2',3'-dideoxyinosine appears as fluffy white solid or powder. Condenses at 347°F and darkens at approximately 572°F. Odorless. (NTP, 1992)
颜色/状态:
White solid
蒸汽压力:
6.6 mm Hg @ 25 °C /Estimated/
亨利常数:
Henry's Law constant = 2.4X10-20 atm-cu m/mol @ 25 °C /Estimated/
稳定性/保质期:
Didanosine unbuffered pediatric powder for oral solution should be stored at 15-30 °C. Following reconstitution with water and admixture with a liquid antacid as directed, didanosine pediatric oral suspensions contain 10 mg of the drug per ml and are stable for 30 days when refrigerated at 2-8 °C. Reconstituted and admixed pediatric oral suspensions of didanosine should be stored in tightly closed, flint glass bottles with child resistant closures and refrigerated at 2-8 °C. Unused portions of reconstituted and admixed pediatric didanosine oral suspension should be discarded after 30 days.
Rapidly metabolized intracellularly to its active moiety, 2,3-dideoxyadenosine-5-triphosphate (ddA-TP). It is then further metabolized hepatically to yield hypoxanthine, xanthine, and uric acid.
The metabolic fate of didanosine has not been fully evaluated in humans; however, because didanosine is an analog of inosine, a naturally occurring purine nucleoside, metabolism of the drug presumably would occur via the same pathways responsible for the elimination of endogenous purines.
Intracellularly, didanosine is converted to dideoxyinosine-5'-monophosphate. ...The monophosphate derivative may then be aminated to dideoxyadenosine-5'-monophosphate in a reaction catalysed by adenylosuccinate synthetase/lyase and phosphorylated to dideoxyadenosine-5'-diphosphate and to dideoxyadenosine-5'-triphosphate via other enzymes (eg, purine nucleoside monophosphate /kinase/, purine /nucleoside/ diphosphate kinase). Intracellular (host cell) conversion of didanosine to triphosphate derivative is necessary for the antiviral activity of the drug.
Didanosine is metabolized along two pathways. A quantitatively minor pathway that is responsible for the antiretroviral activity of the drug involves phosphorylation and reversible amination of didanosine monophosphate to dideoxyadenosine monophosphate through the action of adenylosuccinate synthetase and adenylosuccinate lyase. The dideoxyadenosine monophosphate is further phosphorylated to the triphosphate (ddATP) by purine nucleoside monophosphate kinase and purine nucleoside diphosphate kinase. The intracellular half-time of ddATP is 1224 hr, suggesting that less frequent dosing may be required than with zidovudine or zalcitabine. In addition to inhibiting the viral reverse transcriptase, ddATP becomes incorporated into DNA and terminates the replicating DNA chain in both cellular and viral DNA. Although dideoxyadenosine phosphorylation is critical to the mechanism of antiviral activity, it is responsible for only a small fraction of the total drug disposition. Approximately 40% of the total dose is recovered as unchanged drug in the urine, about 50% as hypoxanthine and about 4% as uric acid, while non-renal clearance occurs via metabolism and/or biliary excretion. The major metabolic pathway involves metabolism to uric acid through purine nucleotide phosphorylase, which produces hypoxanthine. This compound either re-enters the purine nucleotide pools or is further metabolized to xanthine and uric acid through the action of xanthine oxidase.
来源:Hazardous Substances Data Bank (HSDB)
毒理性
毒性总结
副作用包括胰腺炎、周围神经病变、腹泻、高尿酸血症和肝功能不全。
Side effects include pancreatitis, peripheral neuropathy, diarrhea, hyperuricemia and hepatic dysfunction
Mild and transient elevations in liver enzymes occur in up to 9% of patients on didanosine, but these are generally asymptomatic and self-limited. Clinically apparent hepatotoxicity is uncommon, but well described. Several forms of liver injury have been associated with didanosine use: acute idiosyncratic liver injury, lactic acidosis with steatosis and hepatic dysfunction (LASH), and noncirrhotic portal hypertension due to nodular regenerative hyperplasia or hepatoportal sclerosis.
Rare instances of acute, seemingly idiosyncratic liver injury due to didanosine have been described, particularly in children. The injury arises within a few weeks of starting therapy and is associated with hepatocellular pattern of serum enzymes (Case 3). Immunoallergic features (rash, fever and eosinophilia) may occur, but are not prominent and autoantibodies are generally not present. Recovery is rapid with stopping didanosine, but the injury can be severe and lead to acute liver failure. This form of didanosine injury is rare and resembles the idiosyncratic acute hepatitis-like injury that occurs with many medications.
The second pattern of injury due to didanosine is more common and is characterized by development of marked lactic acidosis, microvesicular steatosis, and hepatic synthetic dysfunction (LASH). This form of liver injury typically arises after at least two months of therapy and is preceded by nonspecific prodromal symptoms of anorexia, nausea, vomiting, diarrhea, and weakness which is followed by dyspnea, jaundice and confusion. Lactic acidosis usually accompanies the hepatic injury and may be the predominant clinical feature. Jaundice arises late and serum enzymes are unusually only mildly or moderated elevated, the pattern being mixed or actually cholestatic. Pancreatitis, myopathy and neuropathy may also occur. This distinctive form of hepatotoxicity associated with didanosine can be rapidly fatal (Case 1), but is potentially reversible with intensive support and early withdrawal of therapy (Case 2). Preexisting liver injury, female sex, older age, obesity, alcohol use and concurrent therapy with stavudine, ribavirin or tenofovir appear to increase the risk of this syndrome. LASH is most commonly associated with stavudine therapy, but can also occur with zidovudine, fialuridine, intravenous tetracycline, linezolid and aspirin (Reye syndrome).
