Neurotropic drugs have an effect on the central and peripheral nervous system. This category of drugs includes narcotic and antiepileptic drugs, and in addition, analgesics. These drugs affect the neurotransmitters of the nervous system and the human psyche. Such drugs are widely used in the treatment of depressive and anxiety disorders and other mental illnesses. Next, we will get acquainted with the description and action of various neurotropic drugs, but first consider their classification.
Classification
Anxiolytics are classified as neurotropic drugs along with antidepressants, local irritants, anesthetics, narcotic drugs, antipsychotics, nootropics, general tonic drugs and adaptogens. In addition, this category of drugs includes antiparkinsonian and antiepileptic drugs, hypnotics and sedatives,psychostimulants, as well as drugs that affect neuromuscular transmission. Let's consider these categories separately and start with anxiolytics.
Let's take a closer look at the classification of neurotropic drugs.
Anxiolytics and their effects
Anxiolytic effect is predominantly exerted by substances that are classified as tranquilizers. They are used mainly in the presence of neuroses in patients with a state of mental overstrain and fear. Drugs in this category have not only an anxiolytic effect. They also have hypnotic, muscle relaxant and anticonvulsant properties to varying degrees.
Tranquilizers are especially characterized by an anxiolytic and sedative effect. The hypnotic effect is expressed in facilitating the onset of sleep, enhancing the effects of sleeping pills, analgesics and narcotic drugs.
The muscle relaxant activity of anxiolytics, which is associated with an effect on the nervous system, and not with a peripheral effect, often serves as a positive factor in the use of tranquilizers to relieve tension with a sense of fear and arousal. True, such drugs are not suitable for those patients whose work requires a concentrated reaction.
When choosing anxiolytics for clinical use, differences in the spectrum of drug effects are taken into account. Some of them have all the properties characteristic of tranquilizers, for example, Diazepam, while others have a more pronounced anxiolytic effect, for example, Medazepam. ATin high doses, any anxiolytics exhibit pharmacological properties characteristic of this category of medicines. Anxiolytics include Alzolam along with Alprazolam, Atarax, Bromazepam, Gidazepam, Hydroxyzine, Grandaxin, Diazepabene, Diazepam and others.
Next, let's move on to centrally acting neurotropic drugs and antidepressants, look at the description of these drugs and find out what their effect on the human body is.
Antidepressants: description and action of drugs
The common property of all antidepressants is their thymoleptic effect, that is, they have a positive effect on the affective sphere of the patient. Thanks to the use of these medicines, people have an improvement in their general mental state and mood. Antidepressants are different. For example, in "Imipramine" and a number of other antidepressants, the thymoleptic effect can be combined with a stimulating effect. And drugs such as Amitriptyline, Pipofezin, Fluacizin, Clomipramine and Doxepin have a more pronounced sedative effect.
Maprotiline has an antidepressant effect combined with a sedative and anxiolytic effect. Monoamine oxidase inhibitors, such as Nialamide and Eprobemide, have a stimulating property. The medicine "Pirlindol" relieves the symptoms of depression in people, showing nootropic activity and improving the cognitive functions of the nervous system. Antidepressants are used not only in the psychiatric field, but also in the treatment of neurovegetative and somatic diseases.
The therapeutic effect of oral and parenteral antidepressants usually develops gradually and does not appear until ten days after the start of treatment. This can be explained by the fact that the antidepressant effect is associated with the accumulation of neurotransmitters in the region of nerve endings, and, in addition, with a slowly appearing adaptive change. Antidepressants include drugs in the form of "Azafen", "Befol", "Bioxetine", "Gidifen", "Deprex", "Zoloft", "Imizin", "Lerivon", "Petilil" and other drugs.
Classification of neurotropic antihypertensive drugs is presented below.
Local irritants
Local irritating drugs excite the nerve endings in the skin, causing a local and reflex reaction that improves tissue trophism and blood supply. These medications also help relieve pain. Local release of histamine and prostaglandins also plays a role in their mechanism of action.
