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Receptor theory and drug targets

Classification of pharmacodynamic targets

Pharmacodynamics examines how drugs exert their effects in the body and the molecular or physicochemical mechanisms through which they modify its function.

Drug targets are most commonly proteins, but nucleic acids, components of pathogens and nonspecific chemical or physical interactions may also contribute to drug effects.

Important: the examples below help classify drug targets. A drug may have several targets and more than one mechanism of action.
Main category Target group Target type Specific target or mechanism Example drug
Proteins Ion channel Voltage-gated ion channel Voltage-gated Na⁺ channel Lidocaine
L-type Ca²⁺ channel Amlodipine
Enzyme Catalytic protein Angiotensin-converting enzyme (ACE) Ramipril
Cyclooxygenase enzymes (COX) Ibuprofen
Monoamine oxidase B (MAO-B) Selegiline
Neprilysin Sacubitril
Transport protein and pump Membrane transporter Serotonin transporter (SERT) Fluoxetine
Sodium–glucose cotransporter 2 (SGLT2) Remogliflozin
Ion pump Gastric H⁺/K⁺-ATPase proton pump Pantoprazol
Na⁺/K⁺-ATPase Digitoxin
Receptor Ion channel receptor GABAA receptor, ligand-gated Cl⁻ channel Diazepam
NMDA receptor, ligand-gated cation channel Memantine
Intracellular ryanodine receptor, a Ca²⁺-release channel of the endoplasmic reticulum Dantrolene
Enzyme-linked receptor Receptor tyrosine kinase: epidermal growth factor receptor (EGFR) Erlotinib
Receptor tyrosine kinase: anaplastic lymphoma kinase (ALK) Crizotinib
Receptor serine/threonine kinase: TGF-β type I receptor (TGFBR1/ALK5) Galunisertib*
Receptor-associated cytoplasmic tyrosine kinase: cytokine receptor–JAK1/JAK2 signalling Ruxolitinib
Membrane-bound receptor guanylyl cyclase: natriuretic peptide receptor A (NPR-A) Nesiritide
Receptor tyrosine kinase: insulin receptor Insulin
G protein-coupled receptor Gs-coupled β2-adrenoceptor Salbutamol
Gq-coupled M3 muscarinic receptor Oxybutynin
Gi-coupled α2-adrenoceptor Clonidine
Nuclear receptor Oestrogen receptor Tamoxifen
Vitamin D receptor (VDR) Calcitriol
Retinoic acid receptor (RAR) Retinoic acid
Thyroid hormone receptor (TR) Thyroxine (T4; mainly after conversion to T3)
Structural protein Cytoskeletal component Tubulin, the building block of microtubules Vincristine
Other macromolecule Nucleic acid DNA Formation of DNA crosslinks Cisplatin
Formation of DNA strand breaks Bleomycin
Physicochemical and nonspecific effects Acid–base reaction Antacid Chemical neutralisation of gastric acid Magnesium hydroxide
Binding in the intestine Bile acid-binding resin Binding of bile acids in the intestine Colestyramine
Biological neutralisation Antitoxin Neutralisation of a bacterial toxin Tetanus antitoxin
Complex formation Chelating agent Binding of heavy metal ions Dimercaprol
Physical contrast effect Diagnostic contrast agent X-ray absorption Barium sulfate
Targets associated with pathogens Bacterium Enzyme DNA gyrase and topoisomerase IV Ciprofloxacin
Virus Enzyme HIV reverse transcriptase Efavirenz
Fungus Biosynthetic enzyme system Ergosterol biosynthesis (lanosterol 14α-demethylase, CYP51) Fluconazole
Protozoan Enzyme Plasmodium falciparum dihydrofolate reductase Pyrimethamine
Helminth Ion channel Glutamate-gated Cl⁻ channel Ivermectin

* Galunisertib is an investigational compound; it is included as an example of the pharmacological modulation of a receptor serine/threonine kinase.

Sacubitril does not act directly on a receptor guanylyl cyclase. Through neprilysin inhibition, it increases the concentrations of natriuretic peptides, among others, which can then activate the corresponding receptor guanylyl cyclases.

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