Cyclisation of Indoles by Using Orthophosphoric Acid in Sumatriptan and Rizatriptan
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The Serotonergic System in Migraine Andrea Rigamonti Domenico D’Amico Licia Grazzi Susanna Usai Gennaro Bussone
J Headache Pain (2001) 2:S43–S46 © Springer-Verlag 2001 MIGRAINE AND PATHOPHYSIOLOGY Massimo Leone The serotonergic system in migraine Andrea Rigamonti Domenico D’Amico Licia Grazzi Susanna Usai Gennaro Bussone Abstract Serotonin (5-HT) and induce migraine attacks. Moreover serotonin receptors play an impor- different pharmacological preventive tant role in migraine pathophysiolo- therapies (pizotifen, cyproheptadine gy. Changes in platelet 5-HT content and methysergide) are antagonist of are not casually related, but they the same receptor class. On the other may reflect similar changes at a neu- side the activation of 5-HT1B-1D ronal level. Seven different classes receptors (triptans and ergotamines) of serotoninergic receptors are induce a vasocostriction, a block of known, nevertheless only 5-HT2B-2C neurogenic inflammation and pain M. Leone • A. Rigamonti • D. D’Amico and 5HT1B-1D are related to migraine transmission. L. Grazzi • S. Usai • G. Bussone (౧) syndrome. Pharmacological evi- C. Besta National Neurological Institute, Via Celoria 11, I-20133 Milan, Italy dences suggest that migraine is due Key words Serotonin • Migraine • e-mail: [email protected] to an hypersensitivity of 5-HT2B-2C Triptans • m-Chlorophenylpiperazine • Tel.: +39-02-2394264 receptors. m-Chlorophenylpiperazine Pathogenesis Fax: +39-02-70638067 (mCPP), a 5-HT2B-2C agonist, may The 5-HT receptor family is distinguished from all other 5- Introduction 1 HT receptors by the absence of introns in the genes; in addi- tion all are inhibitors of adenylate cyclase [1]. Serotonin (5-HT) and serotonin receptors play an important The 5-HT1A receptor has a high selective affinity for 8- role in migraine pathophysiology. -
Triptans Step Therapy/Quantity Limit Criteria
Triptans Step Therapy/Quantity Limit Criteria Program may be implemented with the following options 1) step therapy 2) quantity limits or 3) step therapy with quantity limits For Blue Cross and Blue Shield of Illinois Option 1 (step therapy only) will apply. Brand Generic Dosage Form Amerge® naratriptan tablets Axert® almotriptan tablets Frova® frovatriptan tablets Imitrex® sumatriptan injection*, nasal spray, tablets* Maxalt® rizatriptan tablets Maxalt-MLT® rizatriptan tablets Relpax® eletriptan tablets Treximet™ sumatriptan and naproxen tablets Zomig® zolmitriptan tablets, nasal spray Zomig-ZMT® zolmitriptan tablets * generic available and included as target agent in quantity limit edit FDA APPROVED INDICATIONS1-7 The following information is taken from individual drug prescribing information and is provided here as background information only. Not all FDA-approved indications may be considered medically necessary. All criteria are found in the section “Prior Authorization Criteria for Approval.” Amerge® Tablets1, Axert® Tablets2, Frova® Tablets3,Imitrex® injection4, Imitrex Nasal Spray5, Imitrex Tablets6, Maxalt® Tablets7, Maxalt-MLT® Tablets7, Relpax® Tablets8, Treximet™ Tablets9, Zomig® Tablets10, Zomig-ZMT® Tablets10, and Zomig® Nasal Spray11 Amerge (naratriptan), Axert (almotriptan), Frova (frovatriptan), Imitrex (sumatriptan), Maxalt (rizatriptan), Maxalt-MLT (rizatriptan orally disintegrating), Relpax (eletriptan), Treximet (sumatriptan/naproxen), Zomig (zolmitriptan), and Zomig-ZMT (zolmitriptan orally disintegrating) tablets, and Imitrex (sumatriptan) and Zomig (zolmitriptan) nasal spray are all indicated for the acute treatment of migraine attacks with or without aura in adults. They are not intended for the prophylactic therapy of migraine or for use in the management of hemiplegic or basilar migraine. Safety and effectiveness of all of these products have not been established for cluster headache, which is present in an older, predominantly male population. -
(DMT), Harmine, Harmaline and Tetrahydroharmine: Clinical and Forensic Impact
