Autonomic Nervous System

Autonomic Nervous System

1. Adrenergic Pharmacology

   • A Receptors
     • A1- Adrenerrgic antagonists
       • MOA: Bind to A1 receptors, blocking SNS response
         • eg. prazosin
           • use: hypertension, peripheral vascular disease
             • AE: hypotension, frequent urination
     • A1- Adrenergic agonists
       • MOA: Bind to A1 receptors, stimulating SNS response
         • eg. phenylephrine
           • use: hypotension, nasal congestion, red eyes
             • Adverse effects: hypertension, blurred vision
     • A2- Agonists
       • MOA: bind to A2 receptors, stopping release of catecholamines
         • eg. clonidine
           • use: hypertension
             • AE: dizziness, drowsiness, dry mouth/nose
   • B Receptors
     • B1- Adrenergic agonists
       • MOA: binds to B1 receptors, stimulating SNS response
         • eg. dobutamine
           • use: cardiac arrest, circulatory shock
             • AE: hypertension, tachycardia
     • B2-Adrenergic agonists
       • MOA: binds to B2 receptors, stimulating SNS response
         • eg. salbutamol, salmeterol
           • use: COPD, asthma
             • AE: tremor, tachycardia, ^ Blood glucose
     • B-Antagonists/ Beta blockers
       • MOA: bind to B receptors, blocking SNS response
         • eg. carvedilol
           • use: cardiac disease, hypertension
             • AE: dizziness lethargy, insomnia
   • Non selective Adrenergic agonists:
     • Bind to A and B receptors, stimulating SNS response
       • eg. adrenaline, noadrenaline, dopamine
         • Use: cardiac arrest, hypotension, shock

2. Cholinergic Pharmacology

   • Muscarinic Receptors
     • Agonists
       • eg. acetylcholine
         • MOA: binds to muscarinic receptors, stimulating PNS response
           • use: miotics
             • AE: problems with eye accomadation
     • Antagonists
       • eg. atropine
         • MOA: bind to muscarinic receptors, Blocking PNS response
           • use: pre-med, dilation of pupils
             • AE: dry mouth, blurred vision
   • Nicotinic Receptors
     • Antagonists
       • eg. vecuronium
         • MOA: binds to nicotine receptors, blocking ACh binding
           • use: pre-med
             • AE: decreased BP
     • Agonists
       • eg. suxamethonium
         • MOA: mimicts ACh & binds to nicotinic receptors
           • use: short acting muscle relaxant
             • AE: muscle spasm, hyperkalemia