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Drugs acting mainly on peripheral neurotransmitter processes

Many modern medicines have a therapeutic effect, affecting in a specific way the transmission of nervous excitement in the endings of the peripheral nerves. Strengthening, weakening or blocking the transfer of nervous excitement, they change the functional state of the corresponding organs and systems.
According to modern data, synaptic transmission of excitation in the central and peripheral nervous system is carried out with the participation of endogenous chemicals - neurotransmitters (neurotransmitters).
Standing out in the process of nervous excitation from nerve endings, they act on postsynaptic receptors, which is accompanied by a corresponding physiological response. The neurotransmitters include acetylcholine, norepinephrine, dopamine, serotonin, GABA and a number of other endogenous compounds. The receptors with which they bind (for which they are endogenous ligands) are called respectively cholinergic, adrenergic, dopaminergic, serotonergic, GABA-ergic, etc.
Recently, the neurotransmitter role of a large group of endogenous physiologically active substances of a peptide nature, neuropeptides, has been discovered.
Most neurotransmitters are isolated from the body in pure form, their chemical structure has been established, their synthesis has been carried out. They are used as neurotropic drugs (acetylcholine, norepinephrine, dopamine, GABA, etc.). A number of modern synthetic drugs have a structural similarity with endogenous neurotransmitters. By binding to the corresponding receptors, these agents have physiological effects that are close to the effects of endogenous ligands, i.e., act as agonists (see Cholinomimetic substances, Adrenergic substances, etc.)
However, synthetic analogs of endogenous neurotransmitters, by binding to receptors, interfere with the action of endogenous ligands, i.e., be their antagonists (see Anticholinergics, Adreno-blocking drugs, etc.).
The action of neurotropic drugs may also be associated with the effect on the biosynthesis and metabolism of endogenous neurotransmitters. Thus, the effect of anticholinesterase drugs is due to the blockade of the enzyme cholinesterase, which breaks down and inactivates acetylcholine. At the same time, the effect of cholinesterase reactivators is reduced to the restoration of the activity of this enzyme.
A major achievement of science recently was the discovery of the existence of subgroups (subpopulations) of adrenergic (a ~, <~, ~~, ~ g), cholinergic (M "M,, M,), dopaminergic (D" D, etc.), serotonergic (C ~, C,) and other receptors. This discovery contributed to the creation of new drugs that act primarily on various receptor subgroups and have a selective pharmacological and therapeutic effect.
In addition to substances involved in the transmission of excitation in the field of synapses (neurotransmitters), there are a number of nutrients (histamine, bradykinin, prostaglandins, adenosine, etc.), which are considered as mediator substances involved in humoral regulation of physiological and pathological processes (inflammation, allergies and others). The action of certain groups of drugs (antihistamine, nonsteroidal anti-inflammatory drugs, etc.) is associated with the effect on the formation and metabolism of these "mediator" substances.
In recent years, the number of endogenous physiologically active compounds found in the body, which are involved in the regulation of nervous and humoral (metabolic) processes, has significantly increased.
Much attention is paid to the study of these substances (regulatory peptides, etc.) due to the possibility of creating new drugs on their basis, as well as taking into account the role of these substances in the mechanisms of pharmacological effects.
Group Drugs that act primarily on peripheral neurotransmitter processes include drugs: