¿Cómo sabe la medicina DÓNDE curarte?

Oh! Have you had your wisdom teeth removed? After the procedure, they prescribe an anti-inflammatory and analgesic that makes you feel much better. Ahhhhh! But how does ketorolac know which tooth was removed? How does medicine know where to cure me?

To find out, let’s follow the journey of a pill. It is important to mention that there are thousands of approved medications and they all work differently, but let’s see what happens in general. After taking a pill, it reaches the stomach,

Where it can dissolve, pass through the epithelial cells and reach the blood vessels, or if the tablet or capsule has a resistant coating, it can pass completely through the stomach and dissolve in the small intestine. , and once dissolved it also passes

Into the blood vessels. In both cases the blood vessels carry the medicine to the liver. In the liver, part of the medicine is metabolized and forms metabolites that are directly excreted, but not all of the medicine molecules are metabolized and these are the ones that pass

Into the circulatory system. The drug molecules are then transported to your organs and tissues. The reality is that the medicines you take, in addition to reaching the part that hurts, are distributed throughout almost the entire body, which is why the list of side effects can be

Enormous. It is inevitable that the medicine reaches other places, although researchers modify the molecules and develop medications that act more in the places they want to cure. Now, you are probably wondering that if the liver metabolizes a part of the medicine and

Excretes it without it having been used, why don’t doctors always give us intravenous injections that go directly into the circulatory system? What are tablets, capsules, tablets and creams used for? Well, sometimes you want the effect to be gradual and that can be

Achieved with pills, whose substances are released little by little. There are even medicines that must be taken with food, so that absorption is slower and more effective. Other compounds are inactive when taken and require the action of liver proteins to

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Transform them into an active ingredient that your body can use. In the case of eye ointments and drops , they heal only the affected part and this reduces side effects. On the other hand, there are medications that must always be injected, such as monoclonal antibodies,

Which are proteins to treat cancer, which if consumed orally, the stomach would digest them as it does with any protein and they would not reach the circulatory system. But we still haven’t answered you, how do the medicines work? Well, it all depends on which one.

There are some medications that bind to receptors that have specific functions. Receptors are proteins in our cells that are like a lock, when a molecule with the correct shape binds to the receptor, it is like a key that opens a lock,

This generates an electrical or biochemical signal within the cell that triggers a response. Molecules capable of producing a response are called agonists. These molecules can be produced by your body, and would be like a master key, or they can be artificial,

In which case they look like the master key, but are a copy. Some artificial agonists can produce a reaction even stronger than the molecules in your body. For example, in your body you have opioid receptors of the Mu subtype, which are “opened” by your endorphins,

Which are a natural pain reliever. Your body does not produce morphine, but this molecule is so similar to endorphin that it is able to “fit” into the opioid receptors of your cells and, like endorphins, prevents pain signals from reaching the

Central nervous system. Just as there are agonist molecules, there are also antagonist molecules. These attach to the receptors, which, although they “fit” the receptors, do not “open” the lock and there is no reaction. Naloxone (e) is a medication used when there is an overdose of morphine.

This medication has a high affinity for the Mu opioid receptors, but it does not allow a reaction in the cell, it is as if it took the place of the lock, but the key is not turned. When the lock is occupied, morphine can no longer bind to opioid receptors.

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Loperamide also acts on the mu receptors in the intestine and causes bowel movements to slow down, allowing more water to be absorbed. Hmm..If it acts on the same Mu receptors, does loperamide act like morphine? Yes, but loperamide has its effect in the large intestine and very little passes into the

Circulatory system and is completely unable to cross the blood-brain barrier, unlike morphine, so the side effects do not affect the nervous system. Ibuprofen disintegrates in the stomach and passes into the circulatory system. Oops, but first a little pause. When cells are damaged they produce arachidonic acid,

The COX cyclooxygenase enzymes convert this into prostaglandin H2 and this into different molecules that cause pain and inflammation that send the pain message to the brain. Ibuprofen inhibits the action of cyclooxygenases, preventing prostaglandin from being formed. Obviously this does not cure the cells,

But it helps relieve the symptoms. The bad thing is that one of these cyclooxygenases also produces prostaglandins that line the stomach wall and by inhibiting the action the wall can be damaged. Acetaminophen, better known as paracetamol, the one that doctors like to prescribe so much,

Is absorbed in the small intestine and from there it passes to the liver. Paracetamol is capable of crossing the blood-brain barrier and reaching the brain. When it reaches the hypothalamus, it blocks the synthesis of prostaglandin E2, which raises the temperature, so blocking it helps reduce fever,

Although it is not well known how it does it. Even less is known about its analgesic effect, but it is believed (although not convincingly) that it blocks cyclooxygenase 3. Antidepressants such as amitriptyline or fluoxetine affect serotonin membrane transporters . Membrane transporters carry free molecules out

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Of the cell and into the cell. When this mechanism is affected, serotonin stays outside longer so that it continues stimulating the receptors. As you can see, it is something very complex and the truth is that we do not know many of the steps that make a medication work. We would like

To think that the discovery or development of medicines follows the scientific method rigorously, but most medicines were discovered by serendipity and only after seeing their effects has there been research into how they work. That is why there are medications that have been more

Useful due to their side effects. Viagra was originally a medication to regulate blood pressure. Thalidomide was used for nausea in pregnant women until it was found to cause babies to be born with very short or missing limbs, but today it is an effective treatment against cancer and leprosy. Or minoxidil

, which was used to treat hypertension and ended up helping hair growth! The difficulty not only lies in the lack of knowledge of the internal processes, it is also that we are all a little different, from our age, lifestyle, other diseases we suffer,

Medicines we take, but also our genes determine the time it takes to digest. or the different variants of proteins that we produce. So the right medication and the dosage needed may vary from person to person. Fortunately, there are already pharmacogenetic studies

And it is possible to know how well your body adapts to certain medications. Pharmacology is far from perfect, but thanks to research we increasingly know a little more about how medicines cure us. Curiously! Did you imagine it would be like this?

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