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IB CHEMISTRY OPTION D MEDICINAL CHEMISTRY D.1: PHARMACEUTICAL PRODUCTS AND DRUG ACTION UNDERSTANDINGS - In animal studies, the therapeutic index is the lethal dose of a drug for 50% of the population (LD 50) divided by the minimum effective dose for 50% of the population (ED50). - In humans, the therapeutic index is the toxic dose of a drug for 50% of the population (TD 50) divided by the minimum effective dose for 50% of the population (ED 50). - The therapeutic window is the range of dosages between the minimum amounts of the drug that produce the desired effect and a medically unacceptable adverse effect. - Dosage, tolerance, and addiction are considerations of drug administration. - Bioavailability is the fraction of the administered dosage that reaches the target part of the body. - The main steps in the development of synthetic drugs include identifying the need and structure, synthesis, yield and extraction. - Drug-receptor interactions are based on the structure of the drug and the site of activity. APPLICATION AND SKILLS - Discussion of experimental foundations for therapeutic index and therapeutic window through both animal and human studies. - Discussion of drug administration methods. - Comparison of how functional groups, polarity, and medicinal administration can affect bioavailability. NATURE OF SCIENCE - Risks and benefits – medicines and drugs go through a variety of tests to determine their effectiveness and safety before they are made commercially available. Pharmaceutical products are classified for their use and abuse potential. MEDICINAL CHEMISTRY: INTRODUCTION *Cross-disciplinary science that links Organic chemistry, pharmacology, biochemistry, biology, medicine, mathematics, and computer science *Primary objective to ________________, ___________ and _____________ new bioactive compounds (i.e. pharmaceutical drugs) suitable for therapeutic use while taking into consideration the benefits and risks of new drugs on _______________, ____________ and the ______________________ The production of ________________ molecules (e.g. drugs, vaccines) used specifically for the treatment of _____________ = one of the most significant achievements of the last 100 years (e.g. eradication of ______________ & ___________, millions of _____________ and _______________ survivors) DEFINITIONS (Drug vs Medicine): - DRUG: a chemical that affects how the body works – for ____________or for ________; term often associated with ____________ substances - MEDICINE: a _____________ or synthetic substance that _______________ health (a beneficial drug) *Drug action depends on interaction with receptors: - The activity of most drugs is determined by their ability to ______ (based on a “good chemical fit” between drug and receptor) to a specific _____________ in the body. The binding ____________ development of disease. - Receptors = ______________ (e.g. enzymes), chemical structures on ________ membranes, or _________ NEW CHALLENGES FOR PHARMACEUTICAL INDUSTRY: - ______________ resistance - ______________ and ________________ hazards associated with cancer treatment and nuclear medicine - appearance of new _______________ (e.g. avian flu, zika-virus) - improving the __________________ of drugs to all parts of the world [esp. diseases for which effective treatments exist (e.g. AIDS, malaria – over a _____________ people die of malaria every year)] 1. THE EFFECTS OF DRUGS AND MEDICINES A PHARMACEUTICAL DRUG or MEDICINE is any chemical (natural or human-made) that does one or more or the following: - Prevent or cure a disease - Alleviate the symptoms of a health condition - Assist in medical diagnosis (e.g. inert barium sulfate used for gastrointestinal X-ray) - alter the ___________________ state, including ______________________, _________________ level or _____________________ - alter incoming ___________________ sensations; - alter _______________or _________________. 2. METHODS OF ADMINISTERING DRUGS *In order to reach the site where the drugs are needed, the majority of drugs have to be absorbed into the ____________________. THE DIFFERENT METHODS OF ADMINISTERING DRUGS: METHOD Orally Rectally Parenterally: by _____________ Inhalation Transdermally Eye or ear drops DESCRIPTION / NOTES - taken by ___________ - generally, ___________-soluble drugs - ones with many __________ functional groups - in the form of _______________ or ___________ - some drugs unstable in highly __________ gastric juices found in the ____________ - subcutaneous (under the _________) injection - intramuscular injection into ____________ tissue - intravenous injection directly into ____________ (_____________ therapeutic effect) - breathed in through the ___________ or ________ - _______________, highly dispersed drugs - applied to _________ in the form of patches, ointments, or therapeutic baths - absorbed directly from the skin into the blood - ______________ compounds - liquids delivered directly to the opening EXAMPLES - tablets, capsules, pills, liquids - treatment of digestive illnesses and hemorrhoids - __________ injections - many ___________ - local ________________ - _________________ conditions (e.g. asthma) - some ____________ treatments (e.g. estrogen) - ______________ patches - ________________ patch (to alleviate symptoms of angina/cardiovascular disease) - eye and ear infections 3. BIOAVAILABILITY OF A DRUG *Drug bioavailability: The fraction of the administered dose that is absorbed into the _________________; OR, the fraction of the dose that reaches the ___________ part of the human body. By definition, when a drug is administered intravenously, its bioavailability is ______%. FACTORS AFFECTING BIOAVAILABILITY: FACTOR EXPLANATION - ↑ polar = ↑ _____________ in water / bloodstream SOLUBILITY of the drug *Drugs containing ______________, ____________ and ____________ groups are usually *Depends ON: soluble = quickly absorbed from GI tract into bloodstream. However, such molecules do not - ______________ of the drug readily pass through _______________ cell membranes. -________________ groups present e.g. Aspirin and morphine, for example, are administered as ionic ___________, to make them more soluble. METHOD OF ADMINISTRATION e.g. Early penicillins could not be taken orally because they were destroyed by ____________ acid – therefore, _____________ instead. 4. RESEARCH, DEVELOPMENT AND TESTING OF NEW PRODUCTS TERM Lethal Dose (LD50) Toxic Dose (TD50) Effective Dose (ED50) DEFINITION - the dose that causes __________ in ____% of the laboratory ______________ - the dose that causes ______________ (an unacceptable adverse effect) in 50% of the _______ patients - the minimum dose of the drug that produces the ___________ therapeutic effect in 50% of the laboratory animals or human patients THERAPEUTIC INDEX (TI) The _______________ and _____________ of a drug can be expressed using its TI. The TI is a _________ that relates the ____________ effects of a drug to its ________ effects. THERAPEUTIC INDEX (TI) ANIMALS HUMANS LD50 ED50 TD50 ED50 EXAMPLE: TI INTERPRETATION 5 100 - the drug becomes dangerous if the recommended, therapeutic dose is exceeded by _____ - the drug becomes dangerous if the recommended, therapeutic dose is exceeded by _____ RISK OF OVERDOSE HIGH THERAPEUTIC WINDOW LARGE LOW SMALL SUMMARY: -The smaller the TI, the easier it is to _______________ on the drug. In other words, drugs with high TI values are ___________. Over-the-counter drugs usually have ______________ TI values. -Therefore, administering drugs with _________________ TI values must be carefully controlled and monitored, and will depend on factors such as __________, ___________, body ____________ and general health. -THERAPEUTIC WINDOW - the __________ of dosages between the minimum amounts of the drug that produce the desired effect and a medically unacceptable adverse effect (the concentration at which it starts to be become toxic). *CONSIDERATIONS OF DRUG ADMINISTRATION CONSIDERATION DESCRIPTION - When a person develops ________________ for a drug, larger and larger doses must be administered in TOLERANCE order to get the _______________ effect. *What are the problems associated with tolerance? -defined as a chronic, relapsing ____________ disease that is characterized by ____________ drug seeking ADDICTION and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. – The __________________effects associated with drug intake. *Risk-to-benefit ratio must be considered SIDE EFFECTS before administering. *Ex: aspirin can cause gastrointestinal ________________ opiates extremely __________________ PLACEBO EFFECT - Also called the placebo response. A remarkable phenomenon in which a placebo - a __________ treatment, an _____________ substance like sugar, distilled water, or saline solution -- can sometimes improve a patient's condition simply because the person has the expectation that it will be helpful. - In general, one-third of a control group taking a placebo pill (“sugar” pill) show some improvement. 5. DEVELOPMENT OF NEW SYNTHETIC DRUGS - Pharmaceutical companies and research groups are constantly developing new drugs. (e.g. improving pre-existing drugs; and, or, developing a completely new drug to fight a new viral strain) - average time for development of new drug = years - For every drug that reaches market, ____________ fail. - major investment/cost ______________ of dollars *To support cost there is a focus on developing drugs that treat conditions prevalent in the developed world. (e.g. obesity, depression, cancer, cardiovascular disease, ulcers) *STAGES IN THE DISCOVERY AND DEVELOPMENT OF A NEW MEDICINE STAGE 1: DISCOVERY RESEARCH (1-3 YEARS) - identification of __________ target compounds (based oftentimes on knowledge of drug-___________ interactions/_______________ of action) *↓ ‘trial and error’ over the years - lead compounds often derived from __________ (e.g. Taxol and yew trees) or ___________________ - synthesis of _______________ (i.e. many chemically related compounds) using a process called ______________________ chemistry - ________________ testing (mostly ______________testing…under strict legislative control) - determine clinical _________________ index STAGE 2: DEVELOPMENT RESEARCH (5 – 6 YEARS) HUMAN TESTING/TRIALS: PHASE 1: 50 – 100 healthy ________________ PHASE 2: 200 – 