A final form of didanosine associated liver injury is noncirrhotic portal hypertension due to nodular regenerative hyperplasia or hepatoportal sclerosis (Case 4). This chronic form of liver injury due to didanosine generally arises after several years of therapy. Patients usually present with signs of portal hypertension and advanced liver disease, ascites, variceal hemorrhage, muscle wasting and weakness with no obvious cause (absence of hepatitis B or C and no history of alcoholism). Serum enzymes are only modestly elevated and bilirubin levels can be normal. Platelet counts tend to be low and a fall of platelet count can be a useful surrogate marker for the development of portal hypertension. These patients have typically been on multiple antiretroviral agents and the attribution of injury to didanosine cannot always be made. The clinical presentation can be after didanosine has been discontinued. Stavudine and zidovudine have also been implicated as have other nucleoside analogues such as azathioprine, mercaptopurine and thioguanine. Major risk factors associated with this complication include duration of didanosine use, low CD4 cell counts and concurrent use of stavudine. Liver biopsy shows the absence of cirrhosis and changes of nodular regenerative hyperplasia or hepatoportal sclerosis or both. Hepatic venous pressure gradients are usually elevated, but probably underestimate the degree of portal hypertension because of its presinusoidal nature. Similarly, noninvasive tests for hepatic fibrosis, such a transient elastography, are usually abnormal but not to the degree that is usually associated with the portal hypertension that occurs with cirrhosis.
Interestingly, a high proportion of patients who develop noncirrhotic portal hypertension have an underlying thrombophilic condition such as protein S or protein C deficiency and are prone to develop portal vein thrombosis which can be the cause of acute decompensation.
Likelihood score: A (well known cause of both acute and chronic forms of clinically apparent liver injury).
Based on data from in vitro and animal studies, it is presumed that the metabolism of didanosine in man occurs by the same pathways responsible for the elimination of endogenous purines. Purines are eliminated by the kidneys.
A single oral dose of 375 mg didanosine was administered to two pregnant women (length of amenorrhoea, 21 and 24 weeks). Maternal blood was collected by venepuncture, and amniotic fluid and fetal blood samples were taken 65 and 78 min after treatment. Didanosine crossed the placenta, with fetal:maternal ratios of 0.14 and 0.19.
Presence of food in the GI tract generally decreases the rate and extent of absorption of oral didanosine. If didanosine delayed-release capsules are administered with food, peak plasma concentrations and AUC of the drug are decreased approximately 46 and 19%, respectively. In one study, the bioavailability of chewable/dispersible, buffered tablets of didanosine administered up to 30 minutes prior to a meal was similar to the drug's bioavailability under fasting conditions. When the tablets were administered up to 2 hours after a meal, peak plasma concentrations and AUC of didanosine were decreased approximately 55%.
来源:Hazardous Substances Data Bank (HSDB)
吸收、分配和排泄
抗酸药提高了地丹诺辛的口服生物利用度。
Antacids increase the oral bioavailability of didanosine.
[EN] SPIROCYCLIC HETEROCYCLE COMPOUNDS USEFUL AS HIV INTEGRASE INHIBITORS<br/>[FR] COMPOSÉS HÉTÉROCYCLIQUES SPIROCYCLIQUES UTILES COMME INHIBITEURS DU VIH
申请人:MERCK SHARP & DOHME
公开号:WO2016094198A1
公开(公告)日:2016-06-16
The present invention relates to Spirocyclic Heterocycle Compounds of Formula (I): (I) and pharmaceutically acceptable salts thereof, wherein A, B, X, R1, R2, R3 and R4 are as defined herein. The present invention also relates to compositions comprising at least one Spirocyclic Heterocycle Compound, and methods of using the Spirocyclic Heterocycle Compounds for treating or preventing HIV infection in a subject.
[EN] METALLOENZYME INHIBITOR COMPOUNDS<br/>[FR] COMPOSÉS INHIBITEURS DE MÉTALLOENZYMES
申请人:VPS 3 INC
公开号:WO2018165520A1
公开(公告)日:2018-09-13
Provided are compounds having HDAC6 modulating activity, and methods of treating diseases, disorders or symptoms thereof mediated by HDAC6.
提供具有HDAC6调节活性的化合物,以及通过HDAC6介导的治疗疾病、疾病或症状的方法。
Integrase inhibitors
申请人:Cai R. Zhenhong
公开号:US20080058315A1
公开(公告)日:2008-03-06
Tricyclic compounds, protected intermediates thereof, and methods for inhibition of HIV-integrase are disclosed.
三环化合物,其受保护的中间体,以及用于抑制HIV整合酶的方法被披露。
3-Aminocyclopentanecarboxamides as modulators of chemokine receptors
申请人:Xue Chu-Biao
公开号:US20060004018A1
公开(公告)日:2006-01-05
The present invention is directed to compounds of Formula I:
which are modulators of chemokine receptors. The compounds of the invention, and compositions thereof, are useful in the treatment of diseases related to chemokine receptor expression and/or activity.
[EN] DERIVATIVES OF AMANITA TOXINS AND THEIR CONJUGATION TO A CELL BINDING MOLECULE<br/>[FR] DÉRIVÉS DE TOXINES D'AMANITES ET LEUR CONJUGAISON À UNE MOLÉCULE DE LIAISON CELLULAIRE
申请人:HANGZHOU DAC BIOTECH CO LTD
公开号:WO2017046658A1
公开(公告)日:2017-03-23
Derivatives of Amernita toxins of Formula (I), wherein, formula (a) R 1, R 2, R 3, R 4, R 5, R 6, R 7, R 8, R 9, R 10, X, L, m, n and Q are defined herein. The preparation of the derivatives. The therapeutic use of the derivatives in the targeted treatment of cancers, autoimmune disorders, and infectious diseases.