Professional Documents
Culture Documents
Pratik Khanal
Classification:-
A. NARCOTIC ANALGESICS
H O
1. Naturally Occuring:-
Morphine, Codeine, Thebaine
O H
H
N
C H 3
H O
M o rp h in e
O
H3C
O H
H
N
CH3
HO
Codeine
2. Semisynthetic opioids:-
Heroin (diacetyl morphine), Oxymorphone, Buprenorphine
A
c
O
OH
H
N
C
H3
A
c
O
H
e
r
o
i
n(
D
i
ac
e
t
y
lm
o
rp
h
i
n
e
)
HO
H N
O OH
Buprenorphine
3. Synthetic Opioids
Meperidine (Pethidine), Fentanyl, Pentazocine, Tramadol
N N
F e n ta n y l
HO
P e n ta z o c in e
Pethidine (Meperidine)
N
H
O
O
H
3C T
rama
dol
B. NARCOTIC ANTAGONISTS
Naloxone, Naltrexone, Nalmefene
H
O
O O
H
N
a
lo
xo
ne
H
O H
O
O O
H
O O
H
N
N
O
H
2C N
a
lt
rex
on
e
N
al
m e
fe
ne
C. ANTITUSSIVE AGENTS:-
Noscapine (Narcotine, Anarcotine), Dextromethorphan, Terpin
Hydrate
O
H
N
O
CH3
O
H 3C O
H
O
H 3C
O
O N o s c a p in e
CH3
OCH3
O H
H 2O H3C N
Dextromethorphan
O H
T e rp in H y d ra te
1. NOCICEPTIVE ANALGESICS:-
2. NEUROPATHIC ANALGESICS:-
Acid
Morphine O H
H
N
CH3
HO H
Conjugate Acid
Base O
O H
H
N
CH3
HO
Conjugate Base
11. Metabolism:- 3- and 6-O glucuronides, N-demethylation and
O-methylation to codeine (minor).
OH
O
O
HO OH
HO
OH
Glucuronic acid
H O G lu c - O
O H O H
M o rp h in e
H H
N H N
C H 3
H O H O
N o rm o rp h in e
M o rp h in e -3 -g lu c u ro n id e
C o d e in e
Peripheral and Nuclear Modifications of Morphine:-
A. Peripheral
I. Ring A and its 3-hydroxyl group is an important structural
feature for analgesic activity. Removal of 3-OH group reduces its
analgesic activity by 10-fold.
M o rp h in e O H
H
N
CH3
HO
3 -D e o x y m o rp h in e
II. Altering C-3 OH by etherification reduces narcotic analgesic
activity, the larger the ether group, the lower the analgesic activity.
With less active as analgesics, compounds such as codeine possess
very useful antitussive activity. O
H 3C
O H
M o rp h in e
H
N
C H 3
H O
C o d e in e
R P = 0 .1 5
H 3 C
M o rp h in e O H
H
N
C H 3
H O
E th y lm o rp h in e
R P = 0 .1
O
N
O H
Morphine
H
N
CH3
HO
Pholcodeine
RP=0.01
III. Derivatization of the C-3 OH by esterification generally only
modestly increases activity.
H 3C O
M o rp h in e O H
H
N
C H 3
H O
3 -A c e ty lm o rp h in e
R P > 1 .0
H 3C O
O H
M o rp h in e
O H
N
CH 3
H 3C O
D ia c e ty lm o rp h in e (H e ro in )
R P = 2 .0
IV. 6-OH of morphine are not required for analgesic activity as
indicated by relative potencies of the following morphine
analogues.
HO
M o rp h in e O H
H
N
CH 3
6 -D e o x y m o rp h in e
R P = 10
M o rp h in e 6 -M e th o x y m o rp h in e
RP = 5
H O
O H
O H
N
C H 3
H 3C O
M o rp h in e -6 -a c e ta te
R P = 4 .2
V. The 7,8 double bond of morphine also is not required for
analgesic activity as indicated by the relative analgesic potency of
dihydromorphine.
HO
Morphine O H
H
N
CH3
HO
Dihydromorphine
RP = 1.2
VI Simple E ring opened analogues of morphine such as the
compound below are less active.
HO
Morphine HO H
N
CH3
HO
RP = 0.13
VII. Replacement of morphine’s N-methyl group by a hydrogen
atom as in normorphine reduces analgesic activity of that analog.
Much of this decrease is due to increased polarity resulting in
reduced BBB translocation to the CNS.
HO
Morphine O H
H
NH
HO
Normorphine
RP = 0.05
B. Nuclear
Annelation – adding a sixth ring across carbons 6 and 14 of the C
ring of morphine – yields compounds such as etorphine,
buprenorphine which are extremely potent analgesics. Etorphine
is typically used to immobilize large animals (elephants).
HO
The lethal dose of etorphine
in humans is reported to be
as low as 30 μg (0.03mg).
OH
Etorphine
HO
H N
O OH
Buprenorphine
Despite the presence of the N-cyclopropyl methyl group, which
normally promotes therapeutically useful μ antagonist action,
buprenorphine is a very potent but partial, agonist with an
analgesic potency between 25- and 40-fold that of morphine. A
0.3 to 0.4 mg dose of this oripavine-based analgesic is equipotent
with 10mg of morphine.
Mechanism of Action:-
OVERVIEW OF PAIN :-