Solns at pH 7 at 25 °C stable for short periods of time. Stability decreased with an incr in pH, temp and time. /sodium salt/
利尿酸是一种高效利尿药,其作用类似于呋塞米,主要抑制髓袢升支髓质部的Na+、Cl-重吸收。临床主要用于充血性心力衰竭、急性肺水肿、肾性水肿、肝硬化腹水、肝癌腹水、血吸虫病腹水、脑水肿及其他类型的水肿。
用法用量 成人口服一般剂量:一次25毫克,每日1~3次。如效果不佳可逐渐增加剂量,但每日总量不宜超过100毫克。通常5~7天为一个疗程。
急性肺水肿治疗:将25~50毫克利尿酸溶解于20~40毫升生理盐水中,在10~20分钟内缓慢静脉注射或点滴给药,若病情需要可增加剂量,但单次剂量不宜超过100毫克。
急性肾衰竭治疗:早期使用时,将25~40毫克利尿酸溶解于40~50毫升生理盐水中,以不超过100毫克的剂量缓慢静脉注射。必要时可在2~4小时内再次给药,但宜更换注射部位。
常见不良反应包括口干、乏力、肌肉痉挛、感觉异常、食欲减退、恶心、视力模糊和头痛等。此外,还可能出现高尿酸血症、高血糖、体位性低血压、胃肠道不适及暂时或永久性耳聋等症状。极少数患者可能会出现肝细胞损伤、过敏性紫癜、粒细胞缺乏、皮疹和发热等问题。孕妇禁用;哺乳期妇女、糖尿病患者、有痛风史者、严重肝功能损害者以及红斑狼疮患者应谨慎使用。无尿患者及婴儿禁用。
药代动力学利尿酸主要分布于细胞外液,其分布容积平均为体重的11.4%,血浆蛋白结合率为91%~97%,几乎都与白蛋白结合。该药物能通过胎盘屏障,并可泌入乳汁中。静脉注射后5分钟内开始发挥作用,0.33~1小时内达峰值,作用持续时间通常为2小时。T1/2β存在较大的个体差异,正常情况下为30~60分钟;在无尿患者中则延长至75~155分钟,在肝肾功能同时严重受损的患者中进一步延长到11~20小时。新生儿由于肝肾廓清能力较差而延长至4~8小时。约88%的药物以原形通过肾脏排泄,其余12%经肝脏代谢后由胆汁排出。当肾功能受损时,肝脏代谢会增加。利尿酸不被透析清除。
化学性质利尿酸是一种白色结晶性粉末,熔点为122℃。它极易溶于乙醇、易溶于乙醚或氯仿及冰醋酸中,但不易溶于水。
用途作为强效利尿剂,该药物主要用于严重水肿情况下的治疗,具有较强的抑制肾小管对钠、氯离子的再吸收作用。尽管其效果显著且快速,但由于毒性较大,在慢性肾功能不全患者中的使用应适当减少。鼠口服LD50值为627毫克/千克。
生产方法2,3-二氯-4-丁酰苯酚制备:将丁酰氯、2,3-二氯苯甲醚和三氯化铝依次加入二硫化碳中,在室温下反应1小时,然后继续反应1小时后回收二硫化碳。用正庚烷处理后再加入三氯化铝回流3小时,冷却至50℃,过滤、洗涤并经酸碱法精制及活性炭脱色后得到熔点为108-111℃的精品,收率约为85%。
依他尼酸制备:将上述制得的2,3-二氯-4-丁酰苯酚与无水乙醇和乙酸钠加热至回流状态后滴加溴乙酸乙酯,在此条件下反应3小时后再回收乙醇,冷却、过滤并用乙醇重结晶得到产物。随后将其投入甲醛及乙醇混合溶液中,并于回流下加入碳酸钾及水与乙醇的混合液继续反应1.5小时。冷却后析出沉淀,经过滤、洗涤和干燥处理最终通过重结晶和活性炭脱色获得目标化合物依他尼酸,收率约为40%。
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
(2,3-二氯-4-丁酰基苯氧基)乙酸 | <2,3-dichloro-4-(1-oxobutyl)phenyloxy>acetic acid | 1217-67-0 | C12H12Cl2O4 | 291.131 |
—— | 2,3-Dichlor-4-(2-methylenbutyryl)phenol | 4115-00-8 | C11H10Cl2O2 | 245.105 |
—— | (2,3-dichloro-4-[2-dimethylaminomethyl-butyryl]phenoxy)acetic acid | 1160-10-7 | C15H19Cl2NO4 | 348.226 |
1-(2,3-二氯-4-羟基苯基)-1-丁酮 | 2,3-Dichlor-4-butyryl-phenol | 2350-46-1 | C10H10Cl2O2 | 233.094 |
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
—— | ethacrynic acid methyl ester | 6463-21-4 | C14H14Cl2O4 | 317.169 |
—— | [2,3-Dichloro-4-(2-methylene-butyryl)-phenoxy]-acetic acid ethyl ester | 23870-41-9 | C15H16Cl2O4 | 331.196 |
—— | ethacrynic acid chloride | 113239-57-9 | C13H11Cl3O3 | 321.588 |
—— | 4-hydroxyphenethyl 2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)acetate | —— | C21H20Cl2O5 | 423.293 |
(2,3-二氯-4-丁酰基苯氧基)乙酸 | <2,3-dichloro-4-(1-oxobutyl)phenyloxy>acetic acid | 1217-67-0 | C12H12Cl2O4 | 291.131 |
—— | N-butyl-2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)acetamide | —— | C17H21Cl2NO3 | 358.265 |
—— | N-<<2,3-dichloro-4-(2-methylenebutyryl)phenoxy>acetyl>glycine | 29922-97-2 | C15H15Cl2NO5 | 360.194 |
