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Acetylcholine -muscarinic receptor agonist | |
Metacholine - muscarinic receptor agonist - modification of the ethylene bridge - S(+) equipotent to ACH - beta methyl substitution => more selective to Muscarininc receptor - more resistant to AChE => slow hydrolysis | |
Carbachol -muscarinic receptor agonist - modification of the acetoxy group - converting ester to carbamate - similar ACh potency, same profile -hydrolysis by AChE | |
Bethanechol - muscarinic receptor agonist - beta methyl substitution - potent and selective Muscarinic agonist -S(+) more potent | |
choline ethyl ether - muscarinic receptor agonist - exception to the classical SAR of muscarinic activity | |
alkyl amino ketones - muscarinic receptor agonist - exception to the classical SAR of muscarinic activity | |
L(+)- Muscarine Chloride | |
epimuscarine | |
pilocarpine - alkaloid, produced from Pilocarpus jaborandi - Potent muscarinic agonist - chemically unstable => ring opening | |
pilocarpic acid - inactive - product of hydrolysis of pilocarpine | |
isopilocarpine - epimerization of pilocarpine - inactive product | |
Physostigmine -indirectly acting parasympathomimetics - reversible AChE - 3ary alkaloid obtained from the Calabar Bean, Physostigma venosum - exhibits high affinity to AChE of 10^-9 to carbachol of 10^-4 -used to treat glaucoma and over dose of anticholinergic -light sensitive -undergoes hydrolysis in aqueous solutions | |
eseroline inactive degradation product of physostigmmine in aqueous solutions | |
rubreserine -inactive degradation product of physostigmmine in aqueous solutions - red color | |
neostigmine -indirectly acting parasympathomimetics - reversible AChE synthetic ionized -indicated for Myastenia Gravis | |
pyridostigmine -indirectly acting parasympathomimetics - reversible AChE synthetic ionized -indicated for Myastenia Gravis | |
donepezil hydrochloride -indirectly acting parasympathomimetics - reversible AChE - lack hepatotoxicity - used for Alzheimer's disease | |
tacrine indirectly acting parasympathomimetics - reversible AChE - cause hepatotoxicity - used for Alzheimer's disease | |
rivastigmine indirectly acting parasympathomimetics - reversible AChE - lack hepatotoxicity - used for Alzheimer's disease | |
Edrophonium -used for diagnostic purposes - improve Myastenia Gravis -worsen cholinergic chrisis | |
Malathion irreversible AChEi organophosphate thio group | |
parathion irreversible AChEi organophosphate thio group low Anti-AChE activity | |
sarin irreversible AChEi organophosphate | |
paraoxon irreversible AChEi organophosphate oxo group high Anti-AChE activity | |
echothiophate iodide irreversible AChEi organophosphate ionized => clnical application for glaucoma | |
oxime reactivation of AChE | |
Pralidoxime chloride (2 -PAM) reactivation of AChE | |
obidoxime reactivation of AChE | |
diacetylmonoxime reactivation of AChE | |
atropine parasympatholytics muscarine receptor antagonist alkaloid obtained from atropa belladonna atropine also found in datura stramonium | |
scopolamine parasympatholytics muscarine receptor antagonist alkaloid obtained from atropa belladonna aslo found in Hyascyamus niger | |
glycopyrrolate -antiholinergic -amino alcohol ester -ionized, exert effect locally in GI | |
propantheline antiholinergic -amino alcohol ester -ionized, exert effect locally in GI | |
clinidium antiholinergic -amino alcohol ester -ionized, exert effect locally in GI | |
ipratronium antiholinergic -amino alcohol ester -ionized, exert effect locally in GI | |
flavoxate antiholinergic -amino alcohol ester -ionized, exert effect locally in GI | |
oxyphencyclimine anticholinergic amino alcohol ester 3ary amine, used for Parkinson treatment systemic, can cross BBB | |
procyclidine anticholinergic amino alcohol 3ary amine, systemic effect | |
trihexyphenidyl anticholinergic amino alcohol 3ary amine, systemic effect | |
benztropine anticholinergic amino ethers | |
orphenadrine anticholinergic amino ether antihistaminic anticholinergic> antihistaminic | |
pirenzepine - selective M1 receptor antagonist - they are competitive antagonists -have antispasmodic effects -produce mydriasis -antisecretory: -decrease gastric secretions -decrease saliva secretions -decrease bronchial secretions | |
