Body’s Primary Nervous System Drugs affecting SNS

CNS-brain and spinal cord 1. Adrenergic Agents/ Sympathomimetics

Peripheral Nervous System (PNS)- located outside the 2. Adrenergic Antagonist/ Sympatholytics blockers
CNS
RECEPTORS:
Autonomic Nervous System/Visceral System- control
A1- increases force of the heart contraction,
and regulate the heart
decreases BP
-regulates respiratory and GI tract
A2- Inhibits release of NE, dilate BV, hypotension
-controls bladder, eyes and glands
B1- increases heart rate, increases renin secretion
Somatic Nervous System- voluntary nervous system that and increases BP
innervates or supply the skeletal muscle
B2- dilates bronchioles
2 Sets of Neuron in Autonomic
Classification of Sympathomimetic/Adrenergic according
1. Afferent- ”sensory neurons” to their effect in organ cell

-send impulses to CNS interpretation  Direct Acting Adrenergic- stimulates adrenergic

receptor by binding and interacting in neurons after
2. Efferent- “motor neurons”
their activation
-receive impulses from the brain transmit to the spinal
- pharmacological actions done by second
cord to the effector organ
messenger
S P
Drugs: Epinephrine
Eyes Dilate pupil Contracts
Debutamine
Heart Increases heart Decreases
Dopamine
rate
 Indirect Acting Adrenergic- stimulate the release of
Lungs Dilates Constrict
NE from the terminal nerve ending
bronchioles bronchiols thus
increases Drugs: Amphetamine
secretion
Tyramine
Bladder Relaxes bladder Constrict
muscle  Mixed Acting- stimulate adrenergic receptor sites
and stimulates the release of nor epinephrine from
GI Tract Relaxes smooth Increases the terminal nerve ending
muscle peristalsis
Drugs: Pseudoephedrine
Salivary Gland Increases
salvation  Central Acting Alpha Agonist- lowers the BP by
stimulating alpha receptor In the brain which open
the peripheral arteries thus increases blood flow
Sympathetic- adrenergic Drugs: Clonidine- selective alpha-adrenergic
-fight or flight class of
Parasympathetic- cholinergic sympathomimetics that
targets the
- rest and digest catecolamines

SE: Bradycardia
 Methyldorpa- teken up into brainstem neurons and
is converted to alpha-methylnolepinephrine other SE
of Central Acting Alpha-agonist
SE: Headache, Nasal Congestion, Drowsiness,
Nightmares, Constipation, Edema
 Adrenergic Neuron Antagonist- drugs that blocks
the release of nor epinephrine from sympathetic
terminal neurons
Drugs: Reserpine- deplete the catecolamines fro
the peripheral sympathetic nerve ending thus decreases
BP
 Cholinergic Antagonist- muscurmic agonist or
parasympathomimetics, that mimcs the
parasympathetics neurotransmitter
 Acetylcholine- cause muslce to relax, pain response,
rapid eye movement (rem) in sleep, regulates
endocrine
Two types of Cholinergic Receptor
1. Muscarinic Receptor- stimulates smooth muscle
2. Nicotonic Receptor- stimulates skeletal muscle
Two Types of Cholinergic Agonist
1. Direct Acting Cholinergic Agonist- acts on receptor to
activate tissue response
 Methacoline/Metoclopromide HCL- a direct
acting cholinergic agonist that is usually
prescribed to treat Gastroparesis, nausea and
Gastroesophageal reflux disease (GERD)
 Betanechol HCL- direct acting cholinergic
agonist acts as an muscarinic receptor that is
used primarily to increase urination in
treatment of urinary retention and neurogenic
bladder
Onset: 30-40 mins after taking the oral
dose
Duration: 2 hours
Nursing Resp: Should be taken on an
empty stomach
1-2hrs before meals to minimize
SE: Hypotension, Blurred vision, Excessive
Salivation, Tachycardia
Caution: Patient with low blood pressure and low heart
rate
 Pilocarpine- direct acting cholinergic agonist that
constricts the pupil thus opening the schlemm canal
to promote aqueous drainage
Use: Treat Glaucoma relieving intraoccular fluid
pressure in the eyes and to promote miosis in eye
surgery and examination
Oral Form: Use to relieve xerostomia (mouth
dryness)
2. Indirect Acting Cholinergic Agonist- “Anti-
cholinesterase”
- Do not act on receptor instead they inhibit or inactivate
the enzymes cholinesterase, permitting the acetylcholine
in short period
Cholinesterase Function- to breakdown acetylcholine
into choline and acetyl acid
Cholinesterase Inhibitor- binds with cholinesterase
allowing acetylcholine to activate muscarinic and
nicotonic cholinergic receptor
Will cause: the increase of muscular contraction
Increase muscle tone
Two Types of Indirect Acting Cholinergic Agonist
1. Reversible- treatment for myasthenia gravis, a chronic
auto immune neuromuscular disease that causes
weakness in the skeletal muscle
Drugs: Mestinon and Pyridostigmine
Slows the breakdown of acerylcholine at the neuro
muscular junction and improving muscle tone
For treatment of Alzheimers diseas, a progressive
disorder that cause brain cell to waste away and
eventually degenerate and die
Anticholinesterase can slightly delay the loss of brain
functions or delay the progression of disease
Drugs use to increase muscular strength in Myesthemia
 Neostigtaine- short acting
 Pyridostigmine Bromide- moderate acting
 Ambenonium Chloride- long acting Forms: Oral, IV, transdermal

 Endrophonium Chloride- short acting for diagnostic SE: dry mouth

purposes
Visual disturbances
Physostigmine- a drug use as antidote for Atropine or
Constipation
reverse Atropine Toxicity
Tachycardia
SE: Hypotension, Bradycardia, Sweating,
Hypersalivation, GI Distress

Caution: Patient who have bradycardia, asthma, heptic

ulcer

2. Irreversible- potent because of their long lasting effect

- produce pupillary constriction

Cholinergic Antagonist:

-Inhibits the action of acetylcholine by occupying the

Acetylcholine receptor

-It blocks parasympathetic nerves thus dominating the

sympathetic

Natural Alkaloids: Atropine Sulfate

- first derived from the Bella Donna plant and purified in

1831

Uses: Primarily use as a preoperative medication to

decrease salivary secretion

Treat sinus bradycardia increases heart rate

Treat Mydriasis and Cycloflegia before eye

exam

SE: dry mouth, decrease perspiration, tachycardia,

atropine fever

Anti-Parkinson- anti cholinergic drugs that affects the

CNS as well as the parasympathetic nervouse system by
suppressing the tremors and muscular rigidity of
Parkinsonism

is a progressive nervous system disease that affects

the movement

Drugs: Biperiden,Benztropine

Drugs use alone to the early stage of Parkinsons

Anticholinergic drugs for treating motion sickness

Scopalamine- a natural alkaloid, classified as

antihistamine for motion sickness