Neurotropic drugs have an effect on the central and peripheral nervous system. This category of drugs includes anesthetic and antiepileptic drugs, and in addition, analgesics. These medicines 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 we will consider their classification.
Classification
Anxiolytics along with antidepressants, locally irritating drugs, anesthetics, narcotic drugs, antipsychotics, nootropics, general tonic medicines and adaptogens are classified as neurotropic drugs. In addition, this category of drugs includes antiparkinsonian and antiepileptic drugs, sleeping pills and sedatives , psychostimulants, as well as drugs that affect neuromuscular transmission. We will consider these categories separately and begin with anxiolytics.
Let us consider in more detail the classification of neurotropic drugs.
Anxiolytics and their effects
The anxiolytic effect is exerted mainly by substances that belong to tranquilizers. They are mainly used in patients with neurosis with a state of mental overstrain and fear. Drugs in this category have not only anxiolytic effects. To varying degrees, they also have a hypnotic, muscle relaxant, and anticonvulsant property.
Anxiolytic and calming effect is especially characteristic for tranquilizers. The hypnotic effect is expressed in facilitating the onset of sleep, enhancing the effects of sleeping pills, analgesics and drugs.
The muscle relaxant activity of anxiolytics, which is associated with an effect on the nervous system, and not with peripheral effects, often serves as a positive factor in the use of tranquilizers to relieve tension with a sense of fear and excitement. 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 effects of drugs 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. In large dosages, any anxiolytics exhibit pharmacological properties characteristic of this category of medicines. Anxiolytics include Alzolam along with Alprazolam, Atarax, Bromazepam, Hydazepam, Hydroxysin, Grandaxin, Diazepabene, Diazepam and others.
Next, we will move on to central-acting neurotropic drugs and antidepressants, consider the description of these drugs and find out what their effect on the human body is.
Antidepressants: description and effect of drugs
The common property of all antidepressants is their timoleptic effect, that is, they have a positive effect on the patient's affective sphere. Thanks to the use of these medicines, people have an improvement in their general mental state and mood. Antidepressants differ among themselves. For example, at Imipramin and a number of other antidepressants, the timoleptic effect can be combined with a stimulating effect. And such drugs as Amitriptyline, Pipofesin, Fluacisin, Clomipramine and Doxepin have a more pronounced sedative effect.
Maprotiline has an antidepressant effect combined with sedative and anxiolytic. Monoamine oxidase inhibitors, for example, Nialamide and Eprobemide, have a stimulating property. The medicine “Pirlindole” relieves the symptoms of depression in people, showing nootropic activity and improving cognitive functions of the nervous system. Antidepressants are used not only in the psychiatric field, but also in the treatment of neuro-vegetative and somatic diseases.
The therapeutic effect of antidepressants with oral and parenteral use usually develops gradually and appears only 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", "Befola", "Bioxetine", "Hydifen", "Deprex", "Zoloft", "Imizin", "Lerivon", "Petilila" and other medicines.
The classification of neurotropic antihypertensive drugs is presented below.
Locally irritating
Locally irritating medicines excite the nerve endings in the skin, causing a local and reflex reaction, which improves tissue trophism and blood supply. Such drugs also help relieve pain. Local release of histamine and prostaglandins also plays a role in their mechanism of action.
Irritation of receptors of mucous membranes, subcutaneous masses and skin, as a rule, is 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 of this category to one degree or another can be absorbed and thereby cause a resorptive systemic effect, while they affect various regulatory processes.
The integrated reflex effect of irritating substances can be accompanied by vasodilation, as tissue trophism improves along with fluid outflow. In addition, there is a weakening of pain. The immediate 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.
Apifor along with Betalgon, Vipralgon, Capsicam, Menthol, Nikoflex, Pikhanol, Spirol, Finalgon and so on are classified as irritating medicines.
What drugs are still on the list of neurotropic drugs?