telenzepine selective M1 receptor antagonist - they are competitive antagonists -have antispasmodic effects -produce mydriasis -antisecretory: -decrease gastric secretions -decrease saliva secretions -decrease bronchial secretions | |
hexamethonium - ganglionic blocking agent - bisquaternary ammonium -MOA: they block autonomic ganglia => inhibit ganglionic transmission - main therapeutic indication: antihypertensive | |
trimethophan ganglionic blocking agent - sulfonium -MOA: they block autonomic ganglia => inhibit ganglionic transmission - main therapeutic indication: antihypertensive | |
pentolinium ganglionic blocking agent - bisquaternary ammonium -MOA: they block autonomic ganglia => inhibit ganglionic transmission - main therapeutic indication: antihypertensive | |
mecamylamine ganglionic blocking agent - secondary amines -MOA: they block autonomic ganglia => inhibit ganglionic transmission - main therapeutic indication: antihypertensive | |
pempidine ganglionic blocking agent - tertiary amine -MOA: they block autonomic ganglia => inhibit ganglionic transmission - main therapeutic indication: antihypertensive | |
succinylcholine chloride - depolarizing NMJ blocker - produce a 2 phase block phase 1: stimulation phase 2: depression block by receptor desensitization - therapeutic use : muscle relaxation - reversal of effects of depolarizing : give antagonist to sensitize the receptor | |
tubocurarine - non depolarizing NMJ blocker - cc: benzylisoquinoline - they are competitive receptor antagonist - all are ionized - lack CNS side effect - therapeutic use: muscle relaxation - reversal of effects of non depolarizing: AChI | |
atracurium besylate - non depolarizing NMJ blocker - cc: benzylisoquinoline - they are competitive receptor antagonist - all are ionized - Exception: CNS side effects - therapeutic use: muscle relaxation - reversal of effects of non depolarizing: AChI | |
mivacurium chloride non depolarizing NMJ blocker - cc: benzylisoquinoline - they are competitive receptor antagonist - all are ionized - lack CNS side effect - therapeutic use: muscle relaxation - reversal of effects of non depolarizing: AChI | |
doxacurium chloride non depolarizing NMJ blocker - cc: benzylisoquinoline - they are competitive receptor antagonist - all are ionized - lack CNS side effect - therapeutic use: muscle relaxation - reversal of effects of non depolarizing: AChI | |
L-Tyrosine | |
L-Dopa | |
Dopamine | |
Norepinephrine - released NE : binding to receptor postsynaptic and presynaotic uptake 1( recycling NE) uptake 2 ( degradation, metabolism ) - receptor selectivity: alpha 1, 2, beta 1 | |
epinephrine - increasing the size of R1 ( CH3) increase beta and decrease alpha adrenergic activity - receptor activity: Beta 2 > alpha 1,2, beta 1 | |
Isoproterenol increasing the size of R1 (isopropyl) increase beta and decrease alpha adrenergic activity - receptor activity: Beta 2, Beta 1 | |
Colterol - increase the size of R1 to t-butyl group increase selectivity to beta 2 agonistic activity -cc: phenylethanolamines -receptor selectivity :beta 2 > beta 1 beta 2 agonist | |
ritodrine -increasing the size of R1 => increase selectivity to beta 2 agonistic activity - at least one hydroxyl group is required to form hydrogen bonding with receptor | |
Ethylnorepinephrine substation on Carbon 2, R2: ethyl increase beta activity chiral center at C2 -receptor activity: beta > alpha | |
alpha- methylnorepinephrine (1R, 2S) 1R, 2S isomer : maximum direct activity 1R, 2R isomer: indirect activity receptor activity: alpha 2 > alpha 1 | |
terbutaline 3', 5'- dihydroxy substitution: orally active no COMT metabolism receptor activity: beta 2> beta 1 | |
albuterol 3' hydroxymethyl,4'hydroxy substitution non cathechol => orally active receptor activity: beta 2 > beta 1 | |
Phenylephrine 3' hydroxyl substitution => alpha 1 activity | |
Metaraminol 3' hydroxyl substitution => alpha 1 activity | |
Methoxamine 2',5' -dimethoxy substitution => alpha 1 activity | |
pirbuterol beta 2 agonist cc: phenylethanolamies | |
salmeterol beta 2 agonist cc: phenylethanolamines | |