—— | 1-{4-[(4-aminobutylaminooxy)methyl]-2,3-dichlorophenyl}-2-methylenebutan-1-one | 1284258-81-6 | C17H22Cl2N2O3 | 373.279 |
—— | N-(4-fluorobutyl)ethacrynic amide | 1277190-29-0 | C17H20Cl2FNO3 | 376.255 |
—— | N-(4-hydroxy-butyl)ethacrynic amide | 1277190-30-3 | C17H21Cl2NO4 | 374.264 |
—— | [18F]FBuEA | 1277190-28-9 | C17H20Cl2FNO3 | 375.257 |
—— | 2-[2,3-dichloro-4-(2-ethyl-acryloyl)-phenoxy]-N-(2,2,2-trifluoro-ethyl)-acetamide | —— | C15H14Cl2F3NO3 | 384.182 |
—— | N-(3-azidopropyl)-2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)acetamide | 1616732-44-5 | C16H18Cl2N4O3 | 385.25 |
—— | {2-[2,3-dichloro-4-(2-ethyl-acryloyl)-phenoxy]-acetylamino}-acetic acid methyl ester | —— | C16H17Cl2NO5 | 374.221 |
—— | N-benzyl-2-(2,3-dichloro-4-(methylenebutyryl)phenoxy)acetamide | —— | C20H19Cl2NO3 | 392.282 |
二氢依他尼酸 | dihydroethacrynic acid | 5378-94-9 | C13H14Cl2O4 | 305.158 |
—— | 1-[2,3-dichloro-4-(2-oxo-2-piperidin-1-yl-ethoxy)-phenyl]-2-ethyl-propenone | 849122-18-5 | C18H21Cl2NO3 | 370.276 |
—— | N-{[2,3-dichloro-4-(2-methylenebutyryl)phenoxy]-acetyl}-S(+)-serine | 113239-21-7 | C16H17Cl2NO6 | 390.22 |
—— | <2,3-Dichlor-4-(2-cyanmethylbutyryl)phenoxy>essigsaeure | 138470-12-9 | C14H13Cl2NO4 | 330.168 |
2-去亚甲基-2-氯甲基依他尼酸 | <2,3-dichloro-4-(2-hydroxymethyl-1-oxobutyl)phenyloxy>acetic acid | 95772-54-6 | C13H14Cl2O5 | 321.157 |
—— | bis-1,3-ethacrynylphenylenediamine | 819883-70-0 | C32H28Cl4N2O6 | 678.396 |
—— | [1-[4-(2-Amino-2-oxoethyl)phenoxy]-3-(propan-2-ylamino)propan-2-yl] 2-[2,3-dichloro-4-(2-methylidenebutanoyl)phenoxy]acetate | —— | C27H32Cl2N2O6 | 551.467 |
—— | N-[4-(t-butyldimethylsilanyloxy)butyl]ethacrynic amide | 1277190-31-4 | C23H35Cl2NO4Si | 488.527 |
—— | 2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)-N-(4-hydroxy-3-methoxyphenethyl)acetamide | —— | C22H23Cl2NO5 | 452.334 |
—— | 4-(biphenyl-4-yl)-N-(4-(2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)acetamido)butyl)-4-oxobutanamide | 1284259-56-8 | C33H34Cl2N2O5 | 609.549 |
—— | <2,3-Dichlor-4-(2-ethyl-4-oxovaleryl)phenoxy>essigsaeure | 139519-83-8 | C15H16Cl2O5 | 347.195 |
—— | <2,3-Dichlor-4-(2-ethyl-4-nitrobutyryl)phenoxy>essigsaeure | 138470-10-7 | C14H15Cl2NO6 | 364.182 |
—— | 4-[4-(Carboxymethoxy)-2,3-dichlorobenzoyl]hexanoic acid | 183430-21-9 | C15H16Cl2O6 | 363.194 |
—— | (R)-benzyl 2-(2-(2,3-dichloro-4-(2-methylenebutyryl)phenoxy)acetylamino)propionate | —— | C23H23Cl2NO5 | 464.345 |
—— | 2,2'-<(2,6-Diethyl-1,4,7-trioxo-1,7-heptandiyl)bis<(2,3-dichlor-4,1-phenylen)oxy>>diessigsaeure | 138470-18-5 | C27H26Cl4O9 | 636.31 |
—— | 2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)-N-(2-((4-methylphenyl)sulfonamido)ethyl)acetamide | —— | C22H24Cl2N2O5S | 499.415 |
