Simplified Procedure for General Synthesis Of
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The Postmortem Distribution of Vardenafil (Levitra | in an Aviation
Journal of Analytical Toxicology, Vol. 31, July/August 2007 The Postmortem Distribution of Vardenafil (Levitra| in an Aviation Accident Victim with an Unusually High Blood Concentration* Robert D. Johnson ~, Russell J. Lewis, and Mike K. Angler Downloaded from https://academic.oup.com/jat/article/31/6/328/682815 by guest on 27 September 2021 Civil Aerospace Medical Institute, Federal Aviation Administration, Analytical Toxicology and Accident Research Laboratory, AAM-610, CAMI Building, 6500 S. MacArthur Blvd., Oklahoma City, Oklahoma 73169-6901 I Abstract phodiesterase type 5 enzyme (PDE5) found predominantly in the penile corpus cavernosum (2-7). Vardenafil (tevitra) is one of the most widely prescribed Vardenafil undergoes hepatic metabolism, producing the treatments for erectile dysfunction. This report presents a active desethyl metabolite M1. M1 contributes to the ob- rapid and reliable method for the identification and quantification served pharmacological effects provided by vardenafil, as M1 of vardenafil in postmortem fluids and tissues, applies this method exhibits approximately 30% of the potency of the parent to a postmortem case, and describes the distribution of vardenafil in various fluids and tissues.This procedure utilizes sildenafil-d8, drug (1). Under steady-state conditions, the plasma concen- which is structurally closely related to vardenafil, as an tration of M1 is approximately 26% of that seen for vardenafil internal standard for more accurate and reliable quantitation. (1). After oral administration of vardenafil, peak plasma con- The method incorporates solid-phaseextraction and liquid centrations are obtained within 30-60 min (1). Vardenafil chromatography-tandem mass spectrometry (MS) and and its active metabolite have a terminal half-life of approx- MS-MS-MS utilizing an atmospheric pressure chemical imately 4-5 h (1). -
United States Patent Office
Patented Feb. 11, 1947 2,415,786 UNITED STATES PATENT OFFICE UNSYMMETRICALLY SUBSTITUTED PPERAZINES Johannes S. Buck, East Greenbush, and Richard Baltzly, New York, N. Y., assignors to Bur roughs Welcome & Co. (U. S. A.) Inc., New York, N.Y., a corporation of New York No Drawing. Application January 6, 1944, serial No. 517,224 9 Claims. (C. 260-268) 2 This invention relates to N-monosubstituted According to the present invention, these diffi and N-N'-unsymmetrically disubstituted piper culties are overcome by treating piperazine with azines and has for an object to provide new com a halide of benzyl or of a substituted benzyl to positions of the above type and a novel and im form a reaction mixture containing, in addition proved method of making the same. to unreacted piperazine and di-N-N'- Substituted Another object is to provide a method of mak piperazine, a substantial amount of N-mono sub ing and isolating the above substances which is stituted piperazine separating the mono-N-sub Suitable for commercial Operation. stituted piperazine from the unreacted piperazine In our copending application Serial No. 476,914, and the disubstituted piperazine, introducing the filed February 24, 1943, of which the present ap O desired substituent on to the second N' nitrogen plication is a continuation in part and in our atom of the mono-N-substituted piperazine, then Copending application Serial No. 517,225, filed removing the benzyl or substituted benzyl group January 6, 1944, which is also a continuation in by catalytic hydrogenation. part, We have described certain methods for mak As catalysts for this hydrogenation, platinum, ing and isolating substituted piperazines of the palladium and nickel are all suitable, but We pre type fer in general to use palladium since, while CEI-CI equally or perhaps more effective in removing a benzyl group, it is practically devoid of any N /N-R tendency to reduce aromatic rings. -
Recent Progress Toward the Asymmetric Synthesis of Carbon-Substituted Piperazine Pharmacophores and Oxidative Related Heterocycles RSC Medicinal Chemistry