Irritation of mucosal, subcutaneous and skin receptors is usually accompanied by the release and formation of dynorphins, enkephalins, endorphins and peptides, which are of great importance for the perception of pain. Some local drugs in this category can be absorbed to varying degrees and thus cause a resorptive systemic effect, while they affect various regulatory processes.
Integral reflex action of irritating substances may be accompanied by expansionvessels, as tissue trophism improves along with the outflow of fluid. In addition, there is a decrease in pain sensations. Directly the field of application of irritating drugs includes, first of all, bruises, myositis and neuritis. It is also advisable to use them for arthritis, sprains, circulatory disorders and the like.
What other drugs are included in the list of neurotropic drugs?
Local anesthetics: description and action of the drug subgroup
Local anesthetics are aimed at reducing, as well as completely suppressing the excitability of sensitive nerve endings in the skin, mucous membranes and other tissues with direct contact. Depending on the use of a local anesthetic, terminal anesthesia is distinguished, in which the anesthetic is applied to the surface on which it blocks the endings of the most sensitive nerves, and infiltration, when the skin and deeper tissues are sequentially impregnated with an anesthetic solution. In addition, conduction anesthesia is distinguished, in which the anesthetic is injected along the course of the nerve, due to which there is a blockage of the conduction of excitation along the nerve fibers. These neurotropic drugs are very popular in pharmacology.
The first component found to have local anesthetic activity was cocaine alkaloid. Due to its high toxicity, this substance is currentlytime is hardly used. In modern anesthesiology, doctors use a number of local synthetic anesthetics. These include "Anestezin" along with "Novocain", "Trimekain", "Dicain" (this drug is mainly used in ophthalmic practice), "Pyromecain" and "Lidocaine". More recently, long-acting local anesthetics such as Bupivacaine have been developed.
The scope of various drugs directly depends on their pharmacological and physico-chemical properties. For example, the insoluble substance anestezin is used only superficially. As for soluble drugs, they are used for various types of local anesthesia.
A number of local anesthetics have antiarrhythmic activity. "Lidocaine" is relatively widely used in certain types of arrhythmias. For the same purposes, "Trimekain" is used. Among the local anesthetics, it is also worth mentioning drugs in the form of "Dicain", "Inocaine", "Xylocaine", "Marcaine", "Naropina", "Pramoxin", "Rihlokaine", "Scandonest" and "Cytopicture".
What other neurotropic drugs are there?
Next, consider anesthetic drugs and their description.
Anesthetics and their description
For the purpose of general anesthesia, that is, directly for anesthesia or general anesthesia, various drugs are used in modern anesthesiology. Depending on their physical and chemical properties, and in addition, methods of application, they are divided into inhalationdrugs and non-inhaled.
Medications for inhalation anesthesia include a number of easily evaporating liquids in the form of a substance called "halothane" and gaseous elements, mainly nitrous oxide. Due to their good anesthetic properties and safety, fluorinated hydrocarbons, especially halothane, are widely used in anesthetic practice, replacing the previously used cyclopropane. Lost its value as a substance for anesthesia chloroform. Substances for non-inhalation anesthesia include barbiturates in the form of sodium thiopental and non-barbituric drugs such as ketamine hydrochloride and propanidide.
For immersion in anesthesia, non-inhaled narcotic neurotropic drugs of peripheral action are often used, which are administered intravenously or intramuscularly. The main anesthesia is carried out with inhalation or non-inhalation drugs. Basic anesthesia can be single-component or multi-component. Induction anesthesia is carried out with special concentrations of drugs, for example, using nitrous oxide mixed with oxygen.
