ACH)- released at the ganglia from the presynaptic nerve ending

Norepinephrine (NE)- released at the postganglionic nerve ending by the adrenal medulla & neurons

Epinephrine (EPI)- released by the adrenal medulla

Dopamine (DA)- released by the hypothalamus

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Acetylcholine (ACH)- released at the ganglia from the presynaptic nerve ending

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alpha-1: located on the glands smooth muscle, eyes, arteries, & veins

alpha-2: located on the adrenergic nerve endings

beta-1: located on the heart

beta-2: located on the smooth muscle, lungs, uterus, skeletal muscle arteries, and coronary arteries

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muscarinic: located on cardiac, smooth muscle, & glands

nicotinic-1 (Nn): located on the ganglia of the parasympathetic nerves & the sympathetic nerves (synapse area)

nicotinic-2 (Nm): located on the somatic, neuromuscular junction of skeletal muscle

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End Organ Responses from Sympathetic Stimulation

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End Organ Responses from Sympathetic Stimulation

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Adrenal medulla: releases epinephrine

Arteries: vasoconstriction of arteries to skeletal muscle

Heart: increased heart rate, AV conduction, contraction

Intestines, GI Motility, and secretions: decrease

Postganglionic neurotransmitters: norepinephrine gets released

Pupil of the eye: dilation (mydriasis)

Respiratory passages: bronchodilation

Urinary bladder: relaxation

Urinary sphincter: contraction

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End Organ Responses from Parasympathetic Stimulation

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End Organ Responses from Parasympathetic Stimulation

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Heart: decreased heart rate.

Intestines, GI motility, & secretions: Acetylcholine is released.

Pupil of the eye: constriction (miosis)

Respiratory passages: Bronchoconstriction

Urinary bladder: contraction

Urinary sphincter: relaxation

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Drug Classifications and Examples for The Sympathetic Nervous System

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Drug Classifications and Examples for The Sympathetic Nervous System

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Alpha -1 Adrenergic Agonists
MOA:

alpha-1 receptor is stimulated

Contraction of smooth muscle, blood vessels constrict, increases BP

Vasoconstriction of nasal passages -> decongestant effect

Drugs:

1) ephedrine- increases BP

2) phenylephrine (Neo-Synephrine®)- increases BP, nasal decongestant

Adrenergic Agonist
MOA:

Stimulates all alpha and beta receptors, an exception

Vasopressor-vasoconstriction increases BP

Cardiac stimulant

Bronchodilator

Drugs:

1) epinephrine (Adrenalin®)

Alpha-1 Adrenergic Blocking Drugs

MOA:

Binds to alpha-1 receptors and blocks them

Relaxation of smooth muscle

Vasodilation of blood vessels, decreases BP

Relaxes the smooth muscle of ureters and increases urine flow

Drugs:

1) prazosin (Minipress®)

2) terazosin (Hytrin®)

3) doxazosin (Cardura®)

Beta Adrenergic Agonists

*Beta-1 Adrenergic Agonists
MOA:

Low dose- stimulates dopaminergic (d-1) receptors in kidneys causing vasodilation and increased renal blood flow

Moderate dose- stimulates  beta 1 receptors-heart, increases the force of contraction and cardiac output

High dose- stimulates alpha-1 receptors causing vasoconstriction -> increase in blood pressure

Drugs:

1) dobutamine

*Beta-2 Adrenergic Agonists
MOA:

Stimulates beta 2 receptors

Relaxation of the smooth muscle of the lungs à bronchodilation

Relaxation of the smooth muscle of the uterus

Drugs:

1. albuterol (Proventil®, Ventolin®)- bronchodilator

2. terbutaline (Brethine®)- bronchodilator, uterine relaxant

3. formoterol (Foradil®)- bronchodilator

4. salmeterol (Serevent®)- bronchodilator

*Selective Beta-1 Blockers
MOA:

beta-1 receptor is blocked (antagonizes beta-1 effects of NE and EPI)

Decreases force of contraction  (negative inotropic), decreases cardiac output

Decreases HR  (negative chronotropic)

Decreases conduction (negative dromotropic)

Decrease in cardiac output also decreases BP

Drugs:

1) atenolol (Tenormin®)

2) metoprolol (Lopressor®)

*Non-selective Beta Blockers
MOA:

Blocks beta-1 and beta-2 receptors

Decreases force of contraction  (negative inotropic), decreases cardiac output

Decreases HR  (negative chronotropic)

Decreases conduction (negative dromotropic)

Decrease in cardiac output also decreases BP

Drugs:

1) nadolol (Corgard®)

2) propanolol (Inderal®)

3) timolol (Blocadren®)

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Drug Classifications and Examples for The Parasympathetic Nervous System

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Drug Classifications and Examples for The Parasympathetic Nervous System

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Direct –Acting Cholinergic Agonists

MOA:

Directly stimulate/bind to the muscarinic receptors in the parasympathetic division

Mimics ACH

Drugs:

1) acetylcholine

2) pilocarpine (Pilocar®)

3) bethanechol (Urecholine®)

Indirect –Acting Cholinergic Agonists

MOA:

Inhibit acetylcholinesterase, the enzyme that destroys ACH in the synapse

Increases ACH

Drugs:

1) neostigmine (Prostigmin®)

Anticholinergics
MOA:

Binds to a cholinergic receptor

Acts as a blocking drug; competitive antagonism

Drugs:

1) atropine

2) dicyclomine (Bentyl®)

3) ipratropium bromide (Atrovent®)