—— | N-Boc-N-(4-hydroxybutyl)ethacrynic amide | 1277190-33-6 | C22H29Cl2NO6 | 474.381 |
—— | N-Boc-N-(4-fluorobutyl)ethacrynic amide | 1277190-35-8 | C22H28Cl2FNO5 | 476.372 |
—— | 2-(2,3-dichloro-4-(1-hydroxy-2-methylenebutyl)phenoxy)acetic acid | —— | C13H14Cl2O4 | 305.158 |
—— | 2,2'-<(2,6-Diethyl-4-nitro-1,7-dioxo-1,7-heptandiyl)bis<(2,3-dichlor-4,1-phenylen)oxy>>diessigsaeure | 138470-17-4 | C27H27Cl4NO10 | 667.324 |
—— | 2-[2,3-Dichloro-4-(5-ethoxy-4-ethoxycarbonyl-2-ethyl-5-oxopentanoyl)phenoxy]acetic acid | 183430-20-8 | C20H24Cl2O8 | 463.312 |
—— | N-Boc-N-[4-(t-butyldimethylsilanyloxy)butyl]ethacrynic amide | 1277190-32-5 | C28H43Cl2NO6Si | 588.644 |
—— | ethacrynic acid-glutathione conjugate | —— | C23H27Cl2N3O9S | 592.454 |
—— | 1-(2,3-dichloro-4-((3-phenyl-1,2,4-oxadiazol-5-yl)methoxy)phenyl)-2-methylenebutan-1-one | 1006585-49-4 | C20H16Cl2N2O3 | 403.265 |
—— | <2,3-Dichlor-4-(2-ethyl-4-oxo-2-cyclopenten-1-yl)phenoxy>essigsaeure | 138470-19-6 | C15H14Cl2O4 | 329.18 |
—— | 4-(4-(2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)acetyl)piperazin-1-yl)phenyl diethyl phosphate | —— | C27H33Cl2N2O7P | 599.448 |
[(6,7-二氯-2-乙基-2,3-二氢-1-氧代-1H-茚-5-基)氧基]乙酸 | (6,7-Dichlor-2-ethyl-1-oxo-5-indanyloxy)-essigsaeure | 27366-21-8 | C13H12Cl2O4 | 303.142 |
—— | 1-Benzyl-6-ethacrynyl-2-deoxy-α-D-arabinohexopyranoside | —— | C26H30Cl2O7 | 525.426 |
—— | 1-(2,3-dichloro-4-(2-(4-(4-((2-oxido-1,3,2-dioxaphosphinan-2-yl)oxy)phenyl)piperazin-1-yl)-2-oxoethoxy)phenyl)-2-methylenebutan-1-one | —— | C26H29Cl2N2O7P | 583.405 |
—— | N-(2-((5-chloro-2-methoxyphenyl)sulfonamido)ethyl)-2-(2,3-dichloro-4-(2-methylenebutanoyl)phenoxy)acetamide | —— | C22H23Cl3N2O6S | 549.859 |
—— | γ-Glu[2-amino-1-mercapto(S-EA)-6-hexanoic acid]-OH | 350033-80-6 | C24H32Cl2N2O9S | 595.498 |
—— | N-Boc-N-[4-(toluenesulfonyloxy)butyl]ethacrynic amide | 1277190-34-7 | C29H35Cl2NO8S | 628.571 |
—— | 3-(2,3-Dichlor-4-hydroxybenzoyl)valeriansaeure | 138470-15-2 | C12H12Cl2O4 | 291.131 |
—— | 1-(2,3-dichloro-4-((3-(4-(trifluoromethyl)phenyl)-1,2,4-oxadiazol-5-yl)methoxy)phenyl)-2-methylenebutan-1-one | 1206809-03-1 | C21H15Cl2F3N2O3 | 471.263 |
—— | [3H]-Ethacrynic acid glutathione | —— | C23H29Cl2N3O10S | 610.469 |
4-[(4-羧基甲氧基-2,3-二氯-苯基)-羟基-甲基]-己酸 | 4-[[4-(Carboxymethoxy)-2,3-dichlorophenyl]-hydroxymethyl]hexanoic acid | 1027488-65-8 | C15H18Cl2O6 | 365.21 |
—— | γGlu-N-methyl-Cys(ethacrynic acid)-Gly | 350033-79-3 | C24H31Cl2N3O10S | 624.496 |
—— | [2,3-dichloro-4-(6ethyl-3-oxo-1-cyclohexen-1-yl)phenoxy]acetic acid | 183430-18-4 | C16H16Cl2O4 | 343.207 |
—— | [2,3-dichloro-4-(6-ethyl-4-methyl-3-oxo-1-cyclohexen-1-yl)phenoxy]acetic acid | —— | C17H18Cl2O4 | 357.234 |