* Epinephrine (EPI): adrenergic

* Dopamine (DA)

Parasympathetic Neurotransmitters:
* Acetylcholine (ACH): cholinergic 

https://www.openanesthesia.org/autonomic_neurotransmitters/

https://www.physio-pedia.com/Sympathetic_Nervous_System

https://wtcs.pressbooks.pub/pharmacology/chapter/4-2-ans-basics/

-alpha-1 receptor is stimulated

-contraction of smooth muscle, blood vessels constrict, increases BP 

-vasoconstriction of nasal passages à decongestant effect

Adrenergic Agonists
MOA: 

-Stimulates all alpha and beta receptors, an exception

-Vasopressor-vasoconstriction, increases BP

-Cardiac stimulant

-Bronchodilator
Uses: severe allergic reactions/anaphylaxis, shock, cardiac arrhythmias

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 smooth muscle of ureters and increases urine flow
Uses: Hypertension, Benign Prostatic Hyperplasia

Beta Adrenergic Agonists

Beta-1
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 force of contraction and cardiac output 

 -High dose: stimulates alpha-1 receptors causing vasoconstriction à increase in blood pressure
Uses: treatment of shock, increases blood pressure, and increases heart function

Beta-2
    MOA: 

-stimulates beta 2 receptors 

-relaxation of the smooth muscle of the lungs > bronchodilation 

-relaxation of the smooth muscle of the uterus
Uses: asthma, respiratory illness/disease, preterm labor

Beta-Adrenergic Blocking Drugs

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

Non-selective Beta Blockers
MOA: 

-block 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

-can cause bronchoconstriction
Uses: HTN, arrhythmias, angina, tachycardia, migraines, glaucoma (lowers IOP), heart failure (decreases sympathetic activity)

PNS:

* Parasympathomimetics: drugs that mimic the parasympathetic system (agonists, cholinergics)

*Parasympatholytics: drugs that work against parasympathetic system (antagonists, anticholingerics)

Direct –Acting Cholinergic Agonists

  MOA: 

-directly stimulate/bind to the muscarinic receptors in the parasympathetic division 

-mimics ACH

Indirect –Acting Cholinergic Agonists

  MOA:

-inhibit acetylcholinesterase, the enzyme that destroys ACH in the synapse

-increases ACH
Uses: urinary retention and intestinal stasis/ileus, reversal of anticholinergic- rocuronium bromide (Zemuron®) with respiratory paralysis from anesthesia by increasing ACH at the nicotinic 2 (Nm) receptors on skeletal muscle, treatment for myasthenia gravis

Anticholinergics/Parasympatholytics
 MOA: 

-bind to a cholinergic receptor 

-acts as a blocking drug; competitive antagonism

https://wtcs.pressbooks.pub/pharmacology/chapter/4-2-ans-basics/

1.              Alpha-1 Adrenergic Agonists

                   ephedrine

                   phenylephrine (Neo-Synephrineâ)

 

2.             Adrenergic Agonists

                     epinephrine (Adrenalinâ)

      

3.             Alpha-1 Adrenergic Blocker

                          prazosin (Minipressâ)

                          terazosin (Hytrinâ)

                          doxazosin (Carduraâ)

 4.             Beta-1 Adrenergic Agonist

                          dobutamine 

 

 5.           Beta-2 Adrenergic Agonist

                          formoterol (Foradilâ)

                          albuterol (Proventilâ/Ventolinâ)

                          terbutaline (Brethineâ)

 

 6.          Beta Blocker

                  Nonselective

                          nadolol (Corgardâ)

                          propranolol (Inderolâ)

                          timolol (Blocadrenâ)

                  Selective

                          atenolol (Tenorminâ)

                          metoprolol (Lopressorâ)

 

7.          Direct Acting Cholinergic Agonist

                          acetylcholine

                          pilocarpine (Pilocarâ)

                          bethanechol (Urecholineâ)

 8.        Indirect Acting Cholinergic Agents

                  neostigmine (Prostigminâ)

 

9.          Anticholinergic

                           atropine

                           dicyclomine (Bentylâ)

 

10.          Skeletal Muscle Relaxants

        a. Peripherally Acting 

               Depolarizing Agent:

                        succinylcholine

               Non-depolarizing Agent:

                        rocuronium bromide (Zemuronâ)

               Direct Acting:

                         dantrolene (Dantriumâ)

   

        b. Centrally Acting

                 cyclobenzaprine (Flexerilâ)

                  carisoprodol (Somaâ)

                  methocarbamol (Robaxinâ)

                  orphenadrine citrate (Norflexâ)

                  chlorzoxazone  (Parafon Forte DSCâ)

                  metaxalone (Skelaxinâ)

* FROM: Master Drug List - Unit 2