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1
Q

How do drugs work?

x7 mechanisms with examples

A

Drugs produce their effects by acting on numerous different systems within
the body.

Below is a list of the effecter sites at which drugs act, along with some clinical examples.

  1. Receptors
    a Ligand-gated ion channels
    • Suxamethonium is an agonist at nAChR while rocuronium is an antagonist.

• Diazepam is an agonist at GABAA receptors while flumazenil is an antagonist.

b G-protein-coupled receptors

• Dobutamine is an agonist at β-adrenoceptors while atenolol is an antagonist.

• Morphine is an agonist at opioid receptors
while naloxone is an antagonist.

c Tyrosine kinase receptors
• Insulin is an agonist at insulin receptors.
d Intracellular receptors
• Hydrocortisone is an agonist at steroid receptors.

  1. Ion channels
    • Lignocaine blocks the fast Na+ channels.
    • Verapamil blocks L-type Ca2+ channels.
  2. Enzymes
    • Neostigmine inhibits acetylcholinesterase.
    • Aspirin inhibits cyclo-oxygenase 1 and 2.
  3. Hormones
    • Carbimazole reduces thyroxine production.
    • Metformin increases insulin production.
  4. Neurotransmitters
    • Ephedrine increases presynaptic noradrenaline release.
    • Amitriptyline and cocaine reduce noradrenaline reuptake.
  5. Transport systems
    • Digoxin inhibits the cardiac Na+/K+ ATPase pump.
    • Furosemide inhibits the Na+/K+/2Cl
    – ATPase pump in the loop of Henle.
  6. Physicochemical
    • Sugammadex chelates rocuronium.
    • Antacids neutralise gastric acids.