autonomic nervous system drugs

what systems can ANS drugs target

the sympathetic (adrenergic) and the parasympathetic (cholinergic) nervous system

adrenergic drugs categories

sympathetic agonists (sympathomimetic) - activate sympathetic nervous system, causing fight or flight responses

sympathetic antagonists - (sympatholytic) block sympathetic nervous system.

categories of sympathetic agonists

indirect - indirectly act on a receptor by stimulating the release of somthing else to act on it

direct - directly act on a receptor

types of sympathetic agonists (all types)

beta 1 and beta 2 agonists

alpha 1 and alpha 2 agonists

side effects of sympathetic (adrenergic) agonists - generally

increased heart rate, sweating, high bp, increased temp, twitches

sympathetic antagonist

what it is and subtypes

blocks sympathetic action.

the two types are

selective - act on only specific receptors in specific areas

nonselective- act on all receptors

what do adrenergic (sympathetic) antagonists do

block adrenal (sympathetic) action. They stop the sympathetic fight or flight response, effectively slowing down the body metabolism and actions.

• cause lower heart rate

• lower bp

• they are mostly used to lower heart rate and BP

side effects of adrenergic antagonists

cold, low bp, orthostatic hypotension, drowsiness and depression

what are sympathetic/adrenergic receptors

beta 1 - heart

beta 2 - blood vessels and lungs

alpha 1 - smooth muscle contractions

alpha 2 - has sympathetic and parasympathetic actions

parasympathetic nervous system subtypes

cholinergic agonists

cholinergic antagonists

cholinergic nervous system receptors

nicotinic - respond to nicotine. controls the more ‘quick’ actions of the rest and digest systems including muscle contractions, and signal transmissions

muscarinic - respond to muscarine controls more slow functions, like secretions and stimulating digestion

what does activation of cholinergic nervous system do

what does suppression of the cholinergic nervous system do

activation - increases the rest and digest side of things - increase secretions, digestion, fluids, pupil dilation, sleepiness, and also helps with voluntary muscle contractions. its similar - but not the same - to anti-adrenergic drugs

Suppression: causes an increase in HR, BP, and a decrease in digestion, secretions, etc.

side effects of cholinergic antagonists

• tachycardia,

• high bp

• hyperthermia

• constepation

• think - anticholinergic/adrenergic = DRY

side effects cholinergic agonists

increased secretions. sleepiness, diarrhea, vomiting, cramps and pain.

cholinergic crisis:

too much cholinergics - either drugs or hormone. Body starts to shut down. loss of motor function, sweating, dyskinesa, slow movement, muscle twitches

common adrenergic agonists

epinephrine

clonidine

methyldopa

norepinephrine

dopamine hydrochloride

albuterol

epinephrine use, side effects and contraindications

anaphylaxis

• increased heart rate,

• increased bp

• pupillary constriction

• increased blood glucose

contraindications:

• diabetes

• hypertension

• parkinsons

• glaucoma

• hypovolemia (this is not logical but its because epi first causes a bp drop before it increases the bp and this can be fatal)

common adrenergic antagonists

atenolol

propranolol

lobetalol

terazosin hydrochlorite

prazosin hydrochlorite

adrenergic antagonists that target alpha receptors end in

zosin

adrenergic antagonists that target beta receptors end in

olol

atenolol side effects, contraindications and use

contraindications: bradycardia, heart block, cardiogenic shock, acute bronchospasm, diabetes mellitus (as it will lower blood sugar and that plus insulin is bad) pulmonary edema (will dilate the blood vessels in the lungs and is bad if there is already pulmonary edema

Side effects: bradycardia, low bp, bronchospasm, decrease in blood sugar.

common cholinergic agonists

bethanechol chloride

edrophonium

carbechol

common cholinergic antagonists (all receptors)

atropine

hexmeethonium

what anticholinergic is for muscarinic receptors

what anticholinergic is for nicotinic receptors

• atropine, also benztropine

• hexmethonium

bethanechol chloride uses, side effects and contraindications

cholinergic stimulation, decrease blood pressure and heart rate. but this one specifically is for urination increase

• bradycardia,

• increased urination and salivation

• hypotension

• miosis - pupil constriction

Contraindications:

• ibs

• bradycardia

• hypotension

• asthma

• intestinal blockage (will try to make the GI system work and its blocked so it wont and this will cause more blockage build up)

• seizures

• peptic ulcer

atropine use and side effects and contradictions

anti-cholinergic (blocks cholinergic receptors)

• increased heart rate

• increased BP

• slowed digestion and secretions

• less saliva

Contradictions:

Gi obstruction

tachycardia

high bp

ulcerative colitis

urinary retention

myasthenia gravis (it will further block the ach receptors beyond what already was)