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Hey Boghog. After some thought, I'm not sure indirect agonists actually reflect a mechanism of action, provided that a mechanism is necessarily associated with a ligand interaction at a biomolecular target and a mode is associated with a functional effect of that interaction. A (direct) agonist is obviously a mechanism, although there's several functional subclasses of indirect agonists, based upon how they promote neurotransmitter binding at postsynaptic receptors. For example, DAT blockade by cocaine causes dopamine reuptake inhibition, and DAT binding/blockade would obviously be its mechanism of action in dopamine neurons. Transporter reuptake inhibition, however, is a functional consequence rather than a mechanism, since a drug's biomolecular target doesn't need to be the transporter itself to produce this effect (e.g., amphetamine-induced reuptake inhibition involves DAT endocytosis via TAAR1-mediated PKA signaling). Indirect receptor agonism is in turn an effect of reuptake inhibition. Since enzyme inhibition (e.g., MAO-A for serotonin) and neurotransmitter efflux, among other things, cause indirect receptor agonism as well, the term really describes a downstream effect that arises from several triggering mechanisms.

I guess my point is: if a mechanism reflects the interaction of a drug with its initial biomolecular target and a mode describes a downstream effect of the interaction with that target, direct agonists and indirect agonists would reflect a mechanism and a mode respectively. Seppi333 (Insert 2¢) 21:21, 6 November 2015 (UTC)[reply]

Hej Seppi. Interesting semantic question. If there are multiple indirect pathways that stimulate or block a pathway (e.g., Cholinergic, Dopaminergic, GABAergic, Serotonergic), then it would be reasonable to include these in the mode of action section. An indirect agonist may only be a subset of these indirect pathways (others include antagonists, channel blockers or activators, etc.). It is also a bit like combining apples and oranges. All of the other examples currently in this article concern specific mechanisms or modes of action, not a type of mechanism. I may be wrong, but I don't think ATC or other systematic classification would list indirect agonist as a class of drugs. Hence I am not sure that including indirect agonist under mode of action or for that matter mechanism of action is really appropriate. How to classify an indirect agonist I suppose depends on

1. how much is known about the mechanism and
2. how many indirect mechanisms there are for a given effect.

What distinguish a mechanism from mode of action is that the former is molecular while the later is cellular. If both the initial target and down stream target as well as the pathway that links the two are known, then we have a detailed molecular understanding of how that drug works and it would be appropriate to characterize this as a mechanism of action. If only the downstream effect and not the initial target is known, then it would be reasonable to classify this indirect agonist under mode of action. One should keep in mind however that the biological target has been identified for the vast majority of approved drugs (PMID 22711801). In summary, I am leaning toward removing indirect agonist entirely. Boghog (talk) 11:05, 7 November 2015 (UTC)[reply]

Based upon your reply, I agree that it's probably best to cut indirect agonists from the page; I also appreciate the insightful response regarding that class. The cellular/molecular distinction between the two concepts clarifies the relationship IMO. Seppi333 (Insert 2¢) 07:41, 8 November 2015 (UTC)[reply]

Could not the three drug classes antivirals, antibiotics and anti-inflammatory drugs be grouped together, perhaps all three as classes that classify drug according to their mechanism of action? Are these not drugs that have effect by suppressing virus, bacteria and inflammation respectively? I do not immediately see why the classificatory principles of antibiotics and antivirals would necessarily have more in common with the logic that groups together for instance antipsychotics or antidepressants, than with the logic of the NSAID category. It seems that the classification of drug classes into three separate drug class classes is not evident, and that several drug classes could be legitimately assigned to different drug class classes, depending on different arguments. There is not necessarily one correct answer, but one may both argue that antibiotics, for instance, are classified according to their mechanism of action, and that they are classified according to their therapeutic use. If you agree - that it is not evident that anyone drug class belongs to one single drug class class - this point, or a similar one, could perhaps be stated. (See also the section on amalgamated classes which I added.) --Jkbuer (talk) 09:32, 10 December 2015 (UTC)[reply]

Me and My friends are medical students from OMEN- PS - Wikipedia editing efforts will edit this article as much as we can so then it can be verified and get a higher quality than C . We will add more citations, information in updated textbooks, articles and well grounded resources..

btw I just added two sentences from one reliable source that was abt FDA and How does it classify drugs SanabelShaheen (talk) 18:51, 16 September 2023 (UTC)[reply]