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Medicines that act mainly on peripheral neurotransmitter processes

Many modern drugs have a therapeutic effect, affecting in a specific way the transmission of nervous excitation in the ends of peripheral nerves. Strengthening, weakening or blocking the transmission of nervous excitation, 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 from the nerve endings in the process of nervous excitation, they act on postsynaptic receptors, which is accompanied by an appropriate physiological response. 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 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 its pure form, their chemical structure is established, and their synthesis is carried out. They are used as neurotropic drugs (acetylcholine, norepinephrine, dopamine, GABA, etc.). A number of modern synthetic drugs have structural similarities with endogenous neurotransmitters. By binding to the corresponding receptors, these agents exert physiological effects similar to the effects of endogenous ligands, i.e., act as agonists (see Cholinomimetic substances, Adrenergic substances, etc.)
However, synthetic analogues of endogenous neurotransmitters can, by binding to receptors, inhibit the action of endogenous ligands, i.e., be their antagonists (see Anticholinergics, Adrenergic blocking drugs, etc.).
The action of neurotropic drugs may also be associated with an effect on the biosynthesis and metabolism of endogenous neurotransmitters. So, the action of anticholinesterase drugs is due to the blockade of the cholinesterase enzyme, which breaks down and inactivates acetylcholine. At the same time, the action of cholinesterase reactivators is reduced to restoring the activity of this enzyme.
A major achievement of science recently has been the discovery of the existence of subgroups (subpopulations) of adrenergic (a ~, <~, ~~, ~ d), 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 mainly on various subgroups of receptors 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 biogenic substances (histamine, bradykinin, prostaglandins, adenosine, etc.), which are considered as mediators involved in the humoral regulation of physiological and pathological processes (inflammation, allergies and other). The action of certain groups of drugs (antihistamines, non-steroidal anti-inflammatory drugs, etc.) is associated with the influence on the formation and metabolism of these "mediator" substances.
In recent years, the number of endogenous physiologically active compounds found in the body that 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.) in view of the possibility of creating new medicinal substances based on them, and also taking into account the role of these substances in the mechanisms of pharmacological effects.
The group of Medicines that act mainly on peripheral neurotransmitter processes includes drugs: