Sympathetic: Thoracolumbar Dopamine

Parasympathetic: Craniosacral Effect:

 ↑ heart func.
 Vasodilator – cerebral bv affected
Sympathetic: Norepinephrine –
α-receptor(excitatory) & β-receptor Indication:
Parasympathetic: Acetylcholine – Nicotinic and  Tx for Parkinson’s ds.
Muscarinic (↑ heart; ↓ GIT) receptors  Tx for cardiovascular ds.
 Tx for shock
α₁-receptor – Post-junctional synapse

α₂-receptor – Pre-junctional synapse

Dobutamine
β₁-receptor – Excitatory
Effect:
β₂-receptor – Inhibitory
 ↑ heart contraction
(w/o effect on heart rate and bp)
Sympathomimetic • Adrenomimetic •
Indication:
Adrenergic

Catecholamines: Norepinephrine  Tx for Low-output cardiac failure

Epinephrine

Isoproterenol Non-catecholamines

Effect: Ephedrine

Amphetamine → Methamphetamine →
 ↑ heart func.
Pseudoephedrine → Phenylephrine →
 Vasoconstriction
Phenylpropanolamine (cough syrup)
*Vasodilation in Coronary arteries; no
effect on cerebral bv Effect:
 Bronchodilation
 Smooth m. contraction  ↑ heart func.
 Pupil dilation – Mydriasis  Vasoconstriction
 Pupil dilation
Indication:  Bronchodilation
 ↑ CNS
 Adjunct to local anesthetics
 Local hemostatic Indication:
doc for epistaxis → epinephrine
 Tx for heart ds.  BP maintenance
doc for heart-block → isoproterenol  Ophthalmic examination
 TX for allergy/anaphylaxis  Prep. of cough syrup/decongestant
 Tx for bronchial asthma
 Adjuct to ophthalmic examination
Β₂-selective Bronchodilator: α₂-selective blocker

 Salbutamol  Yohimbine
 Terbutaline
Indications:
 Clenbuterol
 Penbutolol  Tx for peripheral vasospasm
 Isoetarine  Tx for hypertension
 Tx for peripheral ischemia
Leads to Down-regulation in prolonged use:
β-blockers
→ Salbutamol needs cAMP to bind to its
receptor Non-selective β-blockers:
→ Salbutamol is metabolized into polar and  Propranolol
non-polar (phosphodiesterase) metabolites  Pronethalol
→ Phosphodiesterase causes lysis of cAMP β₁-selective blockers
*Concomitant use with Aminophylline → lysis of  Metoprolol
phosphodiesterase
Effects:

 Bradycardia
Sympatholytic  Bronchial Constriction
Receptor-blocker: Indication:
α-blockers:  Tx for hypertension
 Ergot Alkaloids – from Claviceps  Tx for angina pectosis (chest pain)
purporea  Tx for hyperthyroidism
 Ergonovine – Hormone-like; Oxytocin-  Tx for myocardial infarct
like  Tx for ventricular fibrillation
 Ergotamine  Tx for digitalis-induced tachycardia

Effect:

 Intense vasoconstriction → necrosis Neuronal-blocking

 Slight CNS → ↓CNS Recerpine
 Intense ↑GIT → emesis -Depletes NE reserve
 Uterine contraction Guanethidine

Bretylium - ↓/inhib. NE release

Non-selective α-blocker:

 Phenoxybenzamine Misc. sympatholytic drugs

 Pentolamine Hydroxydopamine
α₁-selective blocker  Anatomical destruction of neurons &
 Prazosin dendrites
α-methyldopa (inactive)  Tx for Ergot Poisoning → methacholine
 Tx for Urinary Bladder Atomy →
 Biotransformed to α-
bethanechol
methylnorepinephrine → false
 Tx for Rumen Atony → carbachol
neurotransmitter
 Tx for Colic/Impation → carbachol
α-methyl-para-tyrosine

 Inhibits hydroxylase → inhib. of NE

Cholinomimetic alkaloids
synthesis
 Pilocarpine → Pilocarpus iaborandii
Imipramine
 Arecoline → Betel nut
 Inhib. of tyramine → enzyme for  Muscarine → Amanita muscaria
binding
Effect:

 *Same as choline esters

Indication:  Pupil constriction – Myosis
 Tx for hypertensiokn Indication:
 Tx for psychological disorders;
 Tx for Glaucoma
Antidepressant, for Mood Stability
 Tx for Synechia
 Arecoline – taeniacide – gouts
Parasympathomimetic • Cholinergic Cholinesterase-inhibitors:
 Direct Acting Reversible
 Cholinesterase-inhibitor
 Physostigmine → Physostigma
Direct Acting: venenosum
 Neostigmine
 Choline Esters
 Pyridostigmine
 Ach
 Endrophonium
 Choline
 Amberomium
 Carbachol
 Bethanechol Action:
 Methacholine
 *Same as others
Effect:  Skeletal m. twitching/paralysis
 ↓Heart func. Indication:
 ↑GIT
 Tx for Glaucoma
 Some s. muscle contraction
 Tx for Synechia → physostigmine
 Bronchial constriction
 Tx for Impaction
 Skeletal muscle twitching/paralysis
 Tx for Myasthenia gravis → neostigmine
Indication:

 Tx for Reynold’s ds. → methacholine

Irreversible Parasympatholytic

 ChE + Drug → Permanent Receptor-blocking

Organophosphorous compound  Muscarinic-blocker

(O-P compound)  Nicotinic-blocker

 Malathion
 Dichloros Muscarinic-blockers
 Coumaphos
 Atropine → Atropa belladonna
 Trichlorfon
 Scopolamine
 Naphthalofos
 Glycopyrrolate
 Haloxon
 Homatropine
 Ronnel
 Methantheline
Uses:  Prophantheline

 Pesticide *Scopolamine + Morphine → Twilight Sleep →

 Herbicide analgesia & amnesia
 Anthelmentic
Effect:
 External parasiticide
 Vasodilation
O-P compound poisoning:
 Tachycardia
c.s:  ↓GIT
 Some smooth m. contraction
 ↑saliva
 Pupil constriction
 Colic
 ↓CNS func.
 GIT disruption
 Muscle spams Indication:
 Seizure
 Pre-anesthetic
Tx:  Anti-spasmodic/spasmolytic
 Ophthalmic examination
 Atropine Sulfate
 Antidote
 Pralidoxine/2-PAM
 Tx for heaves in horses

Nicotinic-blockers

 Nicotine → Tobacco plants

 Hexamethonium
 Pentamethonium
 Azomethonium
 Pentolinium
 Trimethidium
Effect:

 ↑Cardiovascular
 ↑GIT
 ↑CNS → ↓CNS
 Skeletal m. paralysis

Muscle Relaxants

Depolarizing

 Succinyl choline
 Decamethonium

Non-depolarizing

 Tubocurarine → Curare plant

 d-tubocurarine
 Metacurarine
 Pancuronium
 Alcuronium
 Vencuronium

Indication:

 Facilitates naso-gastric tubing

 Facilitates respi. tube
 Access during surgery
 Chemical restraining
 Anesthesia balance