Pharm- Sympatheic Nervous System

adrenergic

another word for sympathetic nervous system

sympathetic NTs

epinephrine (adrenal medulla) hepatic deactivation
Norepinephrine (postganglionic of sympathetic) reuptake deactivation
ACh (sympathetic sweat glands) NO MAJOR ROLE

receptor sites

Alpha (1&2)
Beta (1&2)

Alpha 1 receptors

located- eye, blood vessels, male sex organs and prostate, bladder
Activation- midrasis, vasoconstriction in BV, ejaculation and prostate contraction, and bladder contraction

Alpha 2 receptors

located- nerve terminals
control release of NE
no major role in PNS

Beta 1 receptor

located- Heart
Activation- increased heart rete and force of contraction, increased AV conduction and renin release (leads to high BP)

beta 2 receptors

located- skeletal muscles and smooth muscles on bronchioles
activation- dilates arterioles and bronchi, relaxes uterus, promotes glycogenolysis, and enhances contraction of skeletal muscles

sympathomimetics

mimic the sympathetic

How NT acts on receptor sites

1. direct binding or activation
2. indirect- promoting, inhibiting NT release, reuptake or storage
3. mixed

adrenergic agonists

1. catecholamines
2. noncatecholamines

catecholamines

adrenergic agonist
cannot be given orally, brief duration, cannot cross BBB

noncatecholamines

adrenergic agonist
given orally, longer half life, and crosses BBB

Adrenergic Drugs

dose dependent
the higher the dose, the less selective the drug becomes

Alpha 1 Activation

Adrenergic Drug effect;
? Increase force of heart contraction,
? blood pressure and cause Mydriasis (dilation of the pupil)
Adrenergic Blocking effect;
Vasodilation and Miosis (constriction of the pupil)
Example:
Epinephrine and Norepinephrine (agonists)

Alpha 1 therapeutic effects

vasoconstriction
Midriasis

Alpha 1 side effects

hypertension
tissue necrosis
bradycardia (to try to lower BP)

Alpha 2 Activation

Adrenergic Drug effect;
Inhabits release of norepinephrine and dilates blood vessels, producing hypotension (Low blood pressure)
Adrenergic Blocking effect;
NO effect on the PNS

Beta 1 Activation

Adrenergic Drug effect;
? Increases heart rate and forces of heart contraction
Adrenergic Blocking effect;
Epi and NE
? Decrease Heart rate

Beta 1 therapeutic effects

initiate contraction of heart after it stops
increase heart rate
improve force of contraction
enhance AV node

Beta 2 activation

Adrenergic Drug effect;
Dilates bronchioles and relaxes gastrointestinal tract
Adrenergic Blocking effect;
Epi & NE
Constricts Bronchioles

beta 2 therapeutic effects

lungs and uterus
bronchodilator
delay of preterm labor

beta 2 side effects

hyperglycemia (bc stimulates glycogenolysis)
tremor (enhances skeletal muscle contraction)

adrenergic antagonist (blockers)

occupy receptor sites to block binding of NT for activation

Alpha blockers (antagonists)

vasodilation
reduces contraction of bladder and prostate

Alpha blocker therapeutic effects

treat hypertension
reverse toxicity caused by alpha 1 agonists
treat pheochromocytoma (tumor of adrenal gland --> outpouring of epi)
treat Raynaud's disease (bc vasodilation)
relieves BPH (bc less contraction of prostate)

Alpha blockers side effects

Orthostatic hypotension
tachycardia
nasal congestion
inhibition of ejaculation
promotion of Na and H2O retention

Beta Antagonists (blockers)

three subgroups:
1. (1st generation) nonselective 2. (2nd generation)cadioselective 3. (3rd generation) dilate blood vessels but can be selective or nonselective

beta blockers therapeutic effects

reduce heart rate,
reduce force of contraction,
reduce AV node,
treat angina,
treat hypertension,
treat arrhythmias,
treat myocardial infarctions,
treat hyperthyroidism,
stage fright,
glaucoma

Adverse effects of Beta 1 blockers

bradycardia
reduced cardiac output
AV node blockade
rebound cardiac excitation

Adverse effects of beta 2 block

bronchoconstriction (bad for asthmatics)
inhibition of glycogenesis (bad for diabetic)
nonspecific beta blockers may bind to beta 1 receptor sites
high doses of beta 1 blockers can block beta 2 receptors

Epinephrine

Adrenergic agonists - Sympathomimetic
Nonselective activator of all receptors (Alpha1, Beta1 and Beta2)
? Heart rate
? Cardiac output
Constriction of blood vessel to skin
Dilation of bronchioles
Dilation of blood vessels to muscles
Emergency Drug; cardiac

Isoproterenol

Adrenergic Agonists - Sympathomimetic
Selective for beta receptors (Beta1, Beta2)
Treats Bronchodiliation

Dopamine

Adrenergic Agonists - Sympathomimetic
Selective for dopamine receptors
will activate (Alpha 1 and Beta 1 at higher doses)
Treats Shock, Congestive Heart Failure

Dobutamine

Adrenergic Agonists
Selective adrenergic drug for Beta 1
Treat Heart Failure

albuterol

selective for beta 2

salmeterol

selective for beta 2

tamsulosin hydrochloride

adrenergic antagonist
alpha 1

doxazosin

adrenergic antagonist
alpha 1

Propranolol

Adrenergic Blocking Agents - Sympatholytic
Blocks Beta1, Beta2 receptors
Treats: Cardiac, Arrhythmias, Cardiac Disease, Antispasmodic

metroprolol

beta 1 cardioselective

Phenylpropanolamine (Prion)

Nonselective Adrenergic drug that affects Alpha1, Beta1 receptors
Treat Incontinence in dogs

Yohimbine (Yobine)

Adrenergic Blocking Agents - Sympatholytic
Blocks Alpha1
Used to treat OD of Xylazine admin toxic effects of antiparasitic drug Amitraz
SE: CNS stimulation, muscle tremors, salivation.
It is a stimulant with aphrodisiac and mild MAOI effects that primaril