Levobupivacaine is extensively metabolized with no unchanged levobupivacaine detected in urine or feces. In vitro studies using [14 C] levobupivacaine showed that CYP3A4 isoform and CYP1A2 isoform mediate the metabolism of levobupivacaine to desbutyl levobupivacaine and 3-hydroxy levobupivacaine, respectively. In vivo, the 3-hydroxy levobupivacaine appears to undergo further transformation to glucuronide and sulfate conjugates. Metabolic inversion of levobupivacaine to R(+)-bupivacaine was not evident both in vitro and in vivo.
来源:DrugBank
代谢
左布比卡因已知的人类代谢物包括N-(2,6-二甲基苯基)哌啶-2-甲酰胺。
Levobupivacaine has known human metabolites that include N-(2,6-Dimethylphenyl)piperidine-2-carboxamide.
Levobupivacaine is extensively metabolized with no unchanged levobupivacaine detected in urine or feces. In vitro studies using [14 C] levobupivacaine showed that CYP3A4 isoform and CYP1A2 isoform mediate the metabolism of levobupivacaine to desbutyl levobupivacaine and 3-hydroxy levobupivacaine, respectively. In vivo, the 3-hydroxy levobupivacaine appears to undergo further transformation to glucuronide and sulfate conjugates. Metabolic inversion of levobupivacaine to R(+)-bupivacaine was not evident both in vitro and in vivo.
Route of Elimination: Following intravenous administration, recovery of the radiolabelled dose of levobupivacaine was essentially quantitative with a mean total of about 95% being recovered in urine and feces in 48 hours. Of this 95%, about 71% was in urine while 24% was in feces.
Half Life: 3.3 hours
Levobupivacaine is a cholinesterase or acetylcholinesterase (AChE) inhibitor. A cholinesterase inhibitor (or 'anticholinesterase') suppresses the action of acetylcholinesterase. Because of its essential function, chemicals that interfere with the action of acetylcholinesterase are potent neurotoxins, causing excessive salivation and eye-watering in low doses, followed by muscle spasms and ultimately death. Nerve gases and many substances used in insecticides have been shown to act by binding a serine in the active site of acetylcholine esterase, inhibiting the enzyme completely. Acetylcholine esterase breaks down the neurotransmitter acetylcholine, which is released at nerve and muscle junctions, in order to allow the muscle or organ to relax. The result of acetylcholine esterase inhibition is that acetylcholine builds up and continues to act so that any nerve impulses are continually transmitted and muscle contractions do not stop. Among the most common acetylcholinesterase inhibitors are phosphorus-based compounds, which are designed to bind to the active site of the enzyme. The structural requirements are a phosphorus atom bearing two lipophilic groups, a leaving group (such as a halide or thiocyanate), and a terminal oxygen.
来源:Toxin and Toxin Target Database (T3DB)
毒理性
致癌物分类
对人类无致癌性(未列入国际癌症研究机构IARC清单)。
No indication of carcinogenicity to humans (not listed by IARC).
来源:Toxin and Toxin Target Database (T3DB)
毒理性
健康影响
急性接触胆碱酯酶抑制剂可能会导致胆碱能危象,表现为严重的恶心/呕吐、流涎、出汗、心动过缓、低血压、崩溃和抽搐。肌肉无力可能性增加,如果呼吸肌受到影响,可能会导致死亡。在运动神经积累的乙酰胆碱会导致神经肌肉接头处尼古丁受体的过度刺激。当这种情况发生时,可以看到肌肉无力、疲劳、肌肉痉挛、肌束震颤和麻痹的症状。当自主神经节积累乙酰胆碱时,这会导致交感系统中尼古丁受体的过度刺激。与此相关的症状包括高血压和低血糖。由于乙酰胆碱积累,中枢神经系统中尼古丁乙酰胆碱受体的过度刺激会导致焦虑、头痛、抽搐、共济失调、呼吸和循环抑制、震颤、全身无力,甚至可能昏迷。当由于乙酰胆碱过量在毒蕈碱乙酰胆碱受体上出现毒蕈碱过度刺激时,可能会出现视力障碍、胸部紧绷、由于支气管收缩引起的喘息、支气管分泌物增加、唾液分泌增加、流泪、出汗、肠蠕动和排尿的症状。对于男性和女性的生育、生长和发育,某些生殖效应与有机磷农药暴露有特定联系。关于生殖效应的大多数研究都是在农村地区使用农药和杀虫剂的农民中进行的。在女性中,月经周期紊乱、怀孕时间延长、自然流产、死产以及后代的一些发育效应与有机磷农药暴露有关。产前暴露与胎儿生长和发育受损有关。神经毒性效应也与有机磷农药中毒有关,在人类中引起四种神经毒性效应:胆碱能综合症、中间综合症、有机磷诱导的迟发性多发性神经病(OPIDP)和慢性有机磷诱导的神经精神障碍(COPIND)。这些综合症在急性 and 慢性暴露于有机磷农药后出现。
Acute exposure to cholinesterase inhibitors can cause a cholinergic crisis characterized by severe nausea/vomiting, salivation, sweating, bradycardia, hypotension, collapse, and convulsions. Increasing muscle weakness is a possibility and may result in death if respiratory muscles are involved. Accumulation of ACh at motor nerves causes overstimulation of nicotinic expression at the neuromuscular junction. When this occurs symptoms such as muscle weakness, fatigue, muscle cramps, fasciculation, and paralysis can be seen. When there is an accumulation of ACh at autonomic ganglia this causes overstimulation of nicotinic expression in the sympathetic system. Symptoms associated with this are hypertension, and