Agen pelepas norepinefrin

Efedrin, salah satu NRA selektif yang paling terkenal.

Agen pelepas norepinefrin (Bahasa Inggris: norepinephrine releasing agent, disingkat NRA), juga dikenal sebagai agen pelepas adrenergik, adalah jenis obat katekolaminergik yang menginduksi pelepasan norepinefrin (noradrenalin) dan epinefrin (adrenalin) dari neuron prasinaptik ke dalam sinapsis. Hal ini pada gilirannya menyebabkan peningkatan konsentrasi ekstraseluler norepinefrin dan epinefrin sehingga terjadi peningkatan neurotransmisi adrenergik.[1][2][3][4]

Jenis obat yang terkait erat dengannya adalah penghambat penyerapan kembali norepinefrin (NRI), misalnya reboksetin.[5][6] Kelas obat lain yang merangsang aktivitas adrenergik adalah kelas agonis reseptor adrenergik.[7]

Penggunaan dan contoh

NRA, seringkali sebagai agen pelepas norepinefrin–dopamin (NDRA) daripada sebagai NRA selektif, digunakan untuk berbagai indikasi klinis termasuk yang berikut:[1][2][8][9]

Obat-obatan ini juga digunakan sebagai obat rekreasi, meskipun biasanya hanya diperuntukkan bagi obat-obatan yang juga memicu pelepasan dopamin dan/atau serotonin, misalnya amfetamin, metamfetamin, MDMA, mefedrona, 4-metilaminoreks, dan MDAI.[19][20][21][22]

Katina dan katinona adalah NRA yang ditemukan secara alami di Catha edulis. Efedrin dan pseudoefedrin juga ditemukan secara alami di Ephedra sinica. Kedua tumbuhan ini digunakan secara medis (dan juga secara rekreasional terkait yang pertama).[23][24][25] Amina jejak endogen fenetilamina dan tiramina adalah NRA yang ditemukan pada manusia dan banyak hewan.[26][1][2]

NRA selektif meliputi efedrin, pseudoefedrin, fenilpropanolamina, levometamfetamin, dan D-fenilalaninol. Obat-obatan ini juga melepaskan dopamin dalam jumlah yang jauh lebih sedikit (misalnya ~10 hingga 20 kali lebih lemah).[1][2][25][27] Saat ini belum diketahui adanya NRA yang sangat selektif.[28] Di antara NRA yang paling selektif yang diketahui adalah efedrin, yang memiliki potensi sekitar 19 kali lebih tinggi dalam menginduksi pelepasan norepinefrin dibandingkan pelepasan dopamin dalam satu penelitian.[28][29] Levometamfetamin telah menunjukkan potensi sekitar 15 kali lebih tinggi dalam menginduksi pelepasan norepinefrin dibandingkan pelepasan dopamin.[27][29] D-Fenilalaninol memiliki potensi 13 kali lebih tinggi dalam menginduksi pelepasan norepinefrin dibandingkan pelepasan dopamin.[27] Berbeda dengan levometamfetamin, levoamfetamin adalah NDRA, dengan preferensi hanya sekitar 3 kali lipat untuk menginduksi pelepasan norepinefrin dibandingkan pelepasan dopamin dalam satu penelitian (dibandingkan dengan dekstroamfetamin yang kira-kira sama kuatnya dalam pelepasan norepinefrin dan dopamin dalam penelitian yang sama).[21] NRA memainkan peran penting dalam pengobatan ADHD, obesitas, narkolepsi, dan sebagai simpatomimetik dengan meningkatkan sinyal adrenergik.[1][2][8][30]

Mekanisme kerja

Lihat juga

Referensi

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