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Receptor Site Theory

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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Receptor Site Theory

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  1. Receptor Site Theory RC 195

  2. Autonomic Nervous System Made up of: Sympathetic or Adrenergic And Parasympathetic or Cholinergic systems

  3. Autonomic Nervous System and the Lung

  4. Sympathetic (Adrenergic) and Parasympathetic (Cholinergic) each have opposing effects

  5. ORGAN SYMP. PARASYMP. • Airway Dilates Constricts Smooth Muscle • Bronchial Dec Inc Gland Secretions • Mast Cells Inhibits Degranulation Degranulation

  6. 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.

  7. Sympathetic (Adrenergic) Receptor Sites

  8. Adrenergic (Sympathetic): Alpha Receptor Locations • Bronchial Mucosa Blood Vessels and Systemic Blood Vessels (Primarily) • Some are found in Mast cells and Bronchial smooth muscle

  9. Adrenergic (Sympathetic) Receptors: Alpha Effects • Constriction of bronchial blood vessels and systemic blood vessels • May cause some bronchoconstriction or mast cell degranulation

  10. Adrenergic (Sympathetic) Receptors: Beta-1 Locations • Primarily found in the heart • There may be some in adipose tissue and the G.I. Tract

  11. Adrenergic (Sympathetic) Receptors: Beta-1 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!

  12. Adrenergic (Sympathetic) Receptors: Beta-2 Locations • Primarily on bronchial smooth muscle and on mast cells • Also on systemic and skeletal muscle • A few in the blood vessels

  13. Adrenergic (Sympathetic) Receptors: Beta-2 Effects • Bronchial smooth muscle relaxation (Bronchodilation) and decreased mast cell degranulation • These are very desirable effects!

  14. Intracellular Events with Adrenergic (Sympathetic) Stimulation:Beta-2

  15. Adrenergic (Sympathetic) Receptors: Alpha • 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

  16. Parasympathetic (Cholinergic) Receptor Sites Also found in airway smooth muscle and mast cells Stimulation has the opposite effect of adrenergic!

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

  18. Adrenergic (Sympathetic) sites are stimulated by: • Neurotransmitter: Norepinephrine • Adrenergic (Sympathetic) drugs • Also known as SYMPATHOMIMETICS or CATECHOLAMINES • Epinephrine is a naturally-occurring sympathomimetic

  19. Parasympathetic (Cholinergic) sites are stimulated by: • Neurotransmitter: Acetylcholine • Cholinergic (Parasympathetic) drugs: Methacholine

  20. 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!

  21. Desired Effects of Adrenergic (Sympathetic) Stimulation • Bronchodilation (or bronchodilatation) • Decreased Mast cell degranulation • Vasoconstriction of mucosal blood vessels, ie, decongestant effect

  22. 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

  23. Enough! Let’s get out of here!

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