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Ethotoin
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Systematic (IUPAC) name |
3-ethyl-5-phenyl-imidazolidine-2,4-dione |
Clinical data |
AHFS/Drugs.com |
Consumer Drug Information |
MedlinePlus |
a682022 |
Pregnancy
category
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Routes of
administration
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Oral |
Pharmacokinetic data |
Half-life |
3 to 9 hours |
Identifiers |
CAS Registry Number
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86-35-1 Y |
ATC code
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N03AB01 |
PubChem |
CID 3292 |
DrugBank |
DB00754 Y |
ChemSpider |
3176 Y |
UNII |
46QG38NC4U Y |
KEGG |
D00708 Y |
ChEBI |
CHEBI:4888 Y |
ChEMBL |
CHEMBL1095 Y |
Chemical data |
Formula |
C11H12N2O2 |
Molecular mass
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204.225 g/mol |
SMILES
- O=C2NC(c1ccccc1)C(=O)N2CC
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InChI
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InChI=1S/C11H12N2O2/c1-2-13-10(14)9(12-11(13)15)8-6-4-3-5-7-8/h3-7,9H,2H2,1H3,(H,12,15) Y
Key:SZQIFWWUIBRPBZ-UHFFFAOYSA-N Y
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Y (what is this?) (verify) |
Ethotoin (marketed as Peganone by Ovation) is an anticonvulsant drug used in the treatment of epilepsy. It is a hydantoin, similar to phenytoin. Ethotoin lacks phenytoin's side effects of gingival hyperplasia and hirsutism, however it is less effective. This, combined with the need for frequent dosing has limited its usefulness. Ethotoin is no longer widely used.
Contents
- 1 Mechanism of action
- 2 Approval history
- 3 Indications and usage
- 4 Dosing
- 5 Side effects
- 6 Chemistry
- 7 References
- 8 External links
Mechanism of action
Similar to phenytoin.
Approval history
- 1957 Peganone was granted Food and Drug Administration (FDA) approval to Abbott Laboratories for treatment of grand mal (tonic clonic) and partial complex (psychomotor) seizures.
- 2003 Peganone was acquired from Abbott Laboratories by Ovation Pharmaceuticals (specialty pharmaceutical company who acquire underpromoted branded pharmaceutical products).
Indications and usage
Ethotoin is indicated for tonic-clonic and partial complex seizures.
Dosing
Ethotoin is available in 250mg tablets. It is taken orally in 4 to 6 divided doses per day, preferably after food.
Side effects
Ataxia, visual disturbances, rash and gastrointestinal problems.
Chemistry
Ethotoin, 3-ethyl-5-phenylimidazolidine-2,4-dione, is synthesized by the reaction of benzaldehyde oxynitrile, with urea or ammonium hydrocarbonate, which forms an intermediate urea derivative which on acidic conditions cyclizes to 5-phenylhydantoin. Alkylation of this product using ethyliodide leads to the formation of ethotoin.
- A. Pinner, Chem. Ber., 21, 2324 (1888).
- W.J. Close, U.S. Patent 2,793,157 (1946).
References
- Schwade ED, Richards RK, Everett GM (May 1956). "Peganone, a new antiepileptic drug". Dis Nerv Syst 17 (5): 155–8. PMID 13317788.
- Shorvon, S.D.; Fish, David R.; Perucca, Emilio; Dodson, W. Edwin, ed. (2004). The Treatment of Epilepsy. Blackwell Publishing. ISBN 0-632-06046-8.