In preparation for the operation, a premedication procedure is carried out, which includes the appointment of analgesic, sedative, anticholinergic and other drugs to the patient. Such funds are used to reduce the negative impact on the body of emotional stress, which usually precedes the operation. Thanks to these medicines, it is possible to prevent the possible side effects that are associated with anesthesia and surgery, we are talking about reflex reactions,hemodynamic disorders, increased secretion of the glands of the respiratory tract, and the like. Premedication helps facilitate anesthesia. Due to premedication, the concentration of the substance used for anesthesia decreases, and at the same time, the excitation phase is less pronounced.
Presently used drugs include Ketalar, Narcotan, Recofol, Thiopental, Urethane, Chloroform and others.
Neuroleptics are also neuroleptics.
Description and action of neuroleptics
Neuroleptics include drugs that are designed to treat psychosis and other severe mental disorders in humans. The category of antipsychotic drugs includes a number of phenothiazine derivatives, for example, Chlorpromazine, butyrophenones in the form of Haloperidol and Droperidol, as well as diphenylbutylpiperidine derivatives, Fluspirilene.
These centrally acting neurotropic agents can have a multifaceted effect on the human body. Their main pharmacological properties include a kind of calming effect, which is accompanied by a decrease in response to external stimuli. At the same time, a weakening of psychomotor arousal can be observed along with affective tension, a weakening of aggressiveness and suppression of a sense of fear. Such medications can suppress hallucinations, delusions, automatism and other psychopathological syndromes. Thanks to neuroleptics, there is a therapeutic effect on patients with schizophrenia andother mental illnesses.
Neuroleptics in normal dosages do not have a pronounced hypnotic effect, but they can cause a drowsy state, thereby contributing to the onset of sleep and enhancing the effect of sleeping pills and other sedative medications. They potentiate the effects of analgesics, drugs, local anesthetics, weakening the effects of psychostimulant drugs. Neuroleptics, first of all, include Solian, along with Sonapax, Teralen, Tizercin, Fluanxol, Chlorpromazine, Eglek, Eskasin and others.
Neurotropic antihypertensives
Peripheral neurotropic drugs include ganglioblockers, sympatholytics and adrenoblockers.
Ganglioblockers block the conduction of vasoconstrictor impulses at the level of sympathetic ganglia. MD is due to the inhibition of n-ChR, which makes it difficult to conduct excitation from preganglionic to postganglionic fibers. This is accompanied by a decrease in arteriole tone and total peripheral vascular resistance, a decrease in vein tone and venous return of blood to the heart. At the same time, blood pressure and cardiac output decrease, blood is deposited in the veins of the abdominal organs, in the lower extremities, and the mass of circulating blood decreases, pressure in the right ventricle and pulmonary artery decreases, and reflex vasoconstrictor reactions are inhibited. Today, ganglioblockers for the treatment of hypertension are little used, as they give many side effects: orthostatic hypotension, inhibition of intestinal motility, constipation, atony of the bladder andothers
Neurotropic antihypertensive drugs are rapidly addictive. Applied with severe (complicated) hypertensive crises, progressive hypertension, not amenable to the action of other drugs. Very carefully should be prescribed to patients older than 60 years. In crises, medium-acting drugs (benzohexonium, pentamine) are usually prescribed parenterally, and for long-term use, pyrilene is administered orally (10–12 hours are effective). For controlled hypotension, short-acting neurotropic antihypertensive drugs (hygronium, arfonad) are used. Ganglion blockers are also used in the treatment of local vascular spasms (endarteritis, Raynaud's disease, acrocyanosis).
Sympatholytics. The main drug is Oktadin. MD is associated with the depletion of norepinephrine stores in sympathetic endings, and as a result, the transmission of vasoconstrictor impulses in peripheral adrenergic synapses is inhibited. The hypotensive effect develops gradually (after 1-3 days) and lasts 1-3 weeks after the withdrawal of this drug from the group of neurotropic antihypertensive drugs. PE: orthostatic hypotension, bradycardia, dyspeptic disorders, exacerbation of peptic ulcer and bronchial asthma.