Local anesthetics: description and effect of the drug subgroup
Local anesthetics are aimed at lowering, as well as at completely suppressing the excitability of sensitive nerve endings in the skin, mucous membranes and other tissues with direct contact. Depending on the use of local anesthetic, terminal anesthesia is allocated , in which anesthetic is applied to the surface on which it blocks the ends 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 isolated, in which anesthetic is injected along the nerve, due to which blocking of the conduction of excitation along nerve fibers occurs. These neurotropic drugs in pharmacology are very popular.
The first component in which local anesthetic activity was detected was cocaine alkaloid. Due to its high toxicity, this substance is currently almost never used. In modern anesthesiology, doctors use a number of local synthetic anesthetics. These include Anestezin along with Novocain, Trimekain, Dikain (this drug is mainly used in ophthalmic practice), Pyromecain and Lidocain. Recently, long-acting local anesthetics, for example, Bupivacaine, have been developed.
The scope of application 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" has a relatively widespread use in some types of arrhythmias. For the same purposes, "Trimekain" is used. Among local anesthetics, it is also worth mentioning drugs in the form of Dikain, Inocain, Xylocain, Markain, Naropin, Pramoxin, Rychlokain, Scandonest and Cytokartin.
What other neurotropic drugs are there?
Next, we consider anesthetic drugs and their description.
Anesthetics and their description
For the purpose of general anesthesia, that is, directly for anesthesia or for general anesthesia, different drugs are used in modern anesthesiology. Depending on their physical and chemical properties, and in addition, methods of use, they are divided into inhaled and non-inhaled.
Medications for inhalation anesthesia include a number of easily evaporating liquids in the form of a substance called “fluorotan” and gaseous elements, mainly nitrous oxide. Due to their good narcotic properties and safety, fluorinated hydrocarbons, in particular fluorotane, are widely used in anesthesiology practice, displacing the previously used cyclopropane. Chloroform has lost its significance as a substance for anesthesia. Substances for non-inhalation anesthesia include barbiturates in the form of sodium thiopental and non-barbituric agents, for example, ketamine hydrochloride and propanidide.
For immersion in anesthesia, non-inhalation narcotic neurotropic drugs of peripheral action are often used, which are administered intravenously or intramuscularly. Basic anesthesia is carried out by inhalation or non-inhalation drugs. The main anesthesia is 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 surgery. Thanks to these medicines, it is possible to prevent possible side effects that are associated with anesthesia and surgery, we are talking about reflex reactions, hemodynamic disorders, increased secretion of the respiratory glands and the like. Premedication helps ease anesthesia. Thanks to premedication, the concentration of the substance used for anesthesia decreases, and at the same time, the excitation phase is less pronounced.
Anesthetics currently used include drugs in the form of Ketalar, Narcotan, Rekofol, Thiopental, Urethane, Chloroform and others.
Antipsychotics also belong to neurotropic drugs.
Description and action of antipsychotics
Antipsychotics include drugs that are intended to treat psychoses and other severe mental disorders in people. A number of phenothiazine derivatives are included in the category of antipsychotic drugs, for example, Chlorpromazine, butyrophenones in the form of Haloperidol and Droperidol, and also diphenylbutylpiperidine derivatives Fluspirilen.
These central neurotropic drugs 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. In this case, weakening of psychomotor agitation can be observed along with affective tension, weakening of aggressiveness and suppression of feelings of fear. Such medications can suppress hallucinations, delusions, automatism and other psychopathological syndromes. Thanks to antipsychotics, there is a therapeutic effect on patients with schizophrenia and other mental illnesses.
Neuroleptics do not have a pronounced hypnotic effect in normal dosages, but they can cause a drowsiness, thereby contributing to the onset of sleep and enhancing the effect of sleeping pills and other soothing medications. They potentiate the effects of analgesics, drugs, local anesthetics, weakening the effects of psychostimulating drugs. To the antipsychotics, first of all, they include Solian along with Sonapaks, Teralen, Tizercin, Fluanksol, Chlorpromazine, Eglek, Eskazin and others.
