Pharmacological modulation of stress-response systems
The regulation of the body's response to a stressor centers on pharmacological modulation of two main pathogenetic systems: the sympathoadrenal and the hypothalamic-pituitary-adrenal axes.
Depending on the nature of the pathological process and the goals of therapy, two groups of medicinal products are used:
- Drugs that block the effects of stress systems: aimed at limiting excessive stress-induced damage. These include adrenolytics, beta-blockers, and glucocorticoid antagonists.
- Drugs that potentiate (enhance) effects: used when stimulation of adaptive responses is necessary. This group comprises catecholamines, glucocorticoids, and mineralocorticoids.
Activation of antistress mechanisms in tissues
Correction of tissue and organ disorders during a stress response is achieved through two strategic pathways.
The first strategic pathway consists in activating central and peripheral antistress systems. This is accomplished by exogenous administration of drugs or stimulation of the endogenous synthesis of key protective substances:
- GABA drugs (gamma-aminobutyric acid derivatives) — reduce excessive excitability of regulatory hubs;
- Antioxidants — scavenge free radicals and prevent oxidative alteration;
- Prostaglandins (PGs) — participate in maintaining local homeostasis and tissue blood flow;
- Adenosine — regulates energy balance and protects cells from exhaustion.
Blockade of cell injury mechanisms
The second strategic pathway of therapy is aimed at the direct prevention and elimination of structural and metabolic disorders in organs and tissues.
| Direction of therapy | Target pathological changes |
|---|---|
| Energy supply | Disorders of energy synthesis and utilization in cells |
| Membrane structure | Alteration of cell membranes and enzyme systems |
| Fluid and electrolyte homeostasis | Ion and water imbalance at the cellular level |
| Genetic apparatus | Alterations in the genetic program of cells and its implementation mechanisms |
| Local regulation | Disorders of local regulatory mechanisms |
Briefly: answers to topical questions
Which specific GABA drugs are used to reduce the excitability of regulatory hubs during stress?
Within the framework of activating antistress mechanisms during a stress response, the sources reference GABA drugs.
GABA drugs and its derivatives include:
- GABA (aminalon\*, gammalon) — GABA itself poorly crosses the blood-brain barrier.
- Nicotinoyl GABA (picamilon\*) — a GABA derivative that penetrates the blood-brain barrier.
- Aminophenylbutyric acid (phenibut\*) — a GABA derivative that penetrates the blood-brain barrier.
- Hopantenic acid (pantogam\*) — a GABA derivative.
- Calcium γ-hydroxybutyrate (neurobutal\*) — a GABA derivative.
GABA is the primary inhibitory neurotransmitter of the central nervous system. GABA drugs improve cerebral metabolism, enhance glucose utilization, and increase the respiratory activity of neurons.
Which beta-blockers are used to limit excessive stress-induced tissue damage?
For the pharmacological management of stress-response systems, the sources indicate adrenoceptor blockers.
Specific beta-blockers mentioned in the sources include:
- Propranolol (anaprin\*).
Adrenoceptor blockers are used in managing the sympathoadrenal and hypothalamic-pituitary-adrenal systems; the goal of this management is to prevent inadequate reactions, eliminate asthenia, irritability, tension, and fear, as well as to adjust the state of these systems to a level appropriate to the strength of the stimulus.
The acronym AGAP helps remember the main antistress substances: Antioxidants, GABA, Adenosine, Prostaglandins.
Class and exam questions
What are the main systems targeted by pharmacological modulation during stress?
The main targets are the sympathoadrenal and hypothalamic-pituitary-adrenal systems.
Which drug classes are used to block the effects of stress systems?
To block stress effects, adrenoceptor blockers, adrenolytics, and glucocorticoid antagonists are used.
How many strategic pathways exist for correcting tissue disorders in stress?
Therapy for tissue disorders in a stress response is carried out via two strategic pathways: activation of antistress mechanisms and blockade of cell injury mechanisms.
Which substances that stimulate anti-stress mechanisms are administered exogenously or formed endogenously?
Such substances include GABA (gamma-aminobutyric acid) drugs, antioxidants, prostaglandins (PGs), and adenosine.
What else to study on this topic
- Mechanisms of action of adrenoceptor blockers and adrenolytics in the hyperactivation of the sympathoadrenal system
- Use of glucocorticoid antagonists to limit stress-induced damage
- The role of GABA drugs and adenosine in central and peripheral antistress defense
- Pathophysiology of cell membrane and enzyme system alteration during stress
- Correction of water-electrolyte imbalance and energy supply disorders in damaged tissues
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