bitolterol -beta 2 agonist - phenylethanolamine - non catechol : orally active - bi- toluoylester ( more lipophilic) - given by inhalation -hydrolyzed by esterase in the lungs to give colterol - twice the DOA than catechol | |
Dobutamine (-) dobutamine : alpha agonist + beta 1 agonist (+) dobutamine: alpha antagonist + beta 1 agonist ( 10x) racemic mixture: selective beta 1 activity exception to SAR | |
dopamine - not strictly adrenergic agonist - DA receptor agonist => dialates renal blood vessels - at higher dose acts on beta 1 receptor - at much higher dose acts on alpha 1 receptor - not orally active | |
(+,-) ephedrine - mixed acting sympathomimetics - alkaloid from Ephedra species (Ma Huang) - non cathechol : orally active more lipophilic - 1R, 2S: direct + indirect acting -used as nasal decongestant - cc: phenylethanoloamines | |
pseudoephedrine - 1S, 2R and 1S, 2S : indirectly acting sympathomimetics | |
amphetamine indirectly acting sympathomimetics dextro> levo non cathechol: orally active no hydrolysis: no 0H, very lipophilic, CNS stimulant | |
metamphetamine indirectly acting sympathomimetics dextro> levo non cathechol: orally active no hydrolysis: no 0H, very lipophilic, CNS stimulant | |
propylhexedrine indirectly acting sympathomimetics same as metamphetamine dextro> levo non cathechol: orally active no hydrolysis: no 0H, very lipophilic, POTENT CNS stimulant | |
xylometazoline - alpha 1 adrenergic agonists - cc: imidazoline derivatives - contain a carbon between C2 of imidazoline and a phenyl ring - contain phenylethylamine moiety ortho methyl: agonistic activity at alpha 1 and alpha 2 receptors - bulky group at para position: increase alpha 1 and decrease alpha 2 activity - mainly used as nasal decongestant | |
oxymetazoline - alpha 1 adrenergic agonists - cc: imidazoline derivatives contain a carbon between C2 of imidazoline and a phenyl ring - contain phenylethanolamine moiety ortho methyl: agonistic activity at alpha 1 and alpha 2 receptors - bulky group at para position: increase alpha 1 and decrease alpha 2 activity - mainly used as nasal decongestant | |
tetrahydrozoline alpha 1 adrenergic agonists - cc: imidazoline derivatives contain a carbon between C2 of imidazoline and a phenyl ring - contain phenylethylamine moiety ortho methyl: agonistic activity at alpha 1 and alpha 2 receptors - mainly used as nasal decongestant | |
naphazoline alpha 1 adrenergic agonists - cc: imidazoline derivatives contain a carbon between C2 of imidazoline and a phenyl ring - contain phenylethylamine moiety ortho methyl: agonistic activity at alpha 1 and alpha 2 receptors - mainly used as nasal decongestant | |
clonidine - potent alpha 2 adrenergic receptor agonist -cc: imidazoline derivatives - developed as nasal vasoconstrictor - produce marked hypotensive effects, maily centrally mediated throughpostsynaptic alpha2 adrenergic receptor - used as antihypertensive agent - effects on peripheral postsynaptic alpha 2 receptors: vasoconstriction - effects on peripheral presynaptic: negative feedback, decrease NE - pka 8.5, 80% ionized, 20% NI | |
Apraclonidine alpha 2 adrenergic agonist imidazoline moiety | |
brimonidine alpha 2 adrenergic agonist imidazoline moiety | |
guanabenz potent alpha 2 adrenergic agonist non imidazoline, clonidine like same indication as clonidine | |
guanfacine potent alpha 2 adrenergic agonist non imidazoline, clonidine like same indication as clonidine | |
alpha -methyldopamine alpha 2\ adrenergic antagonist non imidazoline derivative undergoes bioinactivation | |
phenoxybenzamine - adrenergic antagonist - irreversible alpha blocker - non selective ( alpha 1 and 2 ) - Beta-haloalkylamine derivative - slow onset of action: because it is a prodrug, must undergoe bioactivation ( alkylated receptor active ) -limited use in pheochromocytoma (cancer of adrenal medulla) | |
tolazoline - adrenergic receptor antagonist - reversible - non selective ( blocks alpha 1 and 2 ) - similar to xylometazoline BUT no ortho substitution: no alpha agonistic effects - limited use in treatment of symptoms of pheochromocytoma - rapid onset of action | |
phentolamine - adrenergic receptor antagonist - reversible - non selective ( blocks alpha 1 and 2 ) - limited use in treatment of symptoms of pheochromocytoma - rapid onset of action | |
