27 - IBD Medchem Flashcards

(30 cards)

1
Q

SAR of H1-Antagonist

What causes a INCREASE in H1 Antagonistic Activity?

A

PARA** on **AR1
P–>AR1

INCREASE H1 Antagonistic Activity
&
also DECREASES Anticholinergic Side Effects

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2
Q

What IBD Drug?

MoA?

A

TOFACITINIB

ORAL - Jak3/Jak1 Antagonist
for UC

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3
Q

What IBD Drug?

MoA?

A

H3 Agonist

(R) a-Methylhistamine, -CH3 @ branch

H3 Receptors present in CNS

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4
Q

What IBD Drug?

MoA?

A

PENTOXIFYLLINE
SImilar to Thalidomide & Caffeine
Active metabolite is Lisofylline

  • down regulates the:*
  • *TNF-a production** @ protein & mRNA levels

weaker TNF-a inhibition vs Thalidomide

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5
Q

What is ESSENTIAL for RECEPTOR BINDING?

AdrenoCorticoids

A

C & D Rings
carbons 11-21 (except 19)

C3 Carbonyl** & **Delta4 Double Bond

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6
Q

What IBD Drug & MoA?

A

Sulfasalazine = Prodrug

Sulfapyridine = highly lipid soluble
VV
Absorbed from the Colon

Balsalazide is only in Europe

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7
Q
  • *1-Ene** of Prednisone / Prednisolone
  • *does WHAT?**
A

Increases:
ANTI-INFLAMMATORY Activity x4

&
Salt Retention, Slightly

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8
Q

What can SIGNIFICANTLY LOWER Mineralcorticoid Activity?

Adrenocorticoids

A

Adding Substituents to the
A-SIDE

significantly LOWER mineralcorticoid activity

but does not abolish GC activity

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9
Q

What IBD Drug & MoA?

A

Mesalamine
AminoSalicylate, 5-ASA

Blocking CycloOxygenase
&
Inhibiting Prostaglandin Synthesis @ Colon

Controlled Release formulations:
Target GI location

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10
Q

What Substituents DECREASE Salt Retention?

Glucocorticoids

A

6a-Methyl
in Methyprednisolone
also INHIBITS CYP oxidation @ C6

16a-OH

16a- / 16b-methyl

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11
Q

SAR of H1-Antagonist

What causes a DECREASE in H1 Antagonistic Activity?

A

Ortho / Meta on AR1
OM->AR1

or

PARA** on **BOTH AR1+AR2
PARA on BOTH Aromatics

DECREASE H1 ANTAGONISTIC ACTIVITY

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12
Q

Calcineurin Inhibitors
for IBD

Drugs / MoA / Indications

A

CYCLOSPORINE** // **TACROLIMUS
CSA // FK

  • Prevents* Translocation of NFAT to nucleus
  • Inhibits:*
  • *Transcription of cytokines = IL-2**

Used in:
SEVERE + Treatment-REFRACTORY Cases

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13
Q

What IBD Drug?

MoA?

A

Thalidomide
SImilar to Pentoxifylline & Caffeine

Accelerates the:
*DEGRADATION* of TNF-a MRNA
inhibits the BIOSYNTHESIS

Still investigational, shown efficacy in
children + adolescents with Refractory Cohns Disease

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14
Q

What IBD Drug?

MoA?

A

DIPHENHYDRAMINE

FIRST GEN H1 Antagonist

  • *Lipophylic –> crosses BBB**
  • *CNS Sedation side effects**
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15
Q

H1 Receptor Antagonist

GENERAL STRUCTURE

A

2 Aromatic Rings
+
Tertiay Amine

Distance is 3-4 carbons away

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16
Q

What IBD Drug?

MoA?

A

H1 Agonist/Antagonist

2-MethylHistamine, -CH3 @ 2-position
CH3 is BETWEEN the Nitrogens

ANTIHISTAMINE = ALLERGIES

17
Q

SAR of H1-Antagonist

What causes a DECREASE in H1 Antagonistic Activity?