hypoglycemia. Overstimulation of nicotinic acetylcholine receptors in the central nervous system, due to accumulation of ACh, results in anxiety, headache, convulsions, ataxia, depression of respiration and circulation, tremor, general weakness, and potentially coma. When there is expression of muscarinic overstimulation due to excess acetylcholine at muscarinic acetylcholine receptors symptoms of visual disturbances, tightness in chest, wheezing due to bronchoconstriction, increased bronchial secretions, increased salivation, lacrimation, sweating, peristalsis, and urination can occur. Certain reproductive effects in fertility, growth, and development for males and females have been linked specifically to organophosphate pesticide exposure. Most of the research on reproductive effects has been conducted on farmers working with pesticides and insecticdes in rural areas. In females menstrual cycle disturbances, longer pregnancies, spontaneous abortions, stillbirths, and some developmental effects in offspring have been linked to organophosphate pesticide exposure. Prenatal exposure has been linked to impaired fetal growth and development. Neurotoxic effects have also been linked to poisoning with OP pesticides causing four neurotoxic effects in humans: cholinergic syndrome, intermediate syndrome, organophosphate-induced delayed polyneuropathy (OPIDP), and chronic organophosphate-induced neuropsychiatric disorder (COPIND). These syndromes result after acute and chronic exposure to OP pesticides.
◉ Summary of Use during Lactation:Levobupivacaine is no longer marketed in the US. Levels in breastmilk are low, and it is poorly absorbed orally by the infant. Bupivacaine, the racemic mixture of dextro- and levobupivacaine, has not caused any adverse effects in breastfed infants.
Local anesthetics during labor and delivery with other anesthetics and analgesics has been reported by some to interfere with breastfeeding. However, this assessment is controversial and complex because of the many different combinations of drugs, dosages and patient populations studied as well as the variety of techniques used. In contrast, epidural local anesthetics begun after clamping of the umbilical cord appears to enhance breastfeeding success because of improved pain control. Overall, it appears that with good breastfeeding support epidural levobupivacaine with or without fentanyl or one of its derivatives has little or no adverse effect on breastfeeding success. Labor Labor pain medication may delay the onset of lactation. In one study, adding levobupivacaine wound infiltration to multimodal analgesia after cesarean section improved breastfeeding comfort.
◉ Effects in Breastfed Infants:Relevant published information on levobupivacaine was not found as of the revision date. However, bupivacaine administered to the mother by intrapleural or epidural routes had no effect on 13 breastfed infants.
◉ Effects on Lactation and Breastmilk:A nonrandomized convenience sample of women who did (n = 209) or did not (n = 157) receive epidural analgesia during labor was analyzed to determine whether epidurals affected the onset of lactation. Although not standardized, the typical procedure used sufentanil 10 to 15 mg together with either ropivacaine 0.1% or levobupivacaine 0.0625% epidurally, supplemented by epidural boluses of ropivacaine 0.1% or levobupivacaine 0.0625% about every 2 hours. No difference was found in the time of lactation onset between the two groups. Although women in both groups stated they wished to breastfeed prior to delivery, exclusive breastfeeding at 20 days postpartum was less frequent in the women who received an epidural (43%) than in women who did not (57%).
A randomized, unblinded study of women undergoing cesarean section found that women who received postoperative wound infiltration with levobupivacaine. A bolus of 50 mg was infused subfascially 5 cm lateral to the wound incision, followed by 6.25 mg/hour for 48 hours. Additional analgesia included acetaminophen, celecoxib, nefopam, morphine and droperidol. On day 2 postpartum, women who received the levobupivacaine infusion reported more comfort with breastfeeding. More women who received the levobupivacaine were breastfeeding on day 2, but the difference was not statistically significant.
