PHARMACOLOGY DRUGS ACTING ON THE ANS

1st SEMESTER FINALS S.Y. 2023-2024 PROFESSOR: Nervous

Autonomic MS. ADA MAGNAYON
System

AUTONOMIC NERVOUS SYSTEM C LIN IC A L R ELEV A NC E -

(ANS) A D R EN ER GIC SYSTEM

⋆The autonomic nervous system (ANS) is
responsible for regulating involuntary bodily
functions.
⋆It comprises two main divisions: the
adrenergic and cholinergic systems.
⋆ These systems use neurotransmitters and
receptors to transmit signals between nerve
cells and target tissues.
ADRENERGIC SYSTEM
⋆ Adrenergic and cholinergic systems often
work in opposition to maintain homeostasis.
⋆For example, adrenergic stimulation
increases heart rate, while cholinergic
stimulation slows it down.
⋆Balancing these systems is crucial for overall
physiological stability.
C LIN IC A L R ELEV A NC E -
C H OLIN ER GIC SYSTEM

⋆ The adrenergic system involves the release
of neurotransmitters, primarily
norepinephrine.
⋆ Adrenergic receptors include alpha-1, alpha-
2, beta-1, and beta-2 receptors.
⋆ Adrenergic stimulation increases heart rate,
dilates airways, and redirects blood flow to
muscles, preparing the body for the "fight or
flight" response.
CHOLINERGIC SYSTEM
⋆ Cholinergic medications find applications in
various medical scenarios.
⋆ For instance, acetylcholinesterase inhibitors,
such as donepezil, are used in the treatment of
Alzheimer's disease, enhancing cholinergic
transmission in the brain.
⋆Additionally, medications affecting
muscarinic receptors may be employed to
manage conditions like overactive bladder,
where increased cholinergic activity helps
regulate urinary function.

⋆ Acetylcholine is the neurotransmitter ADRENERGIC AGONISTS

associated with the cholinergic system. Examples:
⋆ Cholinergic receptors include nicotinic and • Epinephrine (Adrenaline)
muscarinic receptors, each with subtypes. • Norepinephrine
⋆ Cholinergic stimulation slows heart rate, • Isoproterenol
stimulates digestion, and promotes salivation, Mechanism of Action:
contributing to the "rest and digest" response. ⋆ Adrenergic agonists stimulate the
sympathetic nervous system by mimicking the
COMPARISON action of norepinephrine and epinephrine.
They activate adrenergic receptors, leading to
⋆ Adrenergic and cholinergic systems often the "fight or flight" response.
work in opposition to maintain homeostasis. Side Effects:
⋆For example, adrenergic stimulation ⋆ Increased heart rate
increases heart rate, while cholinergic ⋆ Elevated blood pressure
stimulation slows it down. ⋆ Dilated pupils
⋆Balancing these systems is crucial for overall ⋆ Sweating
physiological stability. Adverse Effects:
⋆ Hypertension ⋆ Anxiety
⋆ Arrhythmias

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A D R EN ER GIC A GONISTS - N UR SIN G ⋆Emphasize the importance of compliance

C ON SID ER A TION S with prescribed medications.
Vital Signs Monitoring: ⋆Instruct patients to report any signs of
⋆ Assess heart rate, blood pressure, and respiratory distress.
respiratory rate regularly. Interventions:
Report any significant changes promptly. ⋆ Administer medications as prescribed,
Patient Education: noting any specific considerations (e.g., take
⋆ Explain potential side effects and the with food).
importance of reporting them. ⋆ Monitor for signs of heart block and initiate
⋆ Teach patients how to monitor their own appropriate interventions.
pulse and blood pressure.
Interventions: CHOLINERGIC AGONISTS
⋆ Administer as prescribed, ensuring accurate Examples:
dosage and infusion rates. ⋆ Bethanechol
⋆ Be prepared to manage hypertensive ⋆ Pilocarpine
emergencies: ⋆ Donepezil
⋆ Have appropriate antihypertensive Mechanism of Action:
medications readily available. ⋆Stimulating muscarinic receptors, cholinergic
⋆ Ensure emergency equipment is easily agonists mimic acetylcholine, promoting
accessible. parasympathetic activity.
Side Effects:
ADRENERGIC A NTAGONISTS ⋆ Bradycardia
Examples: ⋆ Increased salivation
⋆ Propranolol (Non-selective beta-blocker) ⋆ Diarrhea
⋆ Metoprolol (Selective beta1-blocker) Adverse Effects:
⋆ Prazosin (Alpha1-blocker) ⋆ Hypotension
Mechanism of Action: ⋆ Bronchoconstriction
⋆ Blocking the action of norepinephrine and
epinephrine, adrenergic antagonists inhibit C H OLI N ER GIC A GON ISTS - N UR SIN G
sympathetic activity. C ON SID ER A TION S
Side Effects: Vital Signs Monitoring:
⋆ Bradycardia ⋆ Regularly assess heart rate and blood
⋆ Hypotension pressure.
⋆ Fatigue ⋆ Monitor respiratory rate and breath sounds.
Adverse Effects: Patient Education:
⋆ Heart block ⋆ Teach patients the importance of taking
⋆ Bronchoconstriction (in non-selective beta- medications as prescribed.
blockers) ⋆ Instruct patients on strategies to manage
A D R EN ER GIC A N T AGON ISTS - potential gastrointestinal effects.
N UR SIN G C ON SID ER A TION S Interventions:
Vital Signs Monitoring: ⋆ Administer medications as prescribed,
⋆ Regularly monitor heart rate and blood considering timing and route.
pressure. ⋆ Be prepared to manage bradycardia with
⋆ Assess respiratory rate and pattern. atropine.
Patient Education:

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ANTICHOLINERGIC AG ENTS

Examples:
⋆ Atropine
⋆ Scopolamine
⋆ Ipratropium
Mechanism of Action:
⋆Blocking muscarinic receptors,
anticholinergic agents inhibit parasympathetic
activity.
Side Effects:
⋆ Tachycardia
⋆ Dry mouth
⋆ Blurred vision
Adverse Effects:
⋆ Urinary retention
⋆ Constipation
⋆ Confusion (especially in elderly patients)

C H OLI N ER GIC A GEN TS - N UR SIN G

C ON SID ER A TION S

Vital Signs Monitoring:

⋆ Regularly assess heart rate and blood
pressure.
⋆ Monitor urinary output.
Patient Education:
⋆ Educate patients on potential side effects and
the importance of reporting them.
⋆ Encourage fluid intake to prevent
constipation.
Interventions:
⋆ Administer medications as prescribed,
noting any considerations (e.g., administer
atropine for bradycardia).
⋆ Implement measures to manage constipation,
such as a high-fiber diet and adequate fluids.

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