- Drugs.com: Ethotoin
- PEGANONE 250 mg Ethotoin Tablets, USP (PDF)
External links
Anticonvulsants (N03)
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GABAergics |
GABAAR PAMs |
- Barbiturates: Barbexaclone
- Metharbital
- Methylphenobarbital
- Pentobarbital
- Phenobarbital#
- Primidone; Carbamates: Felbamate; Benzodiazepines: Clobazam
- Clonazepam
- Clorazepate
- Diazepam#
- Lorazepam#
- Midazolam
- Nimetazepam
- Nitrazepam
- Temazepam; Others: Bromide (potassium bromide, sodium bromide)
- Paraldehyde
- Stiripentol
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GABA-T inhibitors |
- Fatty acids: Valproic acid# (sodium valproate, valproate semisodium)
- Valpromide
- Valproate pivoxil; Others: Vigabatrin
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Others |
- GABAR agonists: Progabide; GAT-1 inhibitors: Tiagabine
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Channelergics |
Sodium blockers |
- Hydantoins: Ethotoin
- Fosphenytoin
- Mephenytoin
- Phenytoin#; Ureas: Phenacemide
- Pheneturide; Fatty acids: Valproic acid# (sodium valproate, valproate semisodium)
- Valpromide
- Valproate pivoxil; Carboxamides: Carbamazepine#
- Eslicarbazepine acetate
- Oxcarbazepine; Others: Lacosamide
- Lamotrigine
- Rufinamide
- Topiramate
- Zonisamide
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Calcium blockers |
- Oxazolidinediones: Ethadione
- Paramethadione
- Trimethadione; Succinimides: Ethosuximide#
- Mesuximide
- Phensuximide; Gabapentinoids: Gabapentin
- Pregabalin; Others: Lamotrigine
- Topiramate
- Zonisamide
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Potassium openers |
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Others |
CA inhibitors |
- Sulfonamides: Acetazolamide
- Ethoxzolamide
- Sultiame
- Topiramate
- Zonisamide
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Others |
- Beclamide
- Levetiracetam
- Perampanel
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- #WHO-EM
- ‡Withdrawn from market
- Clinical trials:
- †Phase III
- §Never to phase III
Index of psychology and psychiatry
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Description |
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Disorders |
- Mental and behavioral
- Mood
- Developmental
- pervasive
- dyslexia and specific
- Substance-related
- Emotional and behavioral
- Symptoms and signs
- Evaluation and testing
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Treatment |
- Psychotherapy
- Drugs
- depression
- antipsychotics
- anxiety
- dementia
- hypnotics and sedatives
- psychostimulants, ADHD and nootropics
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English Journal
- Key structural features of ligands for activation of human pregnane X receptor.
- Kobayashi K1, Yamagami S, Higuchi T, Hosokawa M, Chiba K.Author information 1Laboratory of Pharmacology and Toxicology, Graduate School of Pharmaceutical Sciences, Chiba University, Yayoi-cho 1-33, Inage-ku, Chiba 263-8522, Japan. kaoruk@p.chiba-u.ac.jpAbstractThe ligand-binding domain of human pregnane X receptor (hPXR) is highly hydrophobic and flexible, allowing promiscuity in accepting structurally diverse ligands. However, little information is available regarding the critical substituents of compounds involved in the activation of hPXR. The aim of this study was to determine the structure-activity relationships for hPXR-mediated transactivation by barbiturates, hydantoins, and macrolide antibiotics. Most of the barbiturates studied (mephobarbital, pentobarbital, phenobarbital, etc.) activated hPXR. However, barbital, which has a low hydrophobic moiety at the 5-position, and primidone, which has no carbonyl moiety at the 2-position, did not activate hPXR. Therefore, a hydrophobic moiety at the 5-position and a hydrogen-bond acceptor being sufficiently separated from the phenyl-ring are responsible for activation of hPXR by barbiturates. In the case of hydantoins, only mephenytoin and ethotoin, which have an alkylchain at the R1-position, strongly activated hPXR at 300 microM. Phenytoin and 5-(4-methylphenyl)-5-phenylhydantoin, which contain a phenyl or methylphenyl group at both R2- and R3-positions, also activated hPXR, whereas 5-(4-hydroxyphenyl)-5-phenylhydantoin did not activate the receptor. These results suggest that the presence of an alkyl-chain at the R1-position and the presence of bulky and hydrophobic moieties at both R2- and R3-positions are important factors for activation of hPXR by hydantoins. In the case of macrolide antibiotics, troleandomycin, but not oleandomycin, showed significant activation of hPXR. Therefore, triacetate esterification of oleandomycin might increase the hydrophobicity and enhance the activation of hPXR. These findings suggest that hydrophobicity of the ligand and adequate distance between the hydrogen-bond acceptor and the hydrophobic group are important for hPXR activation.
- Drug metabolism and disposition: the biological fate of chemicals.Drug Metab Dispos.2004 Apr;32(4):468-72.
- The ligand-binding domain of human pregnane X receptor (hPXR) is highly hydrophobic and flexible, allowing promiscuity in accepting structurally diverse ligands. However, little information is available regarding the critical substituents of compounds involved in the activation of hPXR. The aim of t
- PMID 15039302
- Separation of enantiomers on HPLC chiral stationary phases based on human plasma alpha1-acid glycoprotein: effect of sugar moiety on chiral recognition ability.