A retrospective medical record study in China compared women who received patient-controlled epidural analgesia during labor (n = 527) to those who did not (n = 395). Epidural analgesia included 0.1% levobupivacaine and 5 mg of sufentanil in 10 mL of saline. All women completed a questionnaire regarding their breastfeeding experience at 6 months postpartum. There were no statistically significant differences between the groups in the proportion who initiated breastfeeding within 1 hour after birth or who exclusively or partially breastfed their infants at 1, 3, or 6 months postpartum.
The plasma concentration of levobupivacaine following therapeutic administration depends on dose and also on route of administration, because absorption from the site of administration is affected by the vascularity of the tissue. Peak levels in blood were reached approximately 30 minutes after epidural administration, and doses up to 150 mg resulted in mean C<sub>max</sub> levels of up to 1.2 ug/mL.
The plasma concentration of levobupivacaine following therapeutic administration depends on dose and also on route of administration, because absorption from the site of administration is affected by the vascularity of the tissue. Peak levels in blood were reached approximately 30 minutes after epidural administration, and doses up to 150 mg resulted in mean Cmax levels of up to 1.2 µg/mL.
Following intravenous administration, recovery of the radiolabelled dose of levobupivacaine was essentially quantitative with a mean total of about 95% being recovered in urine and feces in 48 hours. Of this 95%, about 71% was in urine while 24% was in feces.
来源:DrugBank
吸收、分配和排泄
分布容积
在健康志愿者中静脉给药40毫克后,66.91 ±18.23升。
66.91 ±18.23 L [after intravenous administration of 40 mg in healthy volunteers]
来源:DrugBank
吸收、分配和排泄
清除
静脉给药40毫克于健康志愿者后,平均药物清除率为39.06 ± 13.29升/小时。
39.06 ±13.29 L/h [after intravenous administration of 40 mg in healthy volunteers]
[EN] SELECTIVE MODIFICATION OF ORGANIC COMPOUNDS IN THE PRESENCE OF AMINES AND/OR SULFIDES [FR] MODIFICATION SÉLECTIVE DE COMPOSÉS ORGANIQUES EN PRÉSENCE D'AMINES ET/OU DE SULFURES
The present invention relates to dendrimer synthesis. Specifically, the present invention relates to triazine scaffolds capable of click chemistry for one-step synthesis of functionalized dendrimers, and methods of making and using the same.
[EN] PHARMACEUTICAL COMPOSITIONS OF POLYANIONIC AND NON-IONIC CYCLODEXTRIN-BASED DENDRIMERS AND USES THEREOF<br/>[FR] COMPOSITIONS PHARMACEUTIQUES DE DENDRIMÈRES À BASE DE CYCLODEXTRINE POLYANIONIQUE ET NON-IONIQUE ET UTILISATIONS ASSOCIÉES
申请人:LING CHANG-CHUN
公开号:WO2016161501A1
公开(公告)日:2016-10-13
The present application provides pharmaceutical compositions comprising polyanionic and polynon-ionic cyclodextrin-based dendrimers. The compositions can be used as excipients, or to bind to compounds such as in the use as a rescue medicine to remove undesired drugs and metabolites from a subject. Methods of use in treating a subject are also provided.
PHOSPHONIUM ION CHANNEL BLOCKERS AND METHODS FOR USE
申请人:Nocion Therapeutics, Inc.
公开号:US20210128589A1
公开(公告)日:2021-05-06
The invention provides compounds of Formula (I), or pharmaceutically acceptable salts thereof:
The compounds, compositions, methods and kits of the invention are useful for the treatment of pain, itch, and neurogenic inflammation.
This invention features methods and compositions for delivery of nucleic acids (e.g., DNA, RNA, PNA, and hybrids thereof) to cells. The nucleic acid delivery complexes of the invention permit biologically active nucleic acids to be delivered to cells and organisms in vitro and in vivo in a manner and form that allows the nucleic acids to carry out their desired biological function.
[EN] DEUTERATED MORPHINE DERIVATIVES<br/>[FR] DÉRIVÉS DE MORPHINE DEUTÉRÉS
申请人:SZEGEDI TUDOMÁNYEGYETEM
公开号:WO2014170704A1
公开(公告)日:2014-10-23
The invention relates to new morphine derivatives deuterated at the 7,8-position of the morphine ring, furthermore to a process for the preparation thereof, and to pharmaceutical compositions comprising them. The new deuterated morphine derivatives show high and selective μ-opioid receptor binding activity leading to the benefit of higher analgesic activity at lower dosages inducing thereby reduced adverse effects compared to the hydrogenated derivatives. The compounds of the invention are useful for example in the treatment of pain or can be used as antitussive agents with a reduced risk of the possibility of drug abuse.