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Definitions

• the present invention relates to novel noncardiotoxic compounds and pharmaceutical compositions useful in the treatment of a variety of disorders including the treatment of depression, allergies, psychoses, infection, cancer and gastrointestinal disorders.
• the compounds and pharmaceutical compositions of the present invention are useful in the prevention and/or reduction of severe cardiac conductance and cardiac rhythm disturbances and the cardiac arrhythmias such as torsade de pointes that lead to sudden cardiac death.
• Antipsychotics primarily antagonize central dopaminergic D 2 receptor neurotransmission, although they also have antagonist effects at muscarinic, serotonergic, ⁇ -adrenergic, and Hrhistaminergic receptors. Because antipsychotics are also are used as sedatives, as antiemetics, to control hiccups, to treat migraine headaches, and as antidotes for drug-induced psychosis, the adverse effects of antipsychotics are not confined to psychiatric patients. Antipsychotics are capable of causing orthostatic and severe hypotension, as well as prolongation of the QTc interval and QRS which can result in arrhythmias. Antipsychotics account for about 18 % of moderate (pronounced) toxicity, over 20% of life-threatening toxicity and 17% of the fatalities of all pharmaceuticals.
• Tricyclic antidepressants cause the overwhelming majority of antidepressant poisoning in the United States resulting in morbidity and mortality; the most severe toxicity occurs in the cardiovascular system. Antidepressants account for about 15 % of moderate (pronounced) toxicity and 18% of life-threatening toxicity of the fatalities of all pharmaceuticals.
• Antidepressants affect the prolongation of the QTc interval causing cardiotoxicity that result from direct myocardial depression, cardiac conduction disturbances, effects on peripheral vasomotor tone, and changes in the autonomic nervous system.
• the interactions of tricyclic antidepressants with fast sodium channels in cardiac tissue results in slowed cardiac conduction (e.g. prolonged QRS on the ECG), impaired cardiac contractility and possible ventricular dysrhythmias and inhibition of repolarization in His- Purkinje myocytes (e.g. prolonged QTc on the ECG).
• Torsade de pointes is a particular cardiac problem associated with many therapeutic agents and has been implicated as a possible cause of sudden death, particularly in those individuals with a past history of disturbances of cardiac rhythm, myocardial infarction, congenital repolarization abnormalities and cardiac risk factors such as hyperlipidemia and age.
• This arrhythmia is a variant of paroxysmal ventricular tachycardia associated with a prolonged QTc interval or prominent U waves on the ECG.
• torsade de pointes might remit spontaneously, it is potentially lethal because it can progress to ventricular fibrillation, life-threatening arrhythmias or precipitate sudden death.
• Drug-induced QTc interval prolongation may be clinically important even if the mean increase is not very large.
• the drug terodiline was withdrawn after causing QTc interval prolongation, torsade de pointes, and sudden death.
• therapeutic plasma concentrations of terodiline are associated with increases in mean QTc of only 23 ms, which are similar to the increases associated with quinidine and prenylamine. Nevertheless, much larger increases occurred in a minority of patients who developed arrhythmias. These included those predisposed by existing problems such as heart disease and congenital repolarization abnormalities.
• benign QTc interval prolongation in one subject may indicate that another more susceptible patient might develop extreme QTc interval prolongation and arrhythmias with the same drug at the same dose.
• small increases in QTc interval might increase the risk of ventricular fibrillation/ torsade de pointes over a large population.
• the number of excess cases of sudden death in the large numbers of patients with minor QTc interval prolongation might actually exceed those in the small numbers of patients with extreme QTc interval prolongation.
• the potential of a drug to cause QTc interval prolongation is currently believed to be the lower threshold of determining the cardiotoxicity of a therapeutic drug.
• cardiovascular and noncardiovascular therapeutic agents rely on secondary and tertiary amine structural motifs in their chemical structure that are responsible for their pharmacological activity.
• Many cardiovascular drugs including antiarrhythmics, calcium channel antagonists, adrenergics and ⁇ -blockers contain essential secondary and tertiary amines in their chemical structure.
• Entire therapeutic classes of non-cardiovascular drugs, including antidepressants, antihistamines and antipsychotics rely on the secondary and tertiary amine functionality for their primary activity.
• Others such as gastrointestinal and antiinfective drugs do not necessarily rely on the secondary and tertiary amine group for their primary activity; but, include this structural motif as part of their chemical structure.
• Cardiotoxicity associated with the therapeutic use of secondary and tertiary amine-containing drugs is reflected in a variety of cardiac disturbances, including notable changes in ECG, polymorphic ventricular tachycardia, negative inotropism, drops in blood pressure, orthostatic hypotension and depressed cardiac contractility resulting in acute cardiac arrest.
• Serious cardiac arrhythmias both fatal and non-fatal
• tachycardia including tachycardia, ventricular fibrillation, torsades de pointes, and QTc interval prolongation
• Drugs known to inhibit metabolism of secondary and tertiary amine-containing drugs by cytochrome P450 3A4 include, inter alia, ketoconazole, itraconazole, micoconazole, troleandomycin, erythromycin, fluconazole and clarithromycin.
• cytochrome P450 3A4 It is generally believed that inhibition of a drug's metabolism by cytochrome P450 3A4 increases the plasma concentration of the parent amine-containing drug to toxic levels; however, this view has not been supported by rigorous examination and discrimination between plasma levels of the parent drugs and their metabolites.
• An alternate explanation is that inhibition of cytochrome P450 3A4 by inhibitors administered concomitantly "switches" the metabolism of the parent compound from one involving both cytochrome P450 3A4 and cytochrome P450 2D6 to the metabolism of the parent drug primarily by cytochrome P450 2D6.
• Cisapride (Propulsid ® ), shown below, was commonly used to treat nocturnal heartburn as well as a variety of other gastrointestinal disorders:
• Cisapride (Propulsid ® ) was recently removed from the market by the FDA because of the QTc interval prolongation and life-threatening ventricular arrhythmias such as torsade de pointes which produced sudden cardiac death. These cardiotoxic effects are believed to be due to cardiac conduction delays such as the specific and potent blockade of human cardiac K + channels, particularly the HERG channels.
• the specific, high affinity block of the human cardiac K + channel HERG by cisapride (IC 50 of 0.045 ⁇ M) is similar to that observed for the class III antiarrhