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Drugs that act primarily on peripheral neurotransmitter processes

Many modern medicines have a therapeutic effect, affecting in a specific way the transmission of nervous excitation in the peripheral nerve endings. Strengthening, weakening or blocking the transmission of nervous excitation, they change the functional state of the relevant 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 the nerve endings, they affect the postsynaptic receptors, which is accompanied by a corresponding 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., respectively.
Recently, the neurotransmitter role of a large group of endogenous physiologically active substances of peptide nature, neuropeptides, has been discovered.
Most neurotransmitters are isolated from the body in a pure form, their chemical structure is established, their synthesis is carried out. They are used as neurotropic drugs (acetylcholine, noradrenaline, dopamine, GABA, etc.). A number of modern synthetic drugs have a structural similarity with endogenous neurotransmitters. Linking to the corresponding receptors, these drugs have physiological effects close to the effects of endogenous ligands, that is, they act as agonists (see Cholinomimetic substances, Adrenergic substances, etc.)
However, synthetic analogues of endogenous neurotransmitters can, by binding to receptors, interfere with the action of endogenous ligands, ie, they are their antagonists (see Anticholinergics, Adrenoblokiruyuschie drugs, etc.).
The action of neurotropic drugs can 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 cleaves 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 in recent times has been the discovery of the existence of subgroups (subpopulations) of adrenergic (a ~, <~, ~, ~ r), cholinergic (M "M,, M,), dopaminergic (D" D, etc.) Serotonergic (C ~, C,) and other receptors. This discovery contributed to the creation of new drugs, acting primarily on various subgroups of receptors and providing selective pharmacological and therapeutic effects.
In addition to the substances involved in the transmission of excitation in the region of synapses (neurotransmitters), there are a number of nutrients (histamine, bradykinin, prostaglandins, adenosine, etc.) that are regarded as mediator substances involved in the humoral regulation of physiological and pathological processes (inflammation, allergies and Other). The effect of certain groups of drugs (antihistamines, 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, involved in the regulation of nervous and humoral (metabolic) processes, has significantly increased.
The study of these substances (regulatory peptides, etc.) pays much attention in view of the possibility of creating new medicinal substances on their basis, and also 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: