4.4 ANS Medication Classes and Nursing Considerations

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Classes of medication, categorized according to neuroreceptor, are further discussed in more detail below. Table 4.2[1] contrasts agonist and antagonist medications for each ANS neuroreceptor.

Table 4.2 Comparison of Prototype Medications that Stimulate Versus Inhibit PNS and SNS Receptors

Stimulation (Agonist)
Inhibition (Antagonist)
Nicotine Nicotine is a muscle relaxant with CNS effects. Nicotine patch is used for nicotine addiction by slowly reducing dose and avoiding withdrawal effects Not clinically applicable
Muscarinic Pilocarpine causes muscle contraction; assists with glaucoma by contracting ciliary muscle and draining fluid Atropine in small doses inhibits secretions; in moderate doses increases heart rate; in large doses decreases gastrointestinal motility
Alpha-1 Pseudoephedrine and Phenylephrine cause vasoconstriction, decreased swelling of mucus membranes, and decreased secretions Tamsulosin relaxes smooth muscle in bladder/prostate to improve urine flow and also decreases blood pressure due to vasodilation
Alpha-2 Clonidine decreases CNS outflow to treat ADHD and also reduces blood pressure and heart rate Limited clinical use
Beta-1 Dobutamine increases heart rate, force of heart contraction, and speed of conduction between SA to AV nodes Selective B blocker: Metoprolol works on Beta-1 receptors to decrease blood pressure and heart rate
Beta-2 Albuterol used for bronchodilation Nonselective B blocker: Propranolol works on Beta-2 and Beta-1 receptors; decreases blood pressure but can also cause bronchoconstriction
Catecholamines stimulate multiple adrenergic receptors Epinephrine and Norepinephrine: stimulate alpha- and beta-receptors on target organs, causing increased heart rate and vasoconstriction for improved blood flow to essential organs

Dopamine has dose-dependent effects that target arteries in the kidneys, heart, and brain

Not clinically applicable


Supplementary Videos:  See the supplementary videos below related to sympathetic and parasympathetic nervous system medications.

Sympathetic Nervous System Drugs



Parasympathetic Nervous System Drugs



  1. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain
  2. Forciea, B. (2018, January 12). Sympathetic nervous system drugs. [Video]. YouTube. All rights reserved.  Video used with permission.  https://youtu.be/-e_s-jTPtm4
  3. Forciea, B. (2018, February 2). Parasympathetic nervous system drugs. [Video]. YouTube. All rights reserved. Video used with permission. https://youtu.be/ZSRk_NkbBPg


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