Autonomic Pharmacology

Front 1

Sympathetic Nervous System

Back 1

Widespread Activation
One preganlionic neuron innervates many postganglionic neurons
=Chromaffin cells secrete epinepherine and norepinepherine

Front 2

Parasympathetic NS

Back 2

Discrete Activation
One preganglionic neuron innervates one postganglionic neuron.
-No large-scale release of hormone into the blood.

Front 3

Sympathetic Effect on Organs and Vessels

Back 3

Heart->increased CO
Lungs->Inreased o2 delivery
Liver->Increased glucose production
Adrenal Medulla->Release of epi & norepi
Sweat Glands->Increased sweating
Vascular Smooth Muscle->Vasodilation of arteries and vasoconstriction of unimportant vessels

Front 4

Parasympathetic Effects on Organs and Vessels

Back 4

Increased salivation, decreased CO, contraction of bronchiole smooth muscle, Increased GI motility, urination

Front 5

Parasympathetic NT

Back 5

Postganglionic release Acetylcholin-->muscarinic receptors

Front 6

Sympathetic NT

Back 6

Postganglionic release Epi & Norepi-->Adrenergic Receptors (A&B)
EXCEPT SWEAT GLANDS->acetylcholine=muscarinic and RENAL VASCULAR SMOOTH MUSCLE=dopamine(D1 receptors)

Front 7

Autonomic Drugs

Back 7

Mimics or prevents the effects of sympathetic and parasympathetic nervous systems by activating or blocking ADRENERGIC AND MUSCARINIC RECEPTORS

Front 8

Site of action for Sympathetic & Parasympathetic Drugs

Back 8

Sympathetic=Adrenergice Receptors
Parasympathetic=Muscarinic Cholinergic Receptors

Front 9

Direct vs. Indirect Autonomic Drugs

Back 9

Direct=directly interact with receptors (agonists/antagonists)
Indirect=alter NT concentrations at target sites

Front 10

Sites of action for sympathomimetic druges

Back 10

Reuptake blockers (Cocaine)
MAO Inhibitors (Phenelzine)
Releasing Agents (Amphetamines)
Adrenegic Receptor Agonist

Front 11

Sites of action for Sympatholytic Drugs

Back 11

Synthesis InhibitorsRelease Inhibitors (Reserpine)
Autoreceptor Agonists
Adrenergic Receptor Antagonists

Front 12

Examples of sympathomimetic drugs

Back 12

Cocaine-inhibits reuptake of NE
Phenylzine-inhibits MAO
PPA-releasing agent
Amphetamines-releasing agents
Ephedrine-releasing agent & direct adrenergic receptor agonist
ALL CAN CAUSE MASSIVE CARDIAC EFFECTS
(PPA USED TO BE IN COLD MEDICINE - NOW BANNED BY FDA

Front 13

Sympathetic Receptors

Back 13

A1-prostate gland, vascular smooth muscle (most vessels)
A2-inhibit sympathetic ns in brain
B1-heart
B2-lungs, liver, vascular smooth muscle(arteries)

Front 14

A1 Adrenergic Receptor Agonists

Back 14

Effect: Vasoconstriction
Clinical Uses: Reduce redness of eyes, reduce nasal secretions, vasoconstrictors
Side Effects: Hypertension

Front 15

A1 Adrenergic Receptor Antagonists

Back 15

Effects: Vasodilation
Clinical Uses: Tx of Hypertension, Benign Prostate Hyperplasia (BPH)
Side Effects: Orthostatic Hypotension, Sweating/Flushing

Front 16

A2 Adrenergic Receptor Agonists

Back 16

Effect: Reduced release of NE from sympathetic nerves
Clinical Use: Hypertension
Side Effects: Overall reduction in sympathetic activity

Front 17

A2 Adrenergic Receptor Antagonists

Back 17

Effect: Increased release of NE from sympathetic nerves
Clinical Uses: None
Side Effects: Overall increase in sympathetic activity

Front 18

B1 Adrenergic Receptor Agonists

Back 18

Heart
Effect: Increased force of contraction, Increased HR, Increased impulse conduction through AV node
Clinical Uses: Acute Heart Failre
Side Effects: Hypertension, Risk or Heart attack, cardiac arrhythmias

Front 19

B1 Adrenergic Receptor Anatgonists

Back 19

Effects: Decreased force of contraction, decreased HR, decreased impulse conduction though AV node

Front 20

B2 Adrenergic Receptor Agonist

Back 20

Effects: Glucose metabolization, relaxation of bronchial smooth muscle, relaxation of some arterial smooth muscle
Clinical Uses: Treatment of Asthma
Side Effects: Increase blood glucose, some hypotension

Front 21

B2 Adrenergic Receptor Antagonists

Back 21

Effects: Reduced glucose mobilization, contraction of bronchial smooth muscle, contraction of some arterial smooth muscle
Clinical Uses: None
Side Effects: Impaired glucose mobilization, Bronchoconstriction (Asthma Attack)

Front 22

Epinepherine Receptor Targets

Back 22

A1, B1 & B2
Little change in BP

Front 23

Noriepinepherine Receptor Targets

Back 23

A1 & B1
Large increase in BP

Front 24

Non-selective Beta Blockers

Back 24

Block both B1 and B2 adrenergic receptors
Effects: Decreases CO, Bronchioconstriction-->possible astham attack, impairs glucose mobilization-->impairs recovery from hypoglycemia

Front 25

Cardioselective Beta Blockers

Back 25

Selectively block B1 adrenergic receptors
Effects: Reduces CO without producing effects in the lungs or liver

Front 26

Clinical Uses for muscarinic agonists

Back 26

Tx of non-obstructive GI hypomotility, Tx of xerostomia, prevent urinary retention

Front 27

Clinical Uses for Muscarinic Antagonists

Back 27

Treatment of occasional diarrhea, reduce salivation during dental work, chronic obstructive pulmonary disease, overactive bladder, motion sickness

Front 28

Toxic Effects of Anti-muscarinic drugs

Back 28

Dry as a bone - xerostomia
Blind as a bat - mydriasis (visual difficulty)
Red as a beat - hyperthermia (flushing)
Mad as a hatter - agitation, hallucination
POTENTIALLY LETAL HYPERTHERMIA IN KIDS

Front 29

Anticholinesterases
(Acetylcholinesterases Inhibitors)

Back 29

Prevent acetylcholine metabolism
1) Reversible: forms a hydrolyzable chemical bond-->effects are short-lasting and mild
2) Irreversible: effects are long-lasting and severe