• Recognize changes in the internal and external environments
• Process and integrate the environmental changes that are perceived
• React to the environmental changes by producing an action or response

• Includes: Brain & spinal cord

• Transmits signals b/t CNS and rest of body
• All nervous tissue outside of CNS
• Sensory & motor neurons
• Somatic NS: voluntary control over skeletal muscle
• Autonomic NS (ANS): Involuntary contorl of smooth & cardiac muscle, digestion, glandular secretions

• Sympathetic: activated under stress, "fight or flight" "bear in the woods"
• Parasympathetic: Activated under nonstressful conditions, "rest and digest"
• ANS= sympathetic +parasympathetic

• Pupils: Dilate
• Tear glands: No effect
• Salivary stimulation: Inhibited
• Heart rate: Increases
• Arterioles: Constrict
• Bronchi: Dilation
• GI motility: Inhibited 
• Pancreas: Inhibited
• Bladder: Relaxes
• Erection/Ejaculation: Stimulates ejaculation

• Pupils: constrict
• Tear glands: stimulated
• Salivary stimulation: stimulated
• Heart Rate: Decreases
• Arterioles: Dilate
• Bronchi: Constrict
• GI motility: stimulated
• Pancreas: Stimulated
• Erection/Ejaculation: Stimulates erection

• Two neuron chain: Presynaptic nerve in CNS (preganglionic)-->synapes postsynaptic nerve of PNS (postganglionic)-->connets to organ or tissue
• Connection happens outside CNS at ganglion (ganglionic synapse)

• Sympathetic NS: Catecholamines- Norepinephrine (NE), Epinephrine (Epi) & Dopamine (DA)
• Parasympathetic NS: Acetylcholine (Ach)

There are drugs to:

Increase NT release

Decreses NT degredation

Act as receptor agonist or antagonist 

• Release catecholamines
• Postganglionic in the sympathetic NS

• Release Acetylcholine
• All preganglionic nerves (remember these are CNS)
• Postgangilonic nerves of the parasympathetic NS

• Sympathetic:
• nerves originate in the thoracic & lumbar spine
• alpha1, alpha2, beta1, beta2 receptors
• Parasympathetic:
• nerves originate in cranial and sacral spine
• nicotinic and muscarinic receptors

• Vasoconstriction
• Pupil dialtion
• Decreased secretions
• Decreased GI motility

• Smooth muscle contraction
• Mydriasis during eye exams 
• Treatmen of nasal congetesion and hypotenstion

• Decreased CNS sympathetic outflow 
• Decreases NE release
• Decreases insulin release

• Smooth muscle contraction & NT inhibition
• Treatment of hypertension (activation of recpetors reduces NE release)

• Increases heart rate
• Increases CO
• Increases SV
• Increases cardiac automaticity
• Increases cardiac contractility
• Increases renin secretion

• Heart muscle contraction
• Treatment of cardiac arrest, heart failure, shock

• Bronchial relaxation
• Uterine relaxation
• Vasodilation to skeletal muscle vessels

• Smooth muscle relaxation
• Treatment of asthma & premature labor contractions

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• b2 receptors
• Tx asthma

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• b1 (increase HR, increase contractility)
• b2 (vasodilation, bronchodilation) 
• Tx of: astham, dsyrhythmia, heart failure

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• b2 
• Tx of asthma

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• b2
• Tx of asthma, rapid uterine contactions (slows them)

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a & b receptors
• Tx of cardiac arrest (increases HR), anaphylaxis (bronchodilation

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• b1
• Tx of heart failure (cardiac stimulant)

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a2 in CNS
• Tx of hypertension

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a 
• Tx of nasal congestion

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a>b
• Tx of nasal congetion

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a1 & b1
• Tx of shock

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a>b1
• Tx of shock (vasoconstriction & HR increase)
•  

• Adreneric agent/ adrenergic agonist/ sympathomimetic
• a1, a2
• Tx of shock (vasoconstriction; causes reflex tachycardia), nasal decongestion

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• b1 specific
• Tx of angina, hypertension

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• blocks b1 & b2
• Tx of angina, glaucoma (decreases intraocular pressure), hypertension

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• blocks a1
• Tx of BPH, hypertension

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• blocks a1
• Tx of BPH

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• b1 specific
• Tx of tachyarrhythmias, hypertension

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• Blocks b1 & b2
• Tx of dysrhythmias (decreases HR), HF, HTN

• Adrenergic blocking agent/adrenergic antagonist/ sympatholytic
• b1 specific
• Tx of hypertension

• Located at the ganglionic synapse of both sympathetic and parasympathetic 
• Stimulated by Ach

• Located on organs for parasympathetic stimulation
• Stimulated by Ach

• Enzyme
• Metabolizes Ach in the synaptic cleft into choline & acetate for reuptake into presynaptic nerve terminals

• Directly binding (direct-acting) to acetylcholine receptors
• Inhibiting AchE

• Decrease HR
• Increase GI motility
• Increase urination
• Increase sweating
• Increase salivation
• Increase nasal secretions
• Increase bronchial secretions
• Increase bronchoconstriction
• Miosis

• Direct-acting muscarinic agonist/ parasympathomimemtic
• Tx of glaucoma

• Direct-acting muscarinic agonist/ parasympathomimetic
• Tx of urinary retention

• Cholinesterase inhibitor
• Tx of Alzheimer's

• Cholinesterase inhibitor
• Tx of Alzheimer's 

• Cholinesterase inhibitor
• Tx of anticholinergic overdose (revereses anticholinergic effects, not found to be safe and effective)

• Cholinesterase inhibitor
• Use of diagnosis of myasthenia gravis

• Cholinesterase inhibitor
• Tx of myasthenia gravis

Cholinergic Blocker/Anticholinergic/Muscarinic Antagonist

Clincial effects

• Increase HR
• Decrease GI motility (IBS)
• Decrease gastric acid secretion (peptic ulcer disease)
• Decrease urination (incontinence)
• Decrease sweating
• Decrease salivation (anesthesia)
• Decrease nasal secretions
• Decrease bronchial secretions (anesthesia)
• Decrease broncoconstriction aka bronchodilation
• Mydriasis

Blind as a bat, dry as a bone, red as a beet, mad as a hatter, and hot as a hare

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• dilates bronchi
• Tx of COPD

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• Tx of bradycardia, urinary incontnence, diarrhea; used to decrease secretions during anesthesia

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• Tx of IBS

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• Tx of IBS, urinary incontinence, neurogenic bladder

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• Tx of motion sickness

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• Tx of Parkinson's 

• Cholinergic blocker/ anticholinergic/ muscarinic antagonist
• Tx of Parkinson's

-zosin

-osin