pharmaceuticals Review Toxicokinetics and Toxicodynamics of Ayahuasca Alkaloids N,N-Dimethyltryptamine (DMT), Harmine, Harmaline and Tetrahydroharmine: Clinical and Forensic Impact Andreia Machado Brito-da-Costa 1 , Diana Dias-da-Silva 1,2,* , Nelson G. M. Gomes 1,3 , Ricardo Jorge Dinis-Oliveira 1,2,4,* and Áurea Madureira-Carvalho 1,3 1 Department of Sciences, IINFACTS-Institute of Research and Advanced Training in Health Sciences and Technologies, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; [email protected] (A.M.B.-d.-C.); ngomes@ff.up.pt (N.G.M.G.); [email protected] (Á.M.-C.) 2 UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal 3 LAQV-REQUIMTE, Laboratory of Pharmacognosy, Department of Chemistry, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal 4 Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal * Correspondence: [email protected] (D.D.-d.-S.); [email protected] (R.J.D.-O.); Tel.: +351-224-157-216 (R.J.D.-O.) Received: 21 September 2020; Accepted: 20 October 2020; Published: 23 October 2020 Abstract: Ayahuasca is a hallucinogenic botanical beverage originally used by indigenous Amazonian tribes in religious ceremonies and therapeutic practices. While ethnobotanical surveys still indicate its spiritual and medicinal uses, consumption of ayahuasca has been progressively related with a recreational purpose, particularly in Western societies. The ayahuasca aqueous concoction is typically prepared from the leaves of the N,N-dimethyltryptamine (DMT)-containing Psychotria viridis, and the stem and bark of Banisteriopsis caapi, the plant source of harmala alkaloids. -
Daily Triptans for Headache
Expert Opinion Daily Triptans for Headache Case History Submitted by Randolph W. Evans, MD Expert Opinion by Lawrence Robbins, MD Key words: headache, triptans Abbreviations: CDH chronic daily headache (Headache 2001;41:907-909) Will a triptan a day keep the headache away? I advised the patient that the increased frequency of the headaches could be rebound due to sumatriptan CLINICAL HISTORY and that the headaches might decrease by restricting This 47-year-old woman has a history of migraine the sumatriptan to no more than 2 days per week and since aged 4 years. Until 1 year ago, the headaches oc- starting another preventative such as sodium valpro- curred one to two times per week, lasted all day, re- ate. She is concerned about the possible side effects sulted in functional incapacity, and were not relieved of sodium valproate, which she has read can make you by over-the-counter medications or nonsteroidal anti- fat and bald. She also stated that the headaches were inflammatory drugs. About 10 years ago, she was tak- quite tolerable with the daily sumatriptan and she ing Fiorinal #3 but stopped when she developed could not see the difference between taking daily rebound headaches. She has been on multiple preven- sumatriptan as compared to a preventative which may tative medications including amitriptyline, -blockers, or may not work and may have significant side effects. paroxetine, fluoxetine, and verapamil which were ei- Questions.—Is there evidence to support daily ther not effective or stopped due to side effects. triptan use for migraine? What would you recom- One year ago, she saw another neurologist and mend in this case? had an MRI scan of the brain with normal findings. -
Medication Guide 2012
DeKalb County D.U.I. Court Supervised Treatment Program MEDICATION GUIDE Medication Guide 2012 DeKalb County State Court Decatur, Georgia xxi ********** WELCOME TO THE DEKALB COUNTY D.U.I. COURT SUPERVISED TREATMENT PROGRAM. This 2012 Medication Guide was developed as a collaborative effort by Becky Pirouz, Pharm.D., Director of Pharmacy, Peachford Hospital, and by Lois Michalove, Treatment Coordinator for the DeKalb County D.U.I. Court Supervised Treatment Program, both of whom have extensive experience in addiction recovery and treatment. ********** The following information is intended to assist you in making decisions about medications. This may include those medications that you are prescribed and/or your selection of over-the-counter (OTC) products. Unintended exposure may compromise your treatment program. This is not an exhaustive list, but contains some of the medications that are most commonly used. If in doubt, always consult the Treatment Coordinator. Please inform your physician, dentist, pharmacist and other health care professionals that you are in a recovery program. WE ARE A ZERO-TOLERANCE PROGRAM! DO NOT COMPROMISE YOUR RECOVERY BY MAKING HIGH-RISK CHOICES! xxii - Section 1 – Drugs To Avoid The following drugs must not be used at any time. They are well known to be abused and even small amounts may result in relapse and are contraindicated in your treatment program. However, extenuating circumstances may occur which necessitates the short- term limited use of some of the drugs on this list in consultation with your physician, the Judge and the Treatment Coordinator. This decision should be made prior to your ingestion of any of the Drugs to Avoid. -