"Clonidine" ("Clonidine") - the antihypertensive effect of the drug is due to the effect on adrenaline A2 and imidazoline I2 receptors in the centers of the medulla oblongata. When using the drug, the production of renin in the kidney cells decreases, cardiac output decreases, the vessels dilate. Valid 6-12hours;
"Guanfacine" and "Methyldopa" also contribute to the expansion of blood vessels and slow down cardiac activity. They act longer than Clonidine, up to 24 hours. These substances, like Clonidine, have a number of significant side effects. Significantly pronounced sedation, dry mouth, depression, edema, constipation, dizziness and drowsiness;
Moxonidine is a second-generation centrally acting neurotropic antihypertensive agent, its mechanism of action is more advanced. It selectively acts on imidazoline receptors and inhibits the action of sympathetic NS on the heart. Has fewer side effects than the above centrally acting agents.
Action and description of sedatives
Sedatives are drugs that have a general calming effect on the nervous system. The sedative effect is manifested in a decrease in the reaction to various external stimuli. Against the background of their use, people experience a slight decrease in daily activity.
Drugs of this category regulate the functions of the nervous system, enhancing the processes of inhibition and reducing excitation. As a rule, they enhance the effect of sleeping pills, facilitating the onset and natural sleep. They also enhance the effect of analgesics and other drugs that are aimed at suppressing the nervous system.
Let's consider these neurotropic agents and preparations in more detail. Sedatives include bromine preparations, namely: sodium and potassium bromide, camphor bromide and agentswhich are made from medicinal plants such as valerian, motherwort, passionflower and peony. Bromides began to be used in medicine quite a long time ago, back in the century before last. The effect of bromine s alt on nervous activity was studied by I. Pavlov and his students.
According to the data, the main effect of bromides is directly related to the ability to enhance the processes of inhibition in the brain. Thanks to these drugs, the disturbed balance between the process of inhibition and excitation is restored, especially with increased excitability of the nervous system. The impact of bromides largely depends on the type of higher nervous activity, and in addition, on the functional state of the nervous system. Under experimental conditions, it has been proven that the lower the severity of functional impairment in the cerebral cortex, the lower the dosage required to correct these failures.
Direct dependence of the therapeutic dosage of bromides on the type of nervous activity has been confirmed in the clinic. It is in connection with this that it is necessary to take into account the type and condition of the nervous system in the process of selecting an individual dose.
The main indication for the appointment of sedatives is increased nervous excitability. Other indications are irritability along with vegetative-vascular disorders, sleep disorders, neuroses and neurosis-like states. Compared to sleeping pills, sedatives (especially herbal ones) may have a less pronounced sedative effect.impact. It should be noted that sedatives are well tolerated along with the absence of serious adverse reactions. They, as a rule, do not cause drowsiness, ataxia, addiction or mental dependence. Due to these advantages, sedatives are now widely used as part of daily outpatient practice. The most popular of them are Valocordin along with Valoserdin, Kliofit, Lavocordin, Melaxen, Nervoflux, Novopassit, Patrimin and others.
The classification of neurotropic drugs does not end there.
Sleeping pills
Sleeping pills are currently represented by drugs of various chemical groups. Barbiturates, which for a long time were the main sleeping pills, are now losing their leading role. But compounds from the benzodiazepine series are increasingly being used in the form of Nitrazepam, Midazolam, Temazepam, Flurazepam and Flunitrazepam.
It is important to remember about the incompatibility of neurotropic drugs, chemotherapy drugs and alcohol.
All tranquilizers are able to have a sedative effect on the human body to some extent, contributing to the onset of sleep. According to the intensity of some aspects of the impact, various drugs in this category may differ slightly from each other. The drugs that have the most pronounced hypnotic effect include Triazolam and Phenazepam.
So, we have reviewed the main categories of neurotropic drugs that are currently widely used in various fieldsmedical practice.
