Return to Nursing Pharmacology Table of Contents

Previous Page Next Page
Introduction: General Principles--Lecture I,  slide 3

press above to begin

  • Chemical Aspects of Drugs
  • Chirality
  • Anesthetic agents administered as racemic mixtures
  • Drug-Receptor Interactions: Binding Forces
  • Henderson-Hasselbalch Equation

 

  •  Drug Transfer
    • Aqueous diffusion
    • Lipid diffusion
    • Carrier-mediated Transfer
  • Endocytosis/Exocytosis

 

 

Chirality (stereoisomerism)

  • Chiral refers to molecule with a center of three-dimensional asymmetry.

  • Many drugs, over 50% of all drugs actually, are chiral (existing as enantiomeric pairs)

    •  Enantiomers (molecules having opposite shapes) are pairs of molecules existing in forms that are mirror images of each other (right-& left-hand) but that cannot be superimposed

    •  Other than lack of superimposition, enantiomers are chemically identical (not necessarily pharmacologically identical), but may be distinguished by the direction in which they rotate polarized light, either dextro (d or +) or levo (l or -) {light rotational effect determined in solution).

      •  Chemical identity is associated with true enantiomers, i.e. associated with a single asymmetric molecular center; If the molecule has 2 asymmetric centers, the molecule is referred to as a diasteriomer.  Diasteriomers have differing physiochemical properties

    • Consider the above, hypothetical 2 enantiomeric models (1 & 2), each containing a single chiral carbon as well as molecular form 3 which is non-optically active as one can identify a plane of symmetry.

      • Only one of the enantiomers can make a correct 3-point contact with the corresponding receptor position represented by figure  1 above left: (A in the molecule matches up with the alpha  location on the receptor; B in the molecule matches up with the  beta location on the receptor and G in molecule matches up with the gamma location on the receptor. [Above figure from Principles of Drug Action: The Basis of Pharmacology, Third Edition, edited by William . B. Pratt and Palmer Taylor, Churchill Livingston, New York, 1990. p 14: Fig 1-8]

    •  Enantiomers present in equal proportion (50:50) are referred to as racemates.

  • Ways looking at chirality:

    • Chirality has to do with "right or left handedness"

      • If an item appears identical to its image in a mirror it is said to be "achiral" -- an example would be a water glass.

      • The basic issues a comparison between an object and its reflection -- if an object is different from its reflection it is said to be chiral; for instance, ones left-hand and right hand are chiral.

      • Note also that when you put your left-hand up to mirror, the image that appears is a right hand-- began illustrating that left and right hands are in fact mirror images of each other yet not superimposable--not surprisingly gloves are not superimposable either!

      • Let's consider the molecule, thalidomide, below:

      • Note the structure of thalidomide:

        • Thalidomide is chiral, i.e. left and right-handed molecular forms are present

          1. One form produced sedation

          2. The other form was responsible for fetal abnormalities.

            1. Chirality and Drug Action
               
              • Thornley, R "Discuss the Importance of Chirality in Drug Action"

              • "Since animals (including humans produce chiral molecules (proteins are left handed for example) then drugs have to be tailored in such a way  as to account for this.

              • A racemic mixture of a drug may have unwanted side effects due to the presence of both left and right handed enantiomers.  The drug thalidomide was racemic and each had different effects on pregnant women:  the right handed drug alleviated morning sickness, the left handed drug caused birth defects."

              • Reference:  http://www.youtube.com/watch?v=jJX2ZQnoYzc

        • Although the primary therapeutic use for thalidomide today is in treatment of leprosy, in particular a disease complication called erythema nodosum leprosum, thalidomide appears effective in treating certain cancers, such as multiple myeloma.

          • Anti-cancer mechanisms may include:

            • (1) a reduction in inflammatory proteins including tumor necrosis factor alpha

            • (2) immune system modulation and

            • (3) an anti-angiogenesis property which blocks formation of new blood vessels.

              • Tumor growth is dependent on angiogenesis.  

          • At present, thalidomide is FDA-approved only for treatment of leprosy; however, yet has obtained "orphan-drug" status in treating brain malignancies. 

            • Derivatives of thalidomide have proved effective in managing multiple myeloma, a plasma (B) cell malignancy.

 

 

 
 
 
Previous Page Next Page

Return to Nursing Pharmacology Table of Contents