prazosin - selective alpha 1 receptor antagonist reversible - quinazoline derivative -contain 4-amoni-6-7-dimethoxyquinazoline ring connected to piperazine at C2 -lower Blood Pressure | |
terazosin selective alpha 1 receptor antagonist reversible - quinazoline derivative -contain 4-amoni-6-7-dimethoxyquinazoline ring connected to piperazine at C2 -lower Blood Pressure | |
doxazosin selective alpha 1 receptor antagonist reversible - quinazoline derivative -contain 4-amoni-6-7-dimethoxyquinazoline ring connected to piperazine at C2 -lower Blood Pressure | |
tamsulosin selective alpha 1 receptor antagonist reversible high affinity to alpha 1 A subtype present in prostate gland => used to treat BHP ( benign prostatic hyperplasia) - cc: sulfonamide phenylpropylamine | |
indoramin - reversible selective alpha 1 receptor antagonist and H1 (histamine) and 5receptor antagonistHT (serotonin) - indole derivative | |
yohimbine - reversible selective alpha 2 blocker - indole alkaloid from Yohimbe bark - increase Blood Pressure AND Heart Rate - very limited use to treat male sexual impotency | |
practolol - Beta adrenergic receptor antagonist - aryloxypropanolamine with p-acylamino -change of acylamino to ortho or meta => loss of selectivity - inhibited isoproterenol induced tachycardia with minimal effects on isoproterenol induced hypotension -withdrawn from the market due to visual loss | |
pronethalol - beta adrenergic receptor antagonist non selective -arylethanolamine - no partial agonistic activity - carcinogenic in animals | |
propranolol -aryloxypropanolamine -beta adrenergic receptor non selective -10X> potent -no partial agonistic activity -not carcinogenic - used in hypertension, agnia pectoris, arrhythmia, migraine | |
bunolol -non selective beta adrenergic receptor antagonist | |
carteolol -non selective beta adrenergic receptor antagonist | |
metipranolol -non selective beta adrenergic receptor antagonist - exception para postion - ester hydrolysis=> short acting | |
nadolol -non selective beta adrenergic receptor antagonist | |
penbutolol -non selective beta adrenergic receptor antagonist | |
pindolol -non selective beta adrenergic receptor antagonist | |
sotalol -non selective beta adrenergic receptor antagonist - aryl sulfonamide ethanolamine derivative | |
timolol -non selective beta adrenergic receptor antagonist | |
acebutolol -selective beta 1 adrenergic receptor antagonist cardio slective | |
atenolol -selective beta 1 adrenergic receptor antagonist cardio slective | |
betaxolol - selective beta 1 adrenergic receptor antagonist cardio selective | |
esmolol - selective beta 1 adrenergic receptor antagonist cardio slective | |
metoprolol selective beta 1 adrenergic receptor antagonist cardio slective | |
bisoprolol selective beta 1 adrenergic receptor antagonist cardio slective | |
labetolol non selective beta blocker and alpha 1 blocker mixed acting | |
carvedilol non selective beta blocker and alpha 1 blocker mixed acting | |
metyrosine - drugs affecting NE biosynthesis - tyrosine hydroxylase inhibitor | |
carbidopa - drugs affecting NE biosynthesis - L-Dopa decarboxylase inhibitor | |
reserpine -drugs affecting NE storage ( catecholamine depleting agents) - indole alkaloid -isolated from Rauwolfa Serpentina - inhibit catecholamine storage in storage vesicle => depletion of catecholamines | |
guanadrel - drugs affecting NE release ( adrenergic neuronal blocking agents) | |
guanethidine - drugs affecting NE release ( adrenergic neuronal blocking agents) | |
bretylium - drugs affecting NE release ( adrenergic neuronal blocking agents) | |
ergot alkaloid - produced by calviceps purourea, a fungus that infects grains | |
ergotamine - ergot alkaloid - produced by calviceps purourea, a fungus that infects grains -mixed agonist/ antagonist - potent smooth muscle contraction - also used for migraine treatment | |
ergonovine -ergot alkaloid -mixed agonist/ antagonist - potent smooth muscle contraction - also used for migraine treatment - potent inducer of uterine - because of better bioavailability, used to replace ergotmaine | |
