[2-(4-imidazolyl)ethylamine] imidazole ring ethyl amine side chain
TRANSCRIPT
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COMMONWEALTH OF AUSTRALIA
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Copyright
All images in this presentation are the property of Jane Hanrahan or publicly available advertising material unless otherwise referenced.
F. E. R. Simons, Advances in H1-Antihistamines. N Engl. J Med, 2004, 351, 2202-2217.
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Lecture Objectives
Understand the tautomersim of histamine and the role this plays in it’s interaction with receptors.
Identify the different classes of antihistamines
Identify the structural features of first generation antihistamines which make the likely to cause side-effects such as sedation, anti-cholinergic effects
Describe the binding and of histamine and antihistamines, including the residues and types of bonds involved, the importance of conformation and stereochemistry
Identify the structural features of second generation antihistamines and be able to explain why these do not cause sedation
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Histamine
[2-(4-imidazolyl)ethylamine]
Imidazole ringEthyl amine side chain
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Histamine Discovered in 1910 Suggested that it mediated symptoms of allergy
eg wheal & flare, rhinitis Now known that it does not account for all
symptoms of allergy Formed by decarboxylation reaction of Histadine
(histadine decarboxylase) Secreted from mast cells and some CNS neurons Similar to a “local hormone” (autocoid), but lacks
endocrine gland
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Allergies Hypersensitivity reaction of the antibody class IgE
Allergens bind to IgE, excessively activating mast cells or basophils which release massive amounts of histamine.
histamine causes inflammation by increasing vasodilation & capillary permeability, smooth muscle contraction, mucus secretion, and parasympathetic nerve stimulation
inflammatory responses range from runny nose to anaphylactic shock
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H1 Receptors
Found in smooth muscle of intestine, bronchi, blood vessels
Effects blocked by classical H1-antagonists Also found in brain but unevenly distributed
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H2 Receptors
Discovered in 1972 by Black et al Gastric parietal cells, guinea pig atria, uterus Control release of gastric acid from gastric
parietal cells
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H3 Receptors
Discovered in CNS in 1983 When histamine was shown to inhibit it’s
own synthesis and release Probably via presynaptic autoreceptors Histamine was also shown to modulate the
release of other neurotransmitters eg ACh, dopamine, NAd, serotonin via H3 receptors
Predominantly present in basal ganglia, hippocampus and cortical areas
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H4 Receptors
Discovered in 2000
widely expressed in components of the immune system such as the spleen, thymus and leukocytes
May benefit allergic conditions
may lead to the treatment of autoimmune diseases. e.g. rheumatoid arthritis and IBS
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TautomersimA basic organic compound,
Np pKa1=5.80
Na, pKa2=9.40
Nt, pKa3=14.0
exists as a mixture of different ionic and uncharged tautomeric species
pH 1
pH 16
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Histamine
exists almost exclusively (96.6%) as the monocationic conjugate species (Na as NH3
+ ) at physiological pH (7.4)
Nt-H (tele- tautomer) predominates (~ 80%)
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Histamine Receptor
Extracellular Extracellular Extracellular
Intracellular Intracellular Intracellular
Inactive Inactive InactiveActive Active Active
Effect of Agonist(histamine)
Effect of inverseagonist (antihistamine)
N Engl J Med (2004) 351;2203-2217.
G protein-coupled receptors (GPCRs) Seven-transmembrane domain receptors (7TM)
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H1 receptor
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Histamine Recognition
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Histamine Recognition
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Histamine Activation
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Ethylenediamines
Mepyramine (R=OCH3) 1943Tripelenamine, (R=H) 1946
Significant CNS and sedative effects
MepyramineRelaxatabs - sedationAnthisan – topical
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Aminoalkyl ethers
Anticholinergic side-effectsSedationLow GI irritation
e.g. Diphenhydramine maleate(Benadryl)
Benadryl Original, Benadryl Night TimeUnisom SleepGels (50mg)
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Aminoalkyl ethers
Dramamine – Dimenhydrinate (50 mg) Mixture of two drugs – diphenydramine (27.2 mg) and 8-chlorotheophylline (22.8 mg)
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Aminoalkyl ethers
Doxylamine succinate• Potent anti-cholinergic effects
Mersyndol - paracetamol 450 mg, codeine phosphate 9.75 mg, doxylamine succinate 5 mg.
