DRUGS ACTING ON PERIPHERAL NERVOUS SYSTEM, PART II

 

DRUGS ACTING ON PERIPHERAL NERVOUS SYSTEM

PREPARED BY MR. ABHIJIT DAS


ADRENERGIC DRUGS

Adrenergic drugs are agents that activate the sympathetic nervous system by stimulating the release of adrenaline (epinephrine) and noradrenaline (norepinephrine). These drugs are also known as sympathomimetic drugs.

CLASSIFICATION:

·       Direct-acting: Directly stimulate adrenergic receptors.
Examples: Epinephrine, Norepinephrine, Salbutamol

·       Indirect-acting: Increase the release of noradrenaline from nerve endings.
Examples: Amphetamine, Tyramine

·       Mixed-acting: Both directly stimulate receptors and increase noradrenaline release.
Examples: Ephedrine, Pseudoephedrine

PHARMACOLOGICAL ACTIONS:

Ø Heart:

  • Increases heart rate and force of contraction.

Ø Blood Vessels:

  • Narrows blood vessels (Vasoconstriction), raising blood pressure.
  • Expands vessels (Vasodilation) in muscles, improving blood flow.

Ø Lungs:

  • Widens airways (Bronchodilation), making breathing easier.

Ø Eye:

  • Dilates pupils.
  • Lowers eye pressure in glaucoma.

Ø GI Tract:

  • Slows digestion by reducing movement.
  • Tightens digestive tract sphincters.

Ø Urinary Tract:

  • Relaxes bladder, making it harder to urinate.

Ø Metabolism:

  • Increases blood sugar.
  • Enhances fat breakdown for energy.

ADVERSE EFFECTS:

a)    Increased heart rate (tachycardia)

b)    High blood pressure (hypertension)

USES:

a)    Treatment of asthma (bronchodilation)

b)    Management of shock (to raise blood pressure)

 

CHOLINERGIC DRUGS

Cholinergic drugs are agents that activate the parasympathetic nervous system by stimulating the release of Acetylcholine. These drugs are also known as parasympathomimetic drugs.

CLASSIFICATION:

·       Direct-acting: Act directly on cholinergic receptors.
Examples: Pilocarpine, Bethanechol

·       Indirect-acting: Inhibit acetylcholinesterase, increasing acetylcholine levels.
Examples: Neostigmine, Physostigmine

PHARMACOLOGICAL ACTIONS:

Ø Eye:

·       Constricts pupils (miosis)

Ø Heart:

·       Slows heart rate (bradycardia)

·       Reduces force of contraction

Ø Lungs:

·       Causes bronchoconstriction

Ø GI Tract:

·       Increases motility and secretion

·       Relaxes sphincters

Ø Urinary Tract:

·       Promotes urination by contracting the bladder and relaxing sphincters

Ø Glands:

·       Increases secretion (sweat, saliva, tears)

Ø CNS:

·       Improves cognition

ADVERSE EFFECTS:

a)    Bradycardia (slow heart rate)

b)    Excessive salivation

Uses:

a)    Treatment of glaucoma (e.g., Pilocarpine)

b)    Treatment of urinary retention (e.g., Bethanechol)

 

ANTI ADRENERGIC DRUGS

Anti-adrenergic drugs, also called sympatholytic drugs, block the effects of the sympathetic nervous system. They work by inhibiting adrenergic receptors, reducing the action of adrenaline and noradrenaline in the body.

CLASSIFICATION:

Ø Alpha Blockers

  • Alpha-1 Blockers: Example: Prazosin, Doxazosin
  • Alpha-2 Blockers: Example: Yohimbine

Ø Beta Blockers

  • Non-selective Beta Blockers: Example: Propranolol
  • Selective Beta-1 Blockers: Example: Metoprolol

Ø Mixed Alpha and Beta Blockers

  • Example: Carvedilol, Labetalol

PHARMACOLOGICAL ACTIONS:

Heart

  • Decrease heart rate: By reducing the force and rate of heart contraction.

Lungs

  • Bronchoconstriction: Non-selective beta blockers can cause narrowing of airways.

Eye

  • Pupil constriction (miosis)

GI

  • Increase gastrointestinal motility: By relaxing sphincters and promoting digestion.

ADVERSE EFFECTS:

a)    Bradycardia (slow heart rate)

b)    Bronchoconstriction (difficulty breathing, especially in asthmatic patients)

USES:

a)    Hypertension (to lower blood pressure)

b)    Angina (to reduce chest pain and improve heart function)

 

ANTI CHOLINERGIC DRUGS

Anti-cholinergic drugs, also known as parasympatholytic drugs, block the effects of the parasympathetic nervous system by inhibiting cholinergic receptors.

CLASSIFICATION:

Ø Muscarinic Antagonists

  • Example: Atropine, Scopolamine

Ø Nicotinic Antagonists

  • Example: Curare, Pancuronium

PHARMACOLOGICAL ACTIONS:

Heart

  • Increase heart rate

Lungs

  • Bronchodilation

Eye

  • Pupil dilation (mydriasis)

GI

  • Decrease gastrointestinal motility

Urinary Tract

  • Reduce bladder contractions: Used in treating overactive bladder.

ADVERSE EFFECTS:

a)    Dry mouth

b)    Blurred vision

USES:

a)    Treatment of motion sickness (e.g., Scopolamine)

b)    Management of overactive bladder (e.g., Oxybutynin)

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