3. · Acetylcholine (ACH)-cholinergic

o NT released at ganglia from presynaptic nerve endings (both systems)

· Norepinephrine (NE)-adrenergic

o NT released at postganglionic nerve endings

o synthesized from dopamine 

o released by adrenal medulla and neurons

• Epinephrine (EPI)-adrenergic

o acts on adrenergic receptors

o produced by adrenal medulla

• Dopamine (DA)

o sympathetic and CNS neurotransmitter 

o precursor to NE 

o stimulates many receptors (alpha, beta, dopaminergic); different actions based on dose given

Parasympathetic Nervous System (cholinergic) rest and digest; calm

• Most organs and glands receive a nerve from each division (arteries are an exception-not supplied by parasympathetic system, bp controlled by sympathetic system only)

5. Alpha 1: on glands, smooth muscles, eyes, and most arteries and veins, smooth muscle contraction

and vasoconstriction (increased BP) dilation of

pupil (mydriasis).

Stimulated by NE & EPI (catecholamines)  

Located on the heart

  Force of contraction (+ inotropic)

Heart rate (+ chronotropic)

Conduction (+ dromotropic)

Stimulated by NE & EPI (stronger effect by EPI)

5. alpha 2 receptor: found mainly in the central nervous system and in pre and post synaptic neurons where they intercede and inhibit the central and peripheral nervous systems, decreasing contraction of the smooth muscles, causing vasodilation and a decrease in blood pressure, decreased release in norepinephrine.

Decreases contraction of smooth muscles - (vasodilation),

lowers BP

Decreases release of NE/regulates the release

Negative feedback system

5. Beta 2:

Found on smooth muscles, lungs, uterus, skeletal muscle arteries, coronary arteries

Smooth muscle relaxation

Bronchodilation

Uterine relaxation

Relaxation of coronary arteries and skeletal muscle blood vessels-vasodilation

Stimulated by EPI ONLY

o Sympathomimetics: drug effects that mimic the sympathetic system (adrenergic, adrenergic agonists)

o Sympatholytics: drug effects that work against the sympathetic system (adrenergic blockers, inhibitors, adrenergic antagonists) 

atenolol (Tenormin)

metoprolol (Lopressor)

 ·  hypertension (HTN), angina, arrhythmias, tachycardia, migraines, glaucoma (lowers IOP)

heart failure (decreases sympathetic activity)

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

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

o decreases HR (negative chronotropic) 

o decreases conduction (negative dromotropic)

o decrease in cardiac output also decreases BP

7. Sympatholytics: drowsiness, GI upset, CNS depression.

albuterol (Proventil, Ventolin) brochodilator

terbutaline (Brethine) bronchodilator, uterine relaxant

formoterol (Foradil) bronchodilator

salmeterol (Serevent) brochodilator

· asthma, respiratory illness/disease, preterm labor

o   stimulates beta 2 receptors 

o   relaxation of the smooth muscle of the lungs ⇒ bronchodilation 

o   relaxation of the smooth muscle of the uterus

7. Sympatholoytics: jittery, headache, tremors.

epinephrine (Adrenalin)

· allergic reactions/anaphylaxis, shock, cardiac arrhythmias

o contraction of smooth muscle

o vasoconstriction, Contraction- pupillary dilation

7. Sympathomimetics: increases heart rate and BP

Sympatholytics: slows digestion/urination, excessive nasal dryness.

ephedrine – increases BP

phenylephrine (Neo-Synephrine)

·       Increase circulation of vital organs

·       Increase BP

·       Promote decongestion

o   increase circulation of vital organs

o   increase BP

o   promote decongestion

o   increase circulation of vital organs

o   contraction of smooth muscle, blood vessels constrict    

o   vasoconstriction, contraction- pupillary dilation

7. Sympathomimetics: increases BP, nasal decongestant

Sympatholytics: slows digestion/urination, excessive, nasal dryness.

dobutamine

· Low dose – stimulates dopaminenergic (d-1) receptors in kidneys causing vasodilation and increased renal blood flow.

· Moderate dose – stimulates beta-1 receptors,

heart increase force of contraction

and cardiac output

· High dose – stimulates alpha-1 receptors causing vasoconstriction – increase in BP

7. Sympatholoytics: overstimulation of the heart, CNS irritation.

1. The purpose of the Autonomic Nervous System (ANS) – Visceral, is to regulate the rate at which the following organs work, by increasing or decreasing their activity "homeostasis" 

o Functions to control and coordinate activity of all systems in the body

o Involuntary and voluntary control

o Branches of cranial and spinal motor nerves innervate cardiac and smooth muscle of internal organs and glands

o Regulated by hypothalamus and medulla oblongata

o Autorhythmicity-contraction without any stimulus

prazosin (Minipress)

terazosin (Hytrin)

doxazosin (Cardura)

o   Binds to alpha-1 receptors and blocks them

o   Relaxation of smooth muscle

o   Vasodilation of blood vessels, decreases BP

o   Relaxes smooth muscle of ureters and increases urine flow

· Hypertension, Benign Prostatic Hyperplasia

7. Sympatholoytics: GI upset, increased urination, reflex tachycardia.

nadolol (Corgard)

propranolol (Inderal) 

timolol (Blocadren)

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

o decreases HR (negative chronotropic) 

o decreases conduction (negative dromotropic)

o decrease in cardiac output also decreases BP

o can cause bronchoconstriction

· HTN, arrhythmias, angina, tachycardia, migraines glaucoma (lowers IOP), heart failure (decreases sympathetic activity)

Contraindication: asthma and respiratory disease patients, can trigger respiratory distress

7. Sympatholoytics: GI upset, CNS depression, mental depression