Clemastine (Tavist, Tavegyl)• anti-puritic (stops itching)
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Stereochemistry
R1=Ph or 2-PyridineR2=H or MeR=Cl or H
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Aminopropyl Compounds
Less sedation, High incidence of CNS stimulationLow GI irritationUsed mainly in cold & flu remedies
X=H Pheniramine (Visine Allergy Drops)X=Br Brompheniramine (Dimetapp)X=Cl Chlorpheniramine (Demazin)
Dexchlorpheniramine (Polaramine)
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H1 Antagonists
Triprolidine (Actifed)
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Cyclic Basic Chain
Antazoline• Antistine-Privine eye drops• Albalon eye drops
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First Generation H1 Antihistamines
Ar1= Aryl, substituted phenyl, heteroaryl eg 2-pyridylAr2= Aryl, or benzyl (ArCH2)R=tertiary acyclic eg NMe2, or cyclic eg pyrrolidino basic groupAr-N+ distance ~ 5-6 ÅX=N ethylenediaminesCH-O aminoalkyl ethersCH or C=C alkyl amines
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Binding of Antihistamines
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??????
Which of the two aromatic rings of chlorpheniramine would bind to the hydrophobic site on the H1 receptor?
The pyridine ring The p-chlorophenyl ring
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??????
Provide a chemically based explanation for why the p-chlorophenyl ring cannot bind to the H1 receptor hydrophobic site.
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Tricyclic Antihistamines
Promethazine (Phenergan)
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Tricyclic Antihistamines
Alimemazine/trimeprazine - Vallergan
Available as a syrupOften used to help babies and small children sleep
Antipruritic - eczema or poison ivySedativeAnti-emetic - motion sickness.
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Tricyclic Antihistamines
Cyproheptadine - Periactin
Antihistamine, anticholinergic and antiserotonergic activity
AllergyMigraine prophylaxisAppetite stimulant
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Tricyclic Antihistamines
Azatadine - Zadine
Antipruritic - eczema or poison ivySedative.
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Tricyclic Antihistamines
In potent tricyclic systems, rings A and C are not in the same planei.e. the B ring of phenothiazine is a boat shape
Promethazine
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Conformers
trans conformation of diphenhydramine - Active
Fluorene analogue100 times less active
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Pharmacophores
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Summary
Different tautomeric forms of histamine depending on pH
Role of histamine tautomers in receptor binding and recognition
Recognise basic structural features of different classes of first generation H1 antagonists
Identify side effects of first generation H1 antagonists
Role of stereochemistry in activity
Role of conformers in activity
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????
Which of the following properties would be expected of this antihistamine?
Non-sedative
High risk of antimuscarinic side effects
Therapeutic utility as an antipsychotic
Therapeutic utility as an antiemetic
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?????? Describe the structural feature of the
antihistamine responsible for each of the anticipated properties.
High risk of antimuscarinic side effects
Therapeutic utility as an antiemetic
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Second GenerationAntihstamines
Terfenadine R=CH3
Fexofenadine R=COOH (Telfast )
Terfenadine metabolised in body to Fexofenadine
Terfenadine removed from market due to serious cardiac side-effects
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Zwitterionic Roll-Up
C
OH
N CH2 CH2 CH2
H
CH OH
COOC
CH3H3C
+
-ion-ion bond
Fexofenadine
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Fexofenadine
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Second GenerationH1 Antagonists
Astemizole
also causes cardiac side-effects
slow onset and long duration of action
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Second GenerationH1 Antagonists
Loratadine R=COOCH2CH3
Desloratadine R=H
Related to first generation tricyclic antihistamines
No reported cardiac side-effects
Metabolite (desloratadine) reported to be more potent
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Metabolism
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Second GenerationH1 Antagonists
Cetirizine (Zyrtec)
Long duration of action
No reported cardiotoxicity, but some drowsiness
Single enantiomer - less sedation??
Levoceterizine (Zyzal)
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Second GenerationH1 Antagonists
Acrivastine (Hismanal)
Ebastine R=CH3
Carebastine R=COOH
+
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Azelastine
Second GenerationH1 Antagonists
Levocabastine
Olopatadine (Patanol)
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Second GenerationH1 Antagonists
General structure not as clearly defined as for first generation antihistamines
Most non-sedating H1 antagonists still have large aromatic groups at one side
Lipophillic t-butyl group seems to be associated with cardiotoxicity
Active forms have a carboxylic acid group and are zwitterionic at physiological pH, therefore don’t cross BBB
Metabolism to carboxylic acid removes cardiotoxicity