Volume 11 Number 7 July 2020 RSC Pages 735–850 Medicinal Chemistry rsc.li/medchem ISSN 2632-8682 REVIEW ARTICLE Plato A. Magriotis Recent progress toward the asymmetric synthesis of carbon-substituted piperazine pharmacophores and oxidative related heterocycles RSC Medicinal Chemistry View Article Online REVIEW View Journal | View Issue Recent progress toward the asymmetric synthesis Cite this: RSC Med. Chem.,2020,11, of carbon-substituted piperazine pharmacophores 745 and oxidative related heterocycles Plato A. Magriotis † The important requirement for approval of a new drug, in case it happens to be chiral, is that both enantiomers of the drug should be studied in detail, which has led synthetic organic and medicinal chemists to focus their attention on the development of new methods for asymmetric synthesis especially of relevant saturated N-heterocycles. On the other hand, the piperazine ring, besides defining a major class of saturated N-heterocycles, has been classified as a privileged structure in medicinal chemistry, since it is more than frequently found in biologically active compounds including several marketed blockbuster drugs such as Glivec (imatinib) and Viagra (sildenafil). Indeed, 13 of the 200 best-selling small molecule drugs in 2012 contained a piperazine ring. Nevertheless, analysis of the piperazine substitution pattern reveals a lack Creative Commons Attribution 3.0 Unported Licence. of structural diversity, with almost every single drug in this category (83%) containing a substituent at both Received 16th February 2020, the N1- and N4-positions compared to a few drugs having a substituent at any other position (C2, C3, C5, Accepted 27th April 2020 and C6). Significant chemical space that is closely related to that known to be biologically relevant, therefore, remains unexplored. -
Vardenafil Better Choice for Premature Ejaculation
August 15, 2005 • www.familypracticenews.com Men’s Health 47 Vardenafil Better Choice for Premature Ejaculation BY ROBERT FINN (24%) of the men and was secondary (in On a self-rating scale of 0-8, where 0 Center but is now at the University of San Francisco Bureau most cases to erectile dysfunction) in the means PE almost never, 4 means PE about Hamburg. remaining 26 men (77%). half the time, and 8 means PE almost al- Self-ratings of sexual satisfaction, on a 0- S AN A NTONIO — Vardenafil improved After a 4-week run-in period, 17 men ways, the mean score was 6.14 at baseline, 5 scale, where 0 means not at all satisfied premature ejaculation more than sertra- were given 10-mg vardenafil 10 minutes 4.28 with sertraline, and 3.2 with varde- and 5 means extremely satisfied, averaged line, Frank Sommer, M.D., reported at the before intercourse for 6 weeks. The other nafil. 1.4 at baseline, 3.2 with sertraline, and 4.2 annual meeting of the American Urolog- 17 received 50 mg of sertraline 4 hours be- IVELT, as measured by a stopwatch, with vardenafil. In addition, the partners’ ical Association. fore intercourse. averaged 0.54 minutes at baseline, 2.87 sexual satisfaction showed significant in- Both vardenafil (Levitra), a phosphodi- After a 1-week washout period, the men minutes with sertraline, and 5.23 minutes creases for sertraline and even more so for esterase-5 inhibitor, and sertraline (Zoloft), who had been receiving sertraline with vardenafil, reported Dr. Sommer, vardenafil. -
LEVITRA (Vardenafil Hcl) Tablets
LEVITRA (vardenafil HCl) Tablets DESCRIPTION LEVITRA® is an oral therapy for the treatment of erectile dysfunction. This monohydrochloride salt of vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Vardenafil HCl is designated chemically as piperazine, 1-[[3-(1,4-dihydro-5- methyl-4-oxo-7-propylimidazo[5,1-f][1,2,4]triazin-2-yl)-4- ethoxyphenyl]sulfonyl]-4-ethyl-, monohydrochloride and has the following structural formula: O O HN N x HCl x 3H2O N N O S O N N Vardenafil HCl is a nearly colorless, solid substance with a molecular weight of 579.1 g/mol and a solubility of 0.11 mg/mL in water. LEVITRA is formulated as orange, round, film-coated tablets with "BAYER" cross debossed on one side and "2.5", "5", "10", and "20" on the other side corresponding to 2.5 mg, 5 mg, 10 mg, and 20 mg of vardenafil, respectively. In addition to the active ingredient, vardenafil HCl, each tablet contains microcrystalline cellulose, crospovidone, colloidal silicon dioxide, magnesium stearate, hypromellose, polyethylene glycol, titanium dioxide, yellow ferric oxide, and red ferric oxide. CLINICAL PHARMACOLOGY Mechanism of Action Penile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in erection. -
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. -
Piperazine (MDBZP)
1-(3-4- methylendioxybenzyl)piperazine (MDBZP) Pre-Review Report Expert Committee on Drug Dependence Thirty-fifth Meeting Hammamet, Tunisia, 4-8 June 2012 35th ECDD (2012) Agenda item 5.3e 1-(3-4-methylendioxybenzyl)piperazine (MDBZP) - 2 - 35th ECDD (2012) Agenda item 5.3e 1-(3-4-methylendioxybenzyl)piperazine (MDBZP) Acknowledgements This report has been drafted under the responsibility of the WHO Secretariat, Essential Medicines and Health Products, Medicines Access and Rational Use Unit. The WHO Secretariat would like to thank the following people for their contribution in producing this pre-review report: Dr Simon Elliott, United Kingdom (literature review and drafting), Dr Caroline Bodenschatz (editing) and Mr Kamber Celebi, France (questionnaire report). - 3 - 35th ECDD (2012) Agenda item 5.3e 1-(3-4-methylendioxybenzyl)piperazine (MDBZP) - 4 - 35th ECDD (2012) Agenda item 5.3e 1-(3-4-methylendioxybenzyl)piperazine (MDBZP) Contents SUMMARY ............................................................................................................................... 