AUTONOMIC NERVOUS SYSTEM

Autonomic Nervous System (ANS)

The system that regulates the heart, secretory glands, and smooth muscle.

Sympathetic Nervous System (SNS)

The "Fight or Flight" division of the ANS.

Parasympathetic Nervous System (PSNS)

The "Rest and Digest" division of the ANS.

Agonist

A drug that stimulates a receptor; a stimulator.

Antagonist

A drug that blocks a receptor; a blocker.

Adrenergic

Pertaining to the Sympathetic Nervous System (SNS).

Sympathomimetic

Another term for an Adrenergic Agonist drug.

Sympatholytic

Another term for an Adrenergic Antagonist drug.

Alpha-1 Receptor

An adrenergic receptor that causes vasoconstriction.

Alpha-2 Receptor

An adrenergic receptor that inhibits sympathetic stimulation (e.g., clonidine).

Beta-1 Receptor

An adrenergic receptor that increases heart rate and contractility.

Beta-2 Receptor

An adrenergic receptor that causes bronchodilation and vasodilation (e.g., albuterol).

Epinephrine

A non-selective adrenergic agonist (stimulates alpha and beta receptors).

Epinephrine Indications

Anaphylaxis, cardiac arrest, severe asthma, hypotension, symptomatic bradycardia.

Epinephrine Adverse Effects

Angina, tachycardia, dysrhythmias.

Norepinephrine (Levophed)

An alpha-adrenergic agonist.

Phenylephrine (Neo-synephrine)

An alpha-adrenergic agonist.

Phentolamine (Regitine)

An alpha-1 adrenergic antagonist used to treat IV extravasation of vasoconstricting drugs.

Tamsulosin (Flomax)

An alpha-1 adrenergic antagonist used to treat BPH (enlarged prostate).

Extravasation

The leakage of IV fluid into the surrounding tissue.

Metoprolol (Lopressor, Toprol XL)

A cardioselective beta-1 adrenergic antagonist (beta-blocker).

Metoprolol Indications

Heart rate control, hypertension, post-MI, angina.

Metoprolol Adverse Effects

Bradycardia, hypotension, dizziness, bronchospasms.

Propranolol (Inderal)

A non-selective beta-adrenergic blocker (affects Beta-1 and Beta-2).

Cholinergic

Pertaining to the Parasympathetic Nervous System (PSNS).

Parasympathomimetic

Another term for a Cholinergic Agonist drug.

Parasympatholytic

Another term for a Cholinergic Antagonist or Anticholinergic drug.

Acetylcholine

The primary neurotransmitter of the Parasympathetic Nervous System (PSNS).

Muscarinic Receptors

Cholinergic receptors found on smooth muscle (airway, iris, bladder), heart, and glands.

Nicotinic Receptors

Cholinergic receptors found at neuromuscular junctions for muscle contraction.

SLUDGES Mnemonic

Salivation, Lacrimation, Urination, Diarrhea/Defecation, GI distress, Emesis, Slows heart rate.

Bethanechol (Urecholine)

A direct-acting cholinergic agonist.

Bethanechol Indication

Treatment of post-operative urinary retention.

Bethanechol Adverse Effects

SLUDGES, dizziness, hypotension.

Pyridostigmine (Mestinon)

An indirect-acting cholinergic agonist (acetylcholinesterase inhibitor).

Pyridostigmine Indication

Treatment of myasthenia gravis.

Pyridostigmine Adverse Effects

SLUDGES, pupillary constriction, bronchoconstriction.

Atropine

A cholinergic antagonist (anticholinergic/parasympatholytic).

Atropine Indications

Symptomatic sinus bradycardia, organophosphate overdose, cholinergic antidote.

Atropine Adverse Effects

Effects opposite of SLUDGES (e.g., dry mouth, urinary retention).

Anticholinergic Effects

Dry mouth, blurred vision, constipation, urinary retention, increased heart rate.