Specific Considerations with Endocrine Disease - Adrenal Medullary Disease
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Preganglionic fibers of the sympathetic nervous system stimulate release of catecholamines from the adrenal medulla. Peripheral effects of catecholamines include chronotropic and inotropic stimulation of the heart, vasomotor changes, enhanced hepatic glycogenolysis, and inhibition of insulin release. Catecholamines are biotransformed in the kidney and liver to metanephrine, normetanephrine, and vanillylmandelic acid.