7 1. Substance identification .................................................................................................... 8 A. International Nonproprietary Name (INN) ................................................................ 8 B. Chemical Abstract Service (CAS) Registry Number ................................................. 8 C. Other Names .............................................................................................................. -
Adrenoceptor Antagonistic Properties of Some 1,4-Substituted Piperazine Derivatives
ORIGINAL ARTICLES Department of Bioorganic Chemistry, Chair of Organic Chemistry1; Department of Pharmacodynamics2; Department of Cytobiology and Histochemistry, Laboratory of Pharmacobiology3, Faculty of Pharmacy Medical College; Faculty of Chemistry4, Jagiellonian University Krakow, Poland Synthesis, ␣-adrenoceptors affinity and ␣1-adrenoceptor antagonistic properties of some 1,4-substituted piperazine derivatives H. Marona 1, M. Kubacka 2, B. Filipek 2, A. Siwek 3, M. Dybała 3, E. Szneler 4, T. Pociecha 1, A. Gunia 1, A. M. Waszkielewicz 1 Received March 24, 2011, accepted April 25, 2011 Dr. Anna M. Waszkielewicz, Department of Bioorganic Chemistry, Chair of Organic Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Krakow, Poland [email protected] Pharmazie 66: 733–739 (2011) doi: 10.1691/ph.2011.1543 A series of different 1,4-substituted piperazine derivatives (1–11) was synthesized. It comprised 1- (substituted-phenoxyalkyl)-4-(2-methoxyphenyl)piperazine derivatives (1–5); 1,4-bis(substituted-phenoxy- ethyl)piperazine derivatives (6–8) and 1-(substituted-phenoxy)-3-(substituted-phenoxyalkylpiperazin-1- yl)propan-2-ol derivatives (9–11). All compounds were evaluated for affinity toward ␣1- and ␣2-receptors by radioligand binding assays on rat cerebral cortex using [3H]prazosin and [3H]clonidine as specific radioli- gand, respectively. Furthermore ␣1-antagonistic properties were checked for most promising compounds (1–5 and 10) by means of inhibition of phenylephrine induced contraction in isolated rat aorta. Antago- nistic potency stayed in agreement with radioligand binding results. The most active compounds (1–5) 3 displaced [ H]prazosin from cortical binding sites in low nanomolar range (Ki = 2.1−13.1 nM). -
Drug-Facilitated Sexual Assault Panel, Blood
DRUG-FACILITATED SEXUAL ASSAULT PANEL, BLOOD Blood Specimens (Order Code 70500) Alcohols Analgesics, cont. Anticonvulsants, cont. Antihistamines, cont. Ethanol Phenylbutazone Phenytoin Cyclizine Amphetamines Piroxicam Pregabalin Diphenhydramine Amphetamine Salicylic Acid* Primidone Doxylamine BDB Sulindac* Topiramate Fexofenadine Benzphetamine Tapentadol Zonisamide Guaifenesin Ephedrine Tizanidine Antidepressants Hydroxyzine MDA Tolmetin Amitriptyline Loratadine MDMA Tramadol Amoxapine Oxymetazoline* Mescaline* Anesthetics Bupropion Pyrilamine Methcathinone Benzocaine Citalopram Tetrahydrozoline Methamphetamine Bupivacaine Clomipramine Triprolidine Phentermine Etomidate Desipramine Antipsychotics PMA Ketamine Desmethylclomipramine 9-hydroxyrisperidone Phenylpropanolamine Lidocaine Dosulepin Aripiprazole Pseudoephedrine Mepivacaine Doxepin Buspirone Analgesics Methoxetamine Duloxetine Chlorpromazine Acetaminophen Midazolam Fluoxetine Clozapine Baclofen Norketamine Fluvoxamine Fluphenazine Buprenorphine Pramoxine* Imipramine Haloperidol Carisoprodol Procaine 1,3-chlorophenylpiperazine (mCPP) Mesoridazine Cyclobenzaprine Rocuronium Mianserin* Norclozapine Diclofenac Ropivacaine Mirtazapine Olanzapine Etodolac Antibiotics Nefazodone Perphenazine Fenoprofen Azithromycin* Nordoxepin Pimozide Hydroxychloroquine Chloramphenicol* Norfluoxetine Prochlorperazine Ibuprofen Ciprofloxacin* Norsertraline Quetiapine Ketoprofen Clindamycin* Nortriptyline Risperidone Ketorolac Erythromycin* Norvenlafaxine Thioridazine Meclofenamic Acid* Levofloxacin* Paroxetine -
Mass Spectral, Infrared and Chromatographic Studies on Designer Drugs of the Piperazine Class by Karim M. Hafiz Abdel-Hay a Diss