Neurotropic antihypertensive drugs
Peripheral neurotropic drugs include ganglion blockers, sympatholytics, and adrenergic blockers.
Ganglion blockers block the holding of vasoconstrictive impulses at the level of the sympathetic ganglia. MD is due to inhibition of n-XP, making it difficult to conduct excitation from preganglionic to postganglionic fibers. This is accompanied by a decrease in the tone of arterioles and general peripheral vascular resistance, a decrease in the tone of the veins and venous return of blood to the heart. At the same time, blood pressure decreases, cardiac output, 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 suppressed. Today, ganglion blockers do not use much for the treatment of hypertension, since they give many side effects: orthostatic hypotension, inhibition of intestinal motility, constipation, atony of the bladder, etc.
Addiction quickly develops to neurotropic antihypertensive drugs. Used for severe (complicated) hypertensive crises, progressive hypertension, not amenable to the action of other drugs. Very carefully, patients over 60 years of age should be prescribed. For crises, medications of average duration of action are usually administered parenterally (benzohexonium, pentamine), and for prolonged use, pyrene is administered orally (10-12 hours). For controlled hypotension, neurotropic antihypertensive drugs of short action (hygronium, arfonad) are used. Ganglion blockers are also used in the treatment of local vascular spasms (endarteritis, Raynaud's disease, acrocyanosis).
Sympatolytics. The main drug is Octadin. MD is associated with depletion of norepinephrine reserves in the sympathetic endings, and as a result, the transmission of vasoconstrictive impulses in peripheral adrenergic synapses is inhibited. The antihypertensive 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 exposure to adrenaline A2 and imidazoline I2 receptors in the centers of the medulla oblongata. When using the drug, renin production in the renal cells decreases, cardiac output decreases, blood vessels expand. Valid for 6-12 hours;
"Guangfatsin" and "Methyldopa" also contribute to the expansion of blood vessels and slow down cardiac activity. Act longer than "Clonidine", up to 24 hours. These substances, like Clonidine, have a number of significant side effects. Significantly expressed sedation, a feeling of dry mouth, depression, swelling, constipation, dizziness and drowsiness;
"Moxonidine" is a neurotropic antihypertensive agent of the second-generation central action, its mechanism of action is more perfect. It selectively acts on imidazoline receptors and inhibits the effect of sympathetic NS on the heart. It is characterized by fewer side effects than the above funds with a central effect.
Effect and description of sedatives
Sedatives are drugs that have a general calming effect on the nervous system. Sedation is manifested in a decrease in reaction to various external stimuli. .
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The main indication for the appointment of sedatives is increased nervous irritability. Other indications are irritability along with vegetative-vascular disorders, sleep disturbances, neuroses and neurosis-like conditions. Compared with sleeping pills, sedatives (especially of plant origin) can have a less pronounced calming effect. It should be noted that sedatives are characterized by good tolerance along with the absence of serious adverse reactions. They usually do not cause drowsiness, ataxia, addiction or mental dependence. Thanks to these advantages, sedatives are now widely used as part of everyday outpatient practice. The most popular of them are “Valocordin” along with “Valoserdin”, “Kliofit”, “Lavokordin”, “Melaxen”, “Nervoflux”, “Novopassit”, “Patrimin” and others.
The classification of neurotropic drugs does not end there.
Sleeping pills
Hypnotics are currently represented by drugs of various chemical groups. Barbiturates, which have long been the main sleeping pills, now lose their leading importance. But the compounds from the benzodiazepine series in the form of Nitrazepam, Midazolam, Temazepam, Flurazepam and Flunitrazepam are increasingly being used.
It is important to remember about the incompatibility of neurotropic drugs, chemotherapy drugs and alcohol.
All tranquilizers are able to have a varying degree of sedative effect on the human body, 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 examined the main categories of neurotropic drugs, which are currently widely used in various fields of medical practice.