400 ________________ PHASE 3: 3000+ patients (_________________-blind studies – half given _________, other half given _____________; neither _______________nor ____________knows what they have been given.) *application for marketing at this point STAGE 3: REGULATORY REVIEW (1 – 2 YEARS) - launch of product at end of review STAGE 4: POST-MARKETING MONITORING - post marketing ______________ surveillance - collection of _______________ drug reaction data (may result in withdrawal of drug from market after numerous years of usage – e.g. Thalidamide) *YOUTUBE – GENERAL INTEREST VIDS: 1. Combinatorial Chemistry video 2. ‘Combatting the Counterfeit Drug Trade’ (Ashifi Gogo – Ted Talk) 3. ‘Undercover Agents Go on Hunt for Counterfeit Drugs’ (ABC News) PRE-2014 PROGRAM - D9: DRUG DESIGN D.9.1 Discuss the use of a compound library in drug design. [Traditionally, a large collection of related compounds are synthesized individually and evaluated for biological properties. This approach is time-consuming and expensive.] D.9.2 Explain the use of combinatorial and parallel chemistry to synthesize new drugs. [Combinatorial chemistry is used to synthesize a large number of different compounds and screen them for biological activity, resulting in a “combinatorial library”. Alternatively, parallel synthesis can produce smaller, more focused libraries. Students should be aware of the importance of solid-phase chemistry.] Parallel Synthesis involves the use of _______________ to carry out identical chemical processes between chemicals such as adding fixed volumes of substances using syringes Combinatorial Chemistry (‘Combi-Chem’) - automated ‘trial and error’ technique used to rapidly synthesize thousands of related compounds (e.g. penicillins - main molecular structure maintained / alter side-chain] - synthesized compounds are then screened (in vitro or in vivo) and evaluated for desirable biological/pharmacological properties [e.g. activity against a target enzyme] - benefits = ↓time and $ *Hypothetical Case: Potential time and cost savings of combinatorial chemistry One-At-A-Time Approach Combinatorial Approach Number of employees 4 4 Annual Budget $2 million $2 million Catalysts evaluated/year 200 20,000 50,000 Average preparation and $10,000 $40 $100 evaluation cost/catalyst Development Time 2 10 years 0.5 2 years The Mix and Split Variation of Combi-Chem (e.g. of Solid-Phase Parallel Synthesis): - basically involves reacting a set of starting materials in all possible combinations - Solid Phase/State chemistry - use of polystyrene-based resin-beads, for example Example: Consider 3 amino acids (Use a square, circle and triangle to represent each of the three acids.) Stage 1: Attach Amino Acid to Polystyrene-Based Resin Bead - Attach each amino acid to a very small (0.1 mm diameter) _________ bead. Now, there would be 3 containers, each containing a different amino acid. Stage 2: Mix and Split…and React a) Mix Mix the 3 containers from stage 1. Now, there is one beaker containing all 3 amino acids. b) Split Split the amino acid mixture into 3(or more) separate beakers. Now, there are three beakers, each containing all 3 amino acids. c) React React each of the amino acid mixtures with a different amino acid. (i.e. Mixture 1 + a square ; Mixture 2 + a triangle ; Mixture 3 + a circle) *Each beaker now holds 3 different _____________. Therefore a total of 9 (32) dipeptides now exist at the end of stage 2. Stage 3: Mix, Split, React….(same as Stage 2) a) Mix Mix the final three mixtures attained from part c) of Stage 2. Now, there is one beaker containing all 9 dipeptides. b) Split Split the mixtures into 3 separate beakers. Now, there are three beakers, each containing all 9 dipeptides. c) React React each mixture with a different amino acid. *Each container now holds 9 different ________________. Therefore a total of 27 (33) tripeptides now exist at the end of stage 3. Stage 4: Repeat process. How many total products exist after another mix and split? 34 = …and another , 35 = and so on. Sample Question: Consider three amino acids A, B and C. Calculate the number of dipeptides that could be created from a two-stage combi-chem process. (see p. 431 of text for answer) D.9.3 Describe how computers are used in drug design. [Three-dimensional models of drugs can be created in silico and molecular modeling software can be used for the virtual development and evaluation of new drugs.] *Main Use = Molecular Modelling computer power doubles every _____ months ; also, cost of technology ↓ with time main benefits: - ↑ safety; ↓ time and $ associated with drug design - coverting ____ diagrams of molecules to _____ equivalents - enables “in silica” (i.e. performed on a ____________or via computer ____________) creations * in silica creations ideally possess the ability to mimic molecular behavior to determine medicinal/pharmacological properties in silica creations may be designed to: - mimic the interaction of test molecules with target enzyme (This may involve the manipulation of a ________________ group and/or molecular _______________, for example.) - test the effectiveness of a ligand _______________(i.e. ligands that inhibit target enzymes)