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Receptor Site Theory. RC 195. Autonomic Nervous System. Made up of: Sympathetic or Adrenergic And Parasympathetic or Cholinergic systems. Autonomic Nervous System and the Lung. Sympathetic (Adrenergic) and Parasympathetic (Cholinergic) each have opposing effects.

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Autonomic nervous system l.jpg

Autonomic Nervous System

Made up of:

Sympathetic or Adrenergic

And

Parasympathetic or Cholinergic

systems




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  • ORGAN SYMP. PARASYMP each have opposing effects.

  • Airway Dilates Constricts

    Smooth

    Muscle

  • Bronchial Dec Inc

    Gland

    Secretions

  • Mast Cells Inhibits Degranulation

    Degranulation


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Mast Cells: Basophils that have migrated into the airways and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.


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Sympathetic (Adrenergic) Receptor Sites and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.


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Adrenergic (Sympathetic): Alpha Receptor Locations and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.

  • Bronchial Mucosa Blood Vessels and Systemic Blood Vessels (Primarily)

  • Some are found in Mast cells and Bronchial smooth muscle


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Adrenergic (Sympathetic) Receptors: Alpha Effects and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.

  • Constriction of bronchial blood vessels and systemic blood vessels

  • May cause some bronchoconstriction or mast cell degranulation


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Adrenergic (Sympathetic) Receptors: Beta-1 Locations and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.

  • Primarily found in the heart

  • There may be some in adipose tissue and the G.I. Tract


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Adrenergic (Sympathetic) Receptors: Beta-1 Effects: and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.

  • Positive chronotropic and inotropic effect

    • Increased heart rate and increased stroke volume

      • Increased cardiac output and coronary blood flow

  • May increase Oxygen requirements for the heart!


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Adrenergic (Sympathetic) Receptors: Beta-2 Locations and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.

  • Primarily on bronchial smooth muscle and on mast cells

  • Also on systemic and skeletal muscle

  • A few in the blood vessels


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Adrenergic (Sympathetic) Receptors: Beta-2 Effects and under the skin. They contain histamine and release it when they degranulate causing inflammatory effects.

  • Bronchial smooth muscle relaxation (Bronchodilation) and decreased mast cell degranulation

  • These are very desirable effects!



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Adrenergic (Sympathetic) Receptors: Alpha Stimulation:

  • Decreases c-amp because of stimulation of ATPase

  • Decreased c-amp causes constriction of blood vessels

    • Not too much of an effect on bronchial smooth muscle or mast cells since they usually have more beta-2 receptors


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Parasympathetic (Cholinergic) Receptor Sites Stimulation:

Also found in airway smooth muscle and mast cells

Stimulation has the opposite effect of adrenergic!


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Adrenergic (Sympathetic) and Cholinergic (Parasympathetic) action in airway smooth muscle and mast cells


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Adrenergic (Sympathetic) sites are stimulated by: action in airway smooth muscle and mast cells

  • Neurotransmitter: Norepinephrine

  • Adrenergic (Sympathetic) drugs

    • Also known as SYMPATHOMIMETICS or CATECHOLAMINES

      • Epinephrine is a naturally-occurring sympathomimetic


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Parasympathetic (Cholinergic) sites are stimulated by: action in airway smooth muscle and mast cells

  • Neurotransmitter: Acetylcholine

  • Cholinergic (Parasympathetic) drugs: Methacholine


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Many Respiratory Care Drugs Are Designed to Stimulate the Adrenergic (Sympathetic) Sites

They usually are made to be as beta-2 and/or alpha specific as possible!


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Desired Effects of Adrenergic (Sympathetic) Stimulation Adrenergic (Sympathetic) Sites

  • Bronchodilation (or bronchodilatation)

  • Decreased Mast cell degranulation

  • Vasoconstriction of mucosal blood vessels, ie, decongestant effect


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Side Effects (Undesired) of Adrenergic (Sympathetic) stimulation

  • Beta-1: Tachycardia, Palpitations, Increased Blood pressure, possibly N & V, and headache

    • Always monitor pulse when administering!

  • Alpha: Increased blood pressure and possibly rebound congestion

  • Beta-2: Tremors, agitation, possibly N & V