Amines: noradrenaline; serotonin
Endogenous opioid peptides: enkephalins; beta-endorphins; dynorphins Non-opioid peptides: substance P; angiotensin II; vasoactive intestinal peptide (VIP);
cholecystokinin (CCK); oxytocin Excitatory amino acids: glutamate; aspartate Inhibitory amino acids: GABA; glycine Nitric oxide
Table 9.3 Endogenous opioid peptides
Precursor peptide Opioid peptide
Proenkephalin A leu-enkephalin met-enkephalin Proenkephalin B dynorphin dynorphin A(1-8) Pro-opiomelanocortin beta-endorphin
Active receptor Antagonists M __y t delta, mu naloxone m delta, mu naloxone a kappa nalmefene d mu naloxone i mu, delta, kappa naloxone proprioception) exert inhibitory control on small unmyelinated C afferent fibres. This is brought about by postsynaptic inhibition of the dorsal horn neurons, mediated by inhibitory interneurons. Central descending control of the gating system is achieved primarily through the descending inhibitory or endorphin-mediated analgesia system.
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