The Impact of Triptan and Doxycycline on Neuroinflammatory Biomarkers in Acute Migraine: Study Protocol of a Randomized Controlled Trial Study Protocol
iMedPub Journals INTERNATIONAL ARCHIVES OF MEDICINE 2015 http://journals.imed.pub SECTION: NEUROLOGY Vol. 8 No. 13 ISSN: 1755-7682 doi: 10.3823/1612 The impact of triptan and doxycycline on neuroinflammatory biomarkers in acute migraine: study protocol of a randomized controlled trial STUDY PROTOCOL Shaheen E Lakhan, MD, Abstract PhD, MEd, MS1 Background: Increased inflammatory cytokines and matrix meta- 1 Neurological Institute, Cleveland Clinic, lloproteinases (MMPs) have been recently implicated in migraine. In- Euclid Ave, S100C, Cleveland OH . flammation may be a key player in the pathophysiology of migraine by altering blood-brain barrier (BBB) function. As an inflammation induced MMP, MMP-9 is involved in both BBB disruption and neuro- Contact information: pathic pain, and is largely derived by neutrophil degranulation during neutrophil-BBB interaction. The tetracycline group of antibiotics may Shaheen E Lakhan, MD, PhD, MEd, MS. Neurological Institute, Cleveland Clinic, suppress MMP production and neutrophil degranulation. 9500 Euclid Ave, S100C, Cleveland OH 44195. Methods/Design: We hypothesize that migraine is a primary neu- Tel: (216) 444-2200 roinflammatory disorder. We will address this theory by measuring serum biomarkers in healthy controls and after one of three abortive slakhan @gnif.org therapy strategies for acute migraine attacks and inter-ictally. We intend to investigate known neuroinflammatory biomarkers with a focus on BBB breakdown during acute migraine attacks and assess marker responses to conventional treatment (triptans), novel MMP targeted therapy (doxycycline), or a combination of triptan and do- xycycline. We will measure the effects of the interventions on neu- roinflammatory markers for acute migraine attacks, clinical outcomes (headache relief and recurrence) for acute migraine attacks, inter- ictal neuroinflammatory load per serum biomarkers in migraineurs versus healthy controls, and neuroinflammatory markers correlation with headache duration and peak headache intensity during acute migraine attacks. -
Guideline for Preoperative Medication Management
Guideline: Preoperative Medication Management Guideline for Preoperative Medication Management Purpose of Guideline: To provide guidance to physicians, advanced practice providers (APPs), pharmacists, and nurses regarding medication management in the preoperative setting. Background: Appropriate perioperative medication management is essential to ensure positive surgical outcomes and prevent medication misadventures.1 Results from a prospective analysis of 1,025 patients admitted to a general surgical unit concluded that patients on at least one medication for a chronic disease are 2.7 times more likely to experience surgical complications compared with those not taking any medications. As the aging population requires more medication use and the availability of various nonprescription medications continues to increase, so does the risk of polypharmacy and the need for perioperative medication guidance.2 There are no well-designed trials to support evidence-based recommendations for perioperative medication management; however, general principles and best practice approaches are available. General considerations for perioperative medication management include a thorough medication history, understanding of the medication pharmacokinetics and potential for withdrawal symptoms, understanding the risks associated with the surgical procedure and the risks of medication discontinuation based on the intended indication. Clinical judgement must be exercised, especially if medication pharmacokinetics are not predictable or there are significant risks associated with inappropriate medication withdrawal (eg, tolerance) or continuation (eg, postsurgical infection).2 Clinical Assessment: Prior to instructing the patient on preoperative medication management, completion of a thorough medication history is recommended – including all information on prescription medications, over-the-counter medications, “as needed” medications, vitamins, supplements, and herbal medications. Allergies should also be verified and documented. -