- Haginaka J1, Matsunaga H.Author information 1Faculty of Pharmaceutical Sciences, Mukogawa Women's University, Hyogo, Japan. haginaka@mwu.mukogawa-u.ac.jpAbstractHPLC chiral stationary phases based on human plasma alpha1-acid glycoprotein (AGP) and partially deglycosylated AGP (pd-AGP) were prepared to investigate the effects of sugar moiety of AGP on chiral discrimination of various solutes. Removal of a sugar moiety of AGP by treatment with N-glycosidase was confirmed by high-performance capillary electrophoresis, reversed-phase HPLC and matrix-assisted laser desorption-time of flight (MALDI-TOF) mass spectrometry. The average molecular weights of AGP and pd-AGP were estimated to be ca. 33,000 and 30,600, respectively, by MALDI-TOF mass spectrometry. Next, AGP and pd-AGP were bound to aminopropyl-silica gels activated with N,N '-disuccinimidylcarbonate. The retentivity+ and enantioselectivity of the neutral, acidic and basic solutes tested on the pd-AGP column were significantly or not significantly larger in most solutes than those on the AGP column. This is ascribable to that by cleavage of a sugar chain(s) by N-glycosidase, pd-AGP could become more hydrophobic than AGP, and/ or that a solute could be easily accessible to the specific and/or non-specific binding sites of pd-AGP. It is interesting that warfarin enantiomers are not resolved on the pd-AGP column, but resolved on the AGP column. A sugar chain(s) of AGP cleaved by N-glycosidase might be involved in the enantioselective binding of warfarin enantiomers.
- Enantiomer.Enantiomer.2000;5(1):37-45.
- HPLC chiral stationary phases based on human plasma alpha1-acid glycoprotein (AGP) and partially deglycosylated AGP (pd-AGP) were prepared to investigate the effects of sugar moiety of AGP on chiral discrimination of various solutes. Removal of a sugar moiety of AGP by treatment with N-glycosidase w
- PMID 10763868
- Enantioselective pharmacokinetics of ethotoin in humans following single oral doses of the racemate.
- Hooper WD1, O'Shea NJ, Qing MS.Author information 1Department of Medicine, University of Queensland, Australia.AbstractRacemic ethotoin (1000 mg) was administered orally as a single dose to six healthy adult volunteers. Blood samples were collected at appropriate times for 120 h following the dose. Ethotoin was quantified enantio-selectively in plasma using a novel chiral column HPLC procedure. One of the enantiomers of the chiral metabolite, 5-phenylhydantoin, was also quantified in the HPLC method. The Cmax and AUC0-infinity values for (+)-(S)-ethotoin were significantly greater than those for (-)-(R)-ethotoin (ratio of mean AUC0-infinity values 0.88), but the elimination half-lives of the isomers were virtually identical [12.35 +/- 5.15 h for (-)-(R)-ethotoin; 12.28 +/- 5.34 h for (+)-(S)-ethotoin]. Parameters derived from AUC0-infinity (Cl0/F and V(area)/F) also differed slightly between the isomers. The data were interpreted as indicating a small difference in the absorption of the two isomers; it seemed unlikely, in terms of the identical elimination rates, that their metabolic profiles would differ greatly. The 5-phenylhydantoin was eliminated with a significantly longer half-life (18.69 +/- 6.11 h) than that of ethotoin. Enantioselectivity in the pharmacokinetics of ethotoin is therefore a minor issue.
- Chirality.Chirality.1992;4(3):142-7.
- Racemic ethotoin (1000 mg) was administered orally as a single dose to six healthy adult volunteers. Blood samples were collected at appropriate times for 120 h following the dose. Ethotoin was quantified enantio-selectively in plasma using a novel chiral column HPLC procedure. One of the enantiomer
- PMID 1350205
Japanese Journal
- Studies on Pharmacokinetics of Ethotoin in Epileptic Children and Adolescents Using a Stable Isotope
- CLINICAL PHARMACOLOGICAL STUDIES OF ETHOTOIN IN PEDIATRIC EPILEPTIC PATIENTS
- Rapid and sensitive determination of ethotoin as well as carbamazepine, phenobarbital, phenytoin and primidone in human serum
Related Links
- Ethotoin is a prescription medication used to treat epilepsy. Ethotoin belongs to a group of drugs called... ... See "Drug Precautions" section. Ethotoin may cause other rare, but serious side effects, including: Blood problems ...
- Ethotoin is an anti-epileptic medication, also called an anticonvulsant. Ethotoin is used alone or in combination with other medications to treat seizures in adults and children. Ethotoin may also be used for other purposes not listed in ...
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