CHAPTER 29: Introduction to the
spinal cord, and postganglionic axons that
Autonomic Nervous System
**
Cholinergic receptors – receptor sites on
effectors that respond to acetylcholine
Muscarinic receptors – cholinergic
receptors that also respond to
stimulation by muscarine
Nicotinic receptors – cholinergic
receptors that also respond to
stimulation by nicotine
Monoamine oxidase (MAOI) – enzyme that
breaks down norepinephrine to make it
inactive
**
AUTONOMIC NERVOUS SYSTEM
Autonomic Nervous System – (involuntary or
visceral nervous system); portion of the
central and peripheral nervous system that,
with the endocrine system, functions to
maintain internal homeostasis
- main nerve centers:
1. hypothalamus
2. the medulla
3. spinal chord
A. Nerve Impulse Transmission:
CNS – nerve impulses  outlying organs
Ganglia
– groups of closely packed nerve cell
bodies located outside of CNS
– receive and relay information from
and along the preganglionic neuron
in the CNS
Postganglionic neurons – transmit
impulses to the neuroeffector cells—
muscles, glands, and organs
B. Functions
- regulates blood pressure, heart
rate, respiration, body temperature, water
balance, urinary excretion, and digestive
functions, and etc.
C. Divisions
- two branches:
 SYMPATHETIC NERVOUS SYSTEM:
– “fight-or-flight”
– the system responsible for
preparing the body to respond to stress
– thoracolumbar system
– composed of CNS cells from the
thoracic or lumbar areas, short
preganglionic axons, ganglia near the
react with adrenergic receptors
Adrenergic receptors – receptor sites on
effectors that respond to
norepinephrine/epinephrine.
Alpha receptors – adrenergic
receptors that are found in smooth
muscles
Beta receptors – adrenergic
receptors that are found in the heart,
lungs, and vascular smooth muscle
Acetylcholine—causes movement; is the
neurotransmitter released by these
preganglionic nerves.
Acetylcholinesterase – enzyme responsible
for the immediate breakdown of
acetylcholine from the nerve ending;
prevents overstimulation of cholinergic
receptor sites.
 PARASYMPATHETIC NERVOUS SYSTEM:
– “rest-and-digest”
– response mediator that contains
CNS cells from the cranium or sacral area of
the spinal cord, long preganglionic axons,
ganglia near or within the effector tissue, &
short postganglionic axons that react with
cholinergic receptors
CHAPTER 30: ADRENERGIC
AGONISTS
ADRENERGIC AGONISTS
A drug that stimulates the adrenergic
receptors of the SNS
stimulation can either be:
a.) Direct—occupation of
adrenergic receptor
b.) Indirect—modulation of the
release of neurotransmitters from
the axon
can also affect both the alpha- and beta-
receptors, or they can act at specific
receptor sites
Alpha-agonist—specifically stimulating
alpha-receptors within SNS, causing body
responses when alpha-receptors are
stimulated
Beta-agonist—specifically stimulating beta-
receptors within SNS, causing body
responses when beta-receptors are
stimulated
Sympathomimetic—drugs that mimics the
SNS with the signs and symptoms when
stimulated
AUDREY BRINA PACANA BSN2F
 EFFECTOR Sympathetic Stimulation —increased effects of tricyclic
Eye Dilation of pupil; changes antidepressants (TCAs) and monoamine
lens shape for far vision oxidase inhibitors (MAOIs)
Heart Increases rate and —drugs that cause hypertension (herbal
strength of contraction therapies and OTC preparation)
Arterioles Constriction increases
blood pleasure
DRUG TREATMENT
Blood Increases supply to
Dobutamine Heartfailure
distribution skeletal muscles;
decreases supply to Dopamine Shock
digestive organs Ephedrine Hypotensive episodes
Lungs Dilates bronchioles Epinephrine Shock when increase BP;
heart contractility;
Digestive tract Inhibits motility and
secretion by glands prolong regional
anesthetic;
Liver Decreases bile
bronchospasm
production; increases
blood glucose Norepinephrine Shock; used during
cardiac arrest
Gallbladder Relaxation
Kidneys Decreases urine
production Alpha-Specific Adrenergic Agonists
Pancreas Decreases secretion of Prototype: PHENYLEPHRINE
insulin and digestive -bind primarily to alpha-receptors
enzymes INDICATION: these drugs are used to treat
Spleen Constriction injects stored shock and allergy products, tachycardia,
blood into circulation glaucoma, prolong local anesthesia,
Urinary bladder Contraction of external maintain BP during spinal anesthesia
urethral sphincter; PHARMACOKINETICS:
relaxation of bladder wall —all routes of administration
Reproductive Vasoconstriction; —reach peak levels: 20 mins-45mins
organs ejaculation in males; —metabolized in the liver; excreted in urine
reverse uterine CONTRAINDICATIONS:
contractions in females; —presence of allergy, hypertension or
stimulates tachycardia, narrow-angle glaucoma
CAUTIONS:
—presence of CV disease or vasomotor
Alpha- and Beta- Adrenergic Agonists
spasm, thyrotoxicosis or diabetes, or renal or
Prototype: DOPAMINE
hepatic impairment
INDICATION: these drugs generally
ADVERSE EFFECTS:
indicated for treatment of hypotensive
—blurred vision, sensitivity to light,
states or shock, bronchospasm, and some
arrhythmias, ECG changes, BP changes,
types of asthma
peripheral vascular problems
PHARMACOKINETICS:
DRUG-DRUG INTERACTIONS:
—absorbed rapidly after injection or
—MAOIs,TCAs
through mucous membranes
—metabolized in the liver
—given though IV to achieve rapid onset of DRUG TREATMENT
action Clonidine Essential hypertenstion;
CONTRAINDICATIONS: chronic pain, to ease
—hypersensivity to any component of the opiate withdrawal
drug Midodrine Orthostatic hypotension
—pheochromocytoma Phenylephrine Cold and allergies; shock
—tachyarrhythmias or ventricular fibrillation and shock-like states;
—hypovolemia glaucoma; allergic rhinitis,
—general anesthetics otitis media
CAUTIONS:
—any kind of peripheral vascular disease Parasympathetic Stimulation
ADVERSE EFFECTS:
SNS: arrhythmias, hypertension, palpitations, EFFECTOR Parasympathetic
angina, dyspnea Stimulation
Others: nausea, vomiting, constipation, Eye Constriction of pupil;
headache, sweating, tension or anxiety, changes lens shape of
piloerection, muscle cramps, hypokalemia near vision
DRUG-DRUG INTERACTIONS: Heart Decreases rate of

AUDREY BRINA PACANA BSN2F

 contraction
Arterioles No innervations
Blood Decreases supply to
distributions skeletal muscles;
increases supply to
digestive organs
Lungs Constricts bronchioles
Digestive tract Promotes motility and
secretion by glands
Liver Increase bile production;
decreases blood glucose
Gallbladder Contraction
Kidneys No known action
Pancreas Increases secretion of
insulin and digestive
enzymes
Spleen No known action
Urinary bladder Relaxation of external
urethral sphincter;
contraction of bladder
wall
Reproductive Vasodilation; erection in
organs males; vaginal secretion
in females

AUDREY BRINA PACANA BSN2F