United States Patent 19 11) Patent Number: 5,387,604 Mcdonald Et Al
US005387604A United States Patent 19 11) Patent Number: 5,387,604 McDonald et al. 45 Date of Patent: Feb. 7, 1995 (54) 14 BENZODIOXIN DERIVATIVES AND pp. 323-330, Role of 5HT1-like receptors in the reduc THEIR USE AS SEROTONIN 5HT tion of porcine cranial arteriovenous anastomotic shunt AGONSTS ing by Sumatriptan. 75 Inventors: Ian A. McDonald, Loveland; Ronald Saxena, et al, TiPS, May 1989, vol. 10, pp. 200-204; C. Bernotas, Cincinnati; Mark W. 5HT1-like receptor agonists and the pathophysiology Dudley, Somerville; Jeffrey S. of migraine. Sprouse, Cincinnati, all of Ohio Hamel et al., Br. J. Pharmacol, (1991), 102, pp. 227-233; Contractile 5HT1 receptors in human isolated pial arte 73) Assignee: Merrell Dow Pharmaceuticals Inc., rioles: correlation with 5-HT1D binding sites. Cincinnati, Ohio Edward E. Schwiezer, et al.; Psychopharmacology Bul 21 Appl. No.: 962,434 leting, vol. 22, No. 1, 1986, pp. 183-185; Open Trial of Buspirone in the Treatment of Major Depressive Disor 22 Filed: Oct. 16, 1992 der. Related U.S. Application Data European Journal of Pharmacology, 180 (1990) pp. 339-349, Dreteler, et al.; Comparison of the cardiovas 60 Division of Ser. No. 735,700, Jul. 30, 1991, Pat. No. cular effects of the 5-HT1A receptor agonist flexinoxan 5,189,179, which is a continuation-in-part of Ser. No. with that of 8-OH-DPAT in the rat. 574,710, Aug. 29, 1990, abandoned. European Journal of Pharmacology, 182 (1990) 63-72, 51) int. C.6 .................. C07D 319/20: A61K 31/335. Connor, et al.; Cardiovascular effects of 5HT1 receptor 52 U.S. -
Optimizing Prophylactic Treatment of Migraine: Subtypes and Patient Matching
REVIEW Optimizing prophylactic treatment of migraine: Subtypes and patient matching Michel Dib Abstract: Advances in our understanding of the pathophysiology of migraine have resulted Fédération du système nerveux in important breakthroughs in treatment. For example, understanding of the role of serotonin central, Hôpital de la Salpêtrière, Assistance Publique- Hôpitaux de in the cerebrovascular circulation has led to the development of triptans for the acute relief of Paris, France migraine headaches, and the identifi cation of cortical spreading depression as an early central event associated wih migraine has brought renewed interest in antiepileptic drugs for migraine prophylaxis. However, migraine still remains inadequately treated. Indeed, it is apparent that migraine is not a single disease but rather a syndrome that can manifest itself in a variety of pathological conditions. The consequences of this may be that treatment needs to be matched to particular patients. Clinical research needs to be devoted to identifying which sort of patients benefi t best from which treatments, particularly in the fi eld of prophylaxis. We propose four patterns of precipitating factors (adrenergic, serotoninergic, menstrual, and muscular) which may be used to structure migraine prophylaxis. Finally, little is known about long-term outcome in treated migraine. It is possible that appropriate early prophylaxis may modify the long-term course of the disease and avoid late complications. Keywords: migraine, diagnosis, treatment, prophylaxis, subtypes Migraine headaches are the most frequent type of incapacitating headache and one of the most common reasons for consultation in neurology. However, these headaches have historically been poorly understood in terms of natural history, pathophysiology and prognosis. -
L-Tryptophan
2008 368/L-THEANINE PDR FOR NUTRITIONAL SUPPLEMENTS Sugiyama T, Sadzuka' Y. Enhancing effects of green tea death. Pellagra is a vitamin B3 deficiency disease caused by components on the antitumor activity of adriamycin against dietary lack of niacin and protein, especially proteins M5076 ovarian carcinoma. Cancer Lef(. 