A

Ortho / Meta on AR1
OM->AR1

or

PARA** on **BOTH AR1+AR2
PARA on BOTH Aromatics

DECREASE H1 ANTAGONISTIC ACTIVITY

18
Q

H1 Binding Pocket

4 Components

A

Bidentate H-Bond

Hydrophobic Pocket

Weakly BASIC Pocket
small hydrophobic pocket

Optimal Distance ~4 carbons
between the Bidentate H-bonding group & Imidazole ring

19
Q

Terfenadine & Astemizole

Class / ADR

A

the FIRST Second Generation H1 Antagonist
exhibited:
no CNS sedation & less AC side effects
but….
Metabolized by CYP3A4
VVV
CYP3A4 substrates ketoconazole / clarithromycin
VVV
CARDIAC TOXICITY** & **ARRTHMIAS
due to hERG inhibition

20
Q

What IBD Drug?

MoA?

A

AZATHIOPRINE

PRODRUG of 6-MP

  • INHIBITS*
  • *Purine Nucleotide Biosynthesis**
  • T+B-cells lack the salvage pathway*

AzathioPURINE

21
Q

What IBD Drug?

MoA?

A

Fexofenadine
2nd Generation H1 Antagonist

  • *Carboxylated Active Metabolite of TERFENADINE**
  • *= potency & non-sedating**
  • LESS drug interactions // elminated unchanged*
22
Q

SAR of H1-Antagonist

AR2 Binding Site Considerations

A

HETEROAROMATIC RING
added to AR2 binding site = TOLERABLE

&

PARA** on **BOTH AR1+AR2
PARA on BOTH Aromatics
DECREASE H1 ANTAGONISTIC ACTIVITY

23
Q

What ABOLISHES Glucocorticoid Activity?

AdrenoCorticoids

A

Insertion of Substituents on the
B-SIDE
Beta = ABOVE

insertion at the A-SIDE does NOT abolish GC activity

24
Q

SAR of H1-Antagonist

What causes a DECREASE in H1 Antagonistic Activity?

A

Ortho / Meta on AR1
OM->AR1

or

PARA** on **BOTH AR1+AR2
PARA on BOTH Aromatics

DECREASE H1 ANTAGONISTIC ACTIVITY

25
**TNF-Alpha Monoclonal AB's** for IBD ## Footnote **Drugs / MoA**
**_Infliximab**_ // _**Adalimumab_** Certolizumab // Golimumab * *Monoclonal AB's** that target: * *TNF-A** * *important pro-iflammatory Cytokine**
26
**What IBD Drug?** **MoA?**
**H2 ANTAGONIST** **4-Methylhistamine**, **CH3 @ "4-Position"** CH3 is next to the longer Chain * **Inhibits:*** * *Gastric Acid Secretion**
27
**What IBD Drug?** **MoA?**
**LORATADINE** 2nd Generation H1 Antagonist **Metabolized by CYP3A4** Similar structure to **1st Gen Diphenhydramine** HAS **LINKED Aromatics = Not freely rotating** **Desloratadine = more broken down, *less CYP3A4 metabolism***
28
**What IBD drug & MoA?**
**_Olsalazine_** Aminosalicylate, 5-ASA **Dimer of 5-ASA** linked by an **AZO Bond** converted into ASA by: **Bacteria @ Lower Intestine** **PRODRUG**
29
**What IBD Drug?** **MoA?**
**METHOTREXATE** Folic Acid Analog ***INHIBITS* Pyrimidine Biosynthesis** MTX = PYR
30
**What IBD Drug?** **MoA?**
**CETIRIZINE** Oxidized Active metabolite of **Hydroxyzine** **= potency** ***less drug interactions // eliminated unchanged*** Similar structure to **1st Gen Diphenhydramine** but with **cyclic Nitrogen**