Circulating catecholamines, epinephrine and norepinephrine, originate from two sources. Epinephrine is released
by the adrenal medulla upon activation of preganglionic sympathetic nerves
innervating this tissue. This activation occurs during times of stress (e.g.,
exercise, heart failure, hemorrhage, emotional stress or excitement, pain).
Norepinephrine is also released by the adrenal medulla (about 20% of its total
catecholamine release is norepinephrine). Normally, most of the norepinephrine
released by sympathetic nerves is taken back up by the nerves (some is also
taken up by extra-neuronal tissues) where it is metabolized. A small amount of
norepinephrine, however, diffuses into the blood and circulates throughout the body.
At times of high sympathetic nerve activation, the amount of norepinephrine
entering the blood increases dramatically.
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