1998; 133: 19-26 ... containing the essential amino acid L-tryptophan., Because Sugiyama T, Sadzuka Y. Theanine, a specific glutamate L-tryptophan can be converted into niacin, foods with L derivative in green tea, reduces the adverse reactions of tryptophan but without niacin, such as 'milk, prevent pellagra. doxorubicin by changing the glutathione level. Cancer Lett .. However, if dietary L-tryptophan is diverted into the 2004;212(2): 177 -184. production of protein, niacin deficiency may still exist, Sugiyama T, Sadzuka Y, Sonobe T: Theanine, a major amino leading to pell_agra. acid in green tea,' inhibits leukopenia and enhances antitumor activity induce by idarubicin. Proc Am Assoc Cancer Res. By the end of the 1980s, some millions of people, mainly 1999;40: \O(Abstract 63). ' women 'and mainly in the United States, were using Yamada T, Terashima T, Honma H, et al. Effects of theanine, supplemental, L-tryptophan for a variety of reasons-pre a unique amino acid in tea leaves, on memory in a rat menstrual sY!1drome (PMS), sleep disorders, anxiety, depres behavioral test.. Biosci Biotechnol Biochem. 2008;72(~): I ~56- sion, fibromyalgia, seasonal affective disorder (SAD) and 1359. ' chronic pain syndromes. Supplemental L-tryptophan was Yamada T, Terashima T, Kawano S, et al. Theanine, gamma also used ,as an adjunct in the treatment of cocaine, glutamylethyl~mide, a unique amino acid in tea leav~s, amphetamirie, alcohol and other drug abuse and for jet lag. -
Nitric Oxide
P1: KWW/KKL P2: KWW/HCN QC: KWW/FLX T1: KWW GRBT050-15 Olesen- 2057G GRBT050-Olesen-v6.cls August 18, 2005 15:30 ••Chapter 15 ◗ Nitric Oxide Andrew A. Parsons The importance of nitric oxide (NO) in modulation of type tool inhibitor compounds that were simple analogs of biological pathways has been known for over 20 years. The arginine led to the use of these compounds to probe into seminal studies by Furchgott and Zwadzki that provided the biological role of NO in physiology and pathophys- an initial identification of a labile relaxing factor released iology. Many effects of NO were subsequently suggested from endothelial cells was a stimulus for many investiga- and involved many organ systems and integrated biologi- tors to identify the nature of the transmitter and explore its cal pathways. NO is now believed to play a key role in many role in biology (13). The tremendous volume of research physiologic processes such as in the gastrointestinal tract, papers on NO over the last two decades is a testament to respiratory and cardiovascular systems, as well as the CNS. the key physiologic and pathophysiologic roles that have The first new medicines to modulate the NO pathway have been attributed to this molecule. also been developed for male erectile dysfunction. The wealth of knowledge surrounding this molecule is represented by a variety of excellent reviews that provide a detailed account of the molecular and cellular effects of CONTROL AND REGULATION OF this agent (see Forstermann et al. [12], Ignarro [22]). The NITRIC OXIDE PRODUCTION aim of this manuscript is to provide a brief overview of how NO is generated by enzyme systems and how it can A schematic representation of the steps involved in the en- produce its biological actions with respect to its potential zymatic production of NO is shown in Figure 15-1. -
UCSF UC San Francisco Electronic Theses and Dissertations
UCSF UC San Francisco Electronic Theses and Dissertations Title Deep phenotypic profiling of neuroactive drugs in larval zebrafish Permalink https://escholarship.org/uc/item/3vk1d0gr Author Gendelev, Leo Publication Date 2019 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California Deep phenotypic profiling of neuro-active drugs in larval Zebrafish by Lev Gendelev DISSERTATION Submitted in partial satisfaction of the requirements for degree of DOCTOR OF PHILOSOPHY in Biophysics in the GRADUATE DIVISION of the UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Approved: ______________________________________________________________________________Michael Keiser Chair ______________________________________________________________________________DAVID KOKEL ______________________________________________________________________________Jim Wells ______________________________________________________________________________ ______________________________________________________________________________ Committee Members Copyright 2019 by Lev (Leo) Gendelev ii In Loving Memory of My Mother, Lucy Gendelev iii Acknowledgements First of all, I thank my advisor, Michael Keiser, for his unwavering support through the most difficult of times. I will above all else reminisce over our brainstorming sessions, where my half- wrought white-board scribbles were met with enthusiasm and sometimes even developed into exciting side-projects. My PhD experience felt less like work and more like a fantastical scientific