After more than 60 years of research, the only purinergic compound approved on the basis of its ability to interact with adenosine receptors is adenosine itself in an i.v. formulation for the treatment of cardiac arrythmias. Yet purinergic systems in both the CNS and periphery have been implicated in a wide variety of diseases. The key to exploring the potential of purinergic therapeutics lies in the selection of appropriate therapeutic targets and the development of novel and selective ligands.