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A van der Waals’ bond (B) is formed between apolar molecular groups that have come into close proximity. Spontaneous transient distortion of electron clouds (momentary faint dipole, ??) may induce an opposite dipole in the neighboring molecule.
On the other hand, the high rate of bioinactivation and, therefore, shortened duration of action is a disadvantage. Procaine cannot be used as a surface anesthetic because it is inactivated faster than it can penetrate the dermis or mucosa. The amide type local anesthetic lidocaine is broken down primarily in the liver by oxidative N-dealkylation.

 

The latter diffuses into the subjacent smooth musculature, where it causes a relaxation of active tonus. Acetylcholine (ACh) is too rapidly hydrolyzed and inactivated by acetylcholinesterase (AChE) to be of any therapeutic use; however, its action can be mimicked by other substances, namely direct or indirect parasympathomimetics.
Finally, signalling substances can originate from neighboring cells, e.g., prostaglandins and cytokines. The effect of a drug frequently results from interference with cellular function. Receptors for the recognition of endogenous transmitters are obvious sites of drug action (receptor agonists and antagonists.

 

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