Disclosed are multibinding compounds which are muscarinic receptor antagonists. The multibinding compounds of this invention containing from 2 to 10 ligands covalently attached to one or more linkers. Each ligand is, independently of each other, a muscarinic receptor antagonist or an allosteric modulator provided that at least one of said ligand is a muscarinic receptor antagonist. The multibinding compounds of this invention are useful in the treatment and prevention of diseases such as chronic obstructive pulmonary disease, chronic bronchitis, irritable bowel syndrome, urinary incontinence, and the like.
Three types of compound, quinuclidine-3-spiro-2'-dioxolane (A), piperidine-4-spiro-2'-dioxolane (B), and piperidine-4-spiro-2'-(4'-oxodioxolane) (C) and their methiodides were synthesized. The cholinomimetic activities of these compounds were examined to investigate the relationship between the activities of these compounds, which have rigid skeletons, and those of known muscarinic agents.