Mass Spectral, Infrared and Chromatographic Studies on Designer Drugs of the Piperazine Class by Karim M. Hafiz Abdel-Hay A dissertation submitted to the Graduate Faculty of Auburn University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Auburn, Alabama May 7, 2012 Approved by C. Randall Clark, Chair, Professor of Pharmacal Sciences Jack DeRuiter, Professor of Pharmacal Sciences Forrest Smith, Associate Professor of Pharmacal Sciences Angela Calderon, Assistant Professor of Pharmacal Sciences Abstract The controlled drug 3,4-methylenedioxybenzylpiperazine (3,4-MDBP) has regioisomeric and isobaric substances of mass equivalence, which have similar analytical properties and thus the potential for misidentification. The direct regioisomers of 3,4-MDBP include the 2,3- methylenedioxy substitution pattern and the indirect regioisomers include the three ring substituted methoxybenzoylpiperazines. The ethoxy and methoxymethyl ring substituted benzylpiperazines constitute the major category of isobaric substances evaluated in this study. The direct and indirect regioisomers of 3,4-MDBP and also isobaric substances related to MDBP were synthesized and compared to 3,4-MDBP by using gas chromatographic and spectrophotometric techniques. The GC-MS studies of the direct regioisomers and isobaric substances of 3,4-MDBP indicated that they can not be easily differentiated by mass spectrometry. The synthesized compounds were converted to their perfluoroacyl derivatives, trifluoroacetyl (TFA), pentafluoropropionyl amides (PFPA) and heptafluorobutryl amides (HFBA), in an effort to individualize their mass spectra and to improve chromatographic resolution. Derivatized 3,4-MDBP was not distingushed from its derivatized regioisomers or isobars using mass spectrometry. No unique fragment ions were observed for the various regioisomeric and the isobaric compounds. -
Mechanism of Drug-Induced Qt Interval Prolongation
ABSTRACT Torsades de pointes (TdP) is a polymorphic ventricular tachycardia characterized by a distinctive pattern of undulating QRS complexes that twist around the isoelectric line. TdP is usually self-terminating or can subsequently degenerate into ventricular fibrillation, syncope, and sudden death. TdP has been associated with QT interval prolongation of the electrocardiogram; therefore, the QT interval has come to be recognized as a surrogate marker for the risk of TdP. International guidelines have been developed to harmonize both the preclinical and clinical studies for the evaluation of drug-induced TdP. However, currently preclinical in vitro and in vivo methods as well as biomarkers for proarrhythmias have been imperfect in predicting drug-induced TdP in humans. It is clear that relevant biomarkers together with appropriate models are needed to assess the arrhythmic risk of new chemical entities. The goal of the present dissertation is to create rabbit with myocardial failing heart as an in vivo animal model to predict TdP in humans and to determine mechanism(s) underlying TdP in this model. Electrocardiograms were recorded from bipolar transthoracic leads in 7 conscious healthy rabbits previously trained to rest quietly in slings. The RR and QT relationship, ii QT=2.4RR0.72 (r2=0.79, p < 0.001) was obtained by slowed the heart rate with 2.0 mg/kg zatebradine, and the algorithm for removing effect of heart rate on QT is QTc = QT/(RR)0.72. QTc lengthened significantly in all conscious rabbits given intravenous cisapride, dofetilide or haloperidol (p < 0.05), and QTc did not change with DMSO (vehicle control), propranolol or enalaprilat. -
2020 Medicaid Preapproval Criteria
2020 Medicaid Preapproval Criteria ABILIFY MAINTENA ................................................................................................................................................................ 10 ACTHAR HP ............................................................................................................................................................................ 11 ACTIMMUNE ......................................................................................................................................................................... 13 ADCIRCA ................................................................................................................................................................................ 14 ADEMPAS .............................................................................................................................................................................. 15 ADENOSINE DEAMINASE (ADA) REPLACEMENT ................................................................................................................... 17 AFINITOR ............................................................................................................................................................................... 18 AFINITOR DISPERZ ................................................................................................................................................................. 19 ALDURAZYME .......................................................................................................................................................................