methylergonovine -ergot alkaloid -mixed agonist/ antagonist - potent smooth muscle contraction - also used for migraine treatment - potent inducer of uterine - because of better bioavailability, used to replace ergotmaine | |
methylseregide -ergot alkaloid -mixed agonist/ antagonist -mainly used for migraine treatment | |
morphine - cc: phenantrene - teriary amine group, N-methyl: good agonist Removal of N-methyl: decrease activity increase size of alkyl group: antagonist | |
phenanthrene | |
benzoquinone -oxidation od morphine product | |
codeine - weak mu agonist - potent antitussive agent -partial O-demethylated => morphine | |
Heroin -3,6-diacetyl derivative of morphine - weak affinity to mu receptor -more lipophilic: penetrates BBB - hydrolyzed in the brain to give: 3-acetylmorphine (3-MAM) 6-acetylmorphine (6-MAM) - 6-MAM has potent mu agonist | |
oxymorphone - 3-hydroxy-N-methyl derivative 10X as potent as morphine - 14 beta hydroxyl enhances mu agonist activity and decrease antitussive activity | |
oxycodone -3-hydroxyl-N-methyl derivative same activity as morphine but better oral bioavailability - 14 beta hydroxyl enhances mu agonist activity and decrease antitussive activity | |
naloxone - N-allyl oxymorphone - pure non selective opioid receptor antagonist | |
nalorphine - N-allyl substitution for N-methyl 7,8-double bond reduction 6-keto reduction u | |
morphinan - removal of 4,5 epoxide bridge (modification of E ring) | |
levorphanol -removal of 4,5 epoxide bridge - 8X more potent mu receptor agonist | |
butorphanol -removal of 4,5 epoxide bridge - mu antagonist and kappa agonist | |
dextromethorphan -removal of 4,5 epoxide bridge (+) levorphanol = dextrophan - lacks analgesia - antitussive activity | |
benzomorphans - lacks the epoxide ring and the C ring - retain opioid activity | |
cyclazocine - R: N-cyclopropyl methyl - mixed agonist/ antagonist kappa agonist mu antagonist | |
phenazocine - R: N-ethylphenyl -potent mu agonist about 10X> morphine | |
pentazocine -R: N-methyl of 2-methyl-2-butene - mixed agonist/antagonist kappa agonistic activity: analgesic mu antagonistic activity -only one marketed in US | |
metazocine -R: CH3 - mu agonist -metasocine > morphine | |
meperidine - A and D ring analogs of morphine - cc: phenylpiperidine -first synthesized agent with mu agonist activity of 1/4 of morphine -short DOA (useful in some medical procedure) | |
MPTP 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine -damages DA neurons => parkinsonism - product of reversed ester of meperidine | |
fentanyl - cc: anilidopiperidine - 80X> potent than morphine | |
sufentanil - cc: anilidopiperidine - 10X> potent than fentanyl (fentanyl 80X> morphine) | |
remifentanyl - cc: anilidopiperidine - 25X> potent than morphine | |
alfentanil - cc: anilidopiperidine - 20X> potent than morphine | |
methadone -cc: diphenylheptanone - orally active and long DOA - useful for maintenance therapy of opoids addicts and for pain suppression of terminally ill patients | |
isomethadone | |
diphenoxylate -cc: diphenylheptanone - structural modification of methadone -antidiarrheal opioids | |
loperamide -cc: diphenylheptanone - structural modification of methadone -antidiarrheal opioids | |
thebaine -oripavine derivative - from papaver bracteatum no activity as opioid agonist | |
etorphine - oripavine derivative - 1000 X> morphine - severe respiratory depression -low therapeutic index in humans, used for veterinary medicine | |
buprenorphine -orpavine derivative - 20-50X> morphine - mixed agonist / antagonist -does not produce tolerance and addiction | |
tramadol - synthetic mu agonist - orally active - possess opioid and non opioid analgesic activity -analgesic not reversed by naloxone -O-dimethyl metabolite is 6X> parent drug -less respiratory depression than morphine | |
dezocine -mixed agonist / antagonist -only primary amine opoid agent - exact receptor selectivity is not known - equipotent with morphine | |
nalbuphine - N-cyclobutylmethyl substitution for N-methyl 7,8-double bond reduction 6 keto reduction -mu antagonist and kappa agonist | |
naltrexone -N-cyclopropyl-methyl oxymorphone - pure non selective opioid antagonist |
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