• Central - Brain, Spine
• Peripheral - somatic, autonomic

• parasympathetic (CranioSacral CNS outflow)
• Sympathetic (ThoracoLumbar CNS outflow)

• Ganglionic (Nn) - at the post-ganglion cell body
• Effector Site of the PS (muscarinic)
• Effector Site of the skeletal muscle endplates (Nm)

Peripheral Adrenergic Receptor Locations

• Effector Tissue - Alpha 1, Beta 1,2,3
• Prejunctional (autoregulatory) - Alpha 2

innervation by both divisions of the ANS; antogonistic in nature

Ex. One slows and the other speeds up.

• parasympathetic cholinergic innervation-muscarinic - causes the pupil to constrict when innervated
• causes myosis

• ciliary
• radial
• sphincter

• sympathetic adrenergic innervation of the alpha-1 receptor
• causes pupil dilation - mydriaisis

• parasympathetic cholinergic innervation - muscarinic
• causes pupil constriction - myosis

• causes parasympathetic stimulation thereby causing the pupils to constrict
• myosis

• sympathetic stimulation of the alpha 1 receptor resulting in dilation of the pupil
• mydriaisis

• causes mydriasis

• causes pupil to decrease
• myosis

• PS - muscarinic, causes decrease in HR
• sympathetic - beta-1, causes increase in HR

• PS - muscarinic, causes increase in GI motility
• S - alpha-1, causes decrease in GI motility

• PS - muscarinic - MAJOR innervation
• muscarinic agonist - promotes salivation
• muscarinic antagonist - produces dry mouth (xerostomia)

• alpha - 1
• muscarinic

• Detrusor
• Sphincter
• Trigone

detrusor - contract

sphincter - relax

trigone - relax

• alpha-1
• beta-2
• muscarinic
• histamine

• beta 2
• muscarinic
• histamine

B-2 agonist - relaxation

muscarinic agonist - constriction, increased secretions

• alpha 1
• muscarinic
• beta - 2
• histamine

• alpha 1
• beta 2

• glycogenolyis
• glycolysis

• synthesized in nerve
• released in response to nerve action potential
• diffuse across synapse to interact with receptor

• chemical substance released
• travels through blood stream
• then interacts with receptor tissue to produce effects

• pre-ganglionic fibers
• post-ganglionic fiber of the PS
• motor neuron
• CNS

• nicotinic
• muscarinic

• Alpha - 1
• Beta - 1

• Alpha 1
• Beta 1
• Beta 2
• Beta 3

• phenylalanine
• tyrosine
• DOPA
• Dopamine
• Norepinephrine
• Epinephrine (only in the adrenal medulla)

• Monoamine Oxidase (MAO)
• Catecholamine-O-methyl transferase (COMT)

• located in the adrenergic nerve
• important for degrading catecholamines which are in the adrenergic nerve or taken back up into the adrenergic nerve

• degrades catecholamines that are released into the neuro-effector junction

• cause an increase in catecholamines in the adrenergic nerve

• inhibit the breakdown of dopamine in the CNS
• important for Parkinson's treatment

Re-uptake - taking NE back into the nerve; produce the biggest effect to the dose response curve

inhibitors of NE re-uptake enhance the effect of NE

• vasoconstriction
• hypertension
• reflexbradycardia

• vasodilation
• hypotension
• reflex tachycardia

• tachycardia

• tachycardia
• +inotropic
• +chronotropic

alpha 1

muscarinic

• Axons
• synthesis of neurotransmitters
• release
• neuronal neurotransmitter storage
• catecholamine reuptake
• agonist
• antagonist
• inhibition of degradation

• local anesthetic
• interferes with the movement of ions along the neuronal membrane which interferes with the movement of impoulses.
• not used often, often in conjunction with vasoconstrictor

• inhibits the synthesis of ACh
• inhibits the uptake of choline into the cholinergic nerve

• inhibits tyrosine hydroxylase in order to inhibit the synthesis of epinephrine
• used in patients with pheochromacytoma

• inhibits the release of ACh
• locally used for botox
• reduces the contractile response of muscles

• promotes the release of Ach from cholinergic nerves
• the ACh must be replenished in order for the carbochol to work
• Indirect acting parasympathomimetic

• promotes the release of NE from adrenergic nerves
• dependent on the adrenergic nerve to be intact
• a drug that destroys the adrenergic nerve would make it hard for Tyramine to work
• Indirect Acting Sympathomimetic

• adrenergic neuron blocker
• works in the CNS and PNS
• taken into the adrenergic nerve and causes impairment of the neuronal storage of NE and dopamine
• results in more deamination of NE by MAO and less available for release in response to nerve action potential

• adrenergic neuron blocker
• charged - so no CNS effects
• inhibits the release of NE and causes impairment of the storage of NE

• inhibts catecholamine re-uptake
• synergizes the effect of NE (greater effect from NE)
• sympathomimetic like effect

• inhibit the re-uptake of NE and seratonin in the CNS

• destroys adrenergic nerve
• makes it hard for a drug like Tyramine to work

• Phenylephrine - synthetic sympathomimetic; mimics the effect of NE on alpha receptors
• NE
• EPI - most potent alpha agonist

Alpha 2 agonist

 inhibits the release of NE via autoregulatory agonism. Not an adrenergic neuron blocker

• NE - causes tachycardia and + inotropism
• EPI - increase HR and BP;
• ISO - non-selective B agonist,
• Dobutamine - prototype B1 agonist - tachycardia and +inotropism

• EPI
• ISO
• ex. albuterol - causes bronchodilation

• nicotine

• ganglionic blocker
•  nicotinic sub n antagonist;
• used for emergency BP lowering;
•  non-selective

• nicotinic sub m antagonist
• causes skeletal muscle paralysis

• muscarinic antagonist

• alpha 1 antagonist
• mixed antagonist

• alpha 2 receptor antagonist
• no therapeutic value yet

• beta-1 antagonist (beta blocker)
• used for glaucome, protection against MI and HTN

• non-selective B-blocker (Beta 1-3)
• has membrane stabilizing effect which is beneficial for protection against MI or arrhythmia.
• membrane stabilizing effect not beneficial for glaucoma treatment - stabilizing the eye membrane would make the eye less sensitive to particles - producing damage without you knowing they were there

• Acetylcholinesterase Inhibitor
• increases ACh at muscarinic and nicotinic receptors
• effects limited to PNS

• Monoamine oxidase Inhibitor
• inhibit the degredation of NE
• not really used anymore