Sympathetic system

Pharmacology

Prepared by 
Bashir dhuh Ali
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 Autonomic Nervous System:
Visceral, involuntary nervous system
Nervous system is divided into two
parts: The central nervous system (CNS)
and peripheral nervous system (PNS).

The CNS consist of the brain and spinal

cord.The PNS consist of the all afferent
(sensory) neurons and all efferent (motor)
neurons.
• The efferent system is divided into
somatic nervous system & the autonomic
nervous system.

• Both somatic and autonomic effectors may

be excited by nerve impulses arising from
the same sensory end organs (Body heat).

• Somatic nervous system: is involved in

the voluntary control function of skeletal
muscle (voluntry).
 Sympathetic Parasympathetic
Anatomical Location Thoraco- Lumbar Cranio-sacral
(T1 to L2 or L3) ( 3rd, 7th, 9th & 10th Cranial,
Sacral : 2nd, 3rd & 4th)

Distribution Wide Head, Neck & Trunk

Neurotransmitter Norepinephrine or Acetylcholine

Noradrenaline

Role Prepares body for to Conserves Energy

tackle stress and (Concerned
Emergency
(Concerned information information related
related to Temperature & to mechanoreceptor
Tissue injury) and chemosensory )

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Dr. Abdifatah Ibrahim Omar
Dr. Abdifatah Ibrahim Omar 6
• Function sympathetic nervous system:
• 1- Stimulation of sympathetic nervous system
results of ↑ heart rate and BP, to mobilize
energy stores of the body, and ↑blood flow to
skeletal muscle and heart.
• The function of GIT mobility, bladder and sexual
organs is decreased.
• 2- When the sympathetic integrative centers in
the brain are activated (by anger, stress, and
emergency),the body’s resource are mobilized
for combat or for fight (fight or flight
response).
• Function of parasympathetic nervous system:
• 1- is designed to maintain body function such
as digestive process and elimination of wastes
usually under the condition of minimal stress.
• 2- It usually acts to oppose or balance the
actions of the sympathetic in rest and digest
situations (organ receives dual innervations).
• 3- is involved with the accumulation, storage,
& preservation of body resources.
 Sympathetic Drugs/ agonist

• The sympathomimetics are drugs which

increase the sympathetic activities.
• It is also called “sympathomimetic amines’
because they contain amino group.
• When norepinephrine or epinephrine is the
transmitter, the neuron is termed adrenergic
They are divided into two major groups on
the bases of their structure: cathecolamine
(naturally accuring) & non cathecolamines.

The sympathomimetic drugs are classified as

direct acting, indirect acting, or mixed
acting sympathomimetics.
Classification of adrenergic agonist Based on
mechanism
1. Direct acting:
direct release of norepinephrine into the postsynaptic adrenergic
receptor
albuterol, epinephrine , dopamine & phenylephrine
2.indirect acting :
block reuptake: inhibit Norepinephrine transporter and blocking
reuptake of NE into the presynaptic e.g. amphytamine( CNS
stimulant) & cocaine
block metabolism: by inhibiting MAO and COMTc .
3mixed action : both direct and indirect action e.g Ephedrine &
Pseudoephedrine
Direct acting
Indirect Acting Adrenergic Agonist
 Catecholamines Non-Catecholamines
norepinephrine, dopamine, isoproterenol, phenylephrine, terbutaline, and
and dobutamine ephedrine

Mechanism of action: Direct Interaction Mechanism of action: Indirect interaction

with adrenergic receptors with adrenergic receptor (Increase release
or Inhibit re-uptake process)

Not effective Orally Effective Orally

Can be given through Parenteral or
Inhalation.

Resistant (Not destroyed) to MAO and Not Resistant (Rapidly destroyed) to MAO
COMT and COMT

Longer duration of action Shorter duration of action

Can not Cross BBB Can cross BBB

 Adrenergic receptors
Receptor location Mechanism

α1 Blood vessels, smooth increase phospholipase C enzyme increase

muscle & Kidney intracelular calcium and vasoconstriction

α2 Presynabtic brain & decrease phospholipids C enzyme decrease

pancrease (B islet ) sympathetic activity

β1 Heart ,\& kideny Increase Adenyly cyclase increase myocardial

contractility

β2 Respiratory /uterin ,& Adenyly cyclase leading bronchial dilation

liver .uterine relaxation & glycogenlysis

β3 Adipose tissue Lipolysis

• Adrenaline is used
- Anaphylactic shock: drug of choice
- Angioneurotic edema of larynx
- Bronchial asthma/ Cardiac arrest.
Isoprenaline Non selective beta agonist
- Stimulate heart: tachycardia
- Used Stokes adams syndrome: isoprenaline 30-120
mg every 6 hour through IV administration
- Relax smooth muscles of Bronchi and GIT
- Oral absorption is ineffective, IM injection is
quicker and by inhalation.
- ADR: palpitation, tachycardia, arrhythmias,
headache
Uses of Adrenergic Agonist based on
Receptors
• For Non-Selective adrenergic agonist: it is used
for Shock, Anaphylaxis and Life threatening
cardiac disorders.
• For Alpha1 adrenergic agonist They are used
for the treatment of nasal congestion (upper
respiratory tract infections or allergic rhinitis),
hypotension, and ophthalmic examination
(Mydriasis) subconjunctival hemorrhage (Red eyes)
- ADR: Blurred vision, Urinary retention,
hypertension & Sweating.
• For Alpha2 adrenergic agonists. They are used
for the treatment of hypertension (alone or
with diuretics).
- ADR: hypotension, Peripheral edema, dry
mouth and eyes, Drowsiness, Dizziness,
hallucination, pruritus and impotency.
• For Beta1-receptor agonists (Cardiotonics):
They are used for the treatment of cardiac
arrest, heart failure, and shock.
- ADR: hypertension, Tachycardia, constipation
• For beta-2 adrenergic agonist: they are
used for treatment of Asthma and to reduce
Pre-term labour (Delay delivery) and
peripheral vascular disease (Vasodilation).
- ADR: Muscle tremor, Dizziness, cardiac
arrhythmia and hyperglycaemia (in case of
overdose)
- Contraindications: pregnancy, lactation,
cardiac arrhythmia, hyperthyroidism,
hypertension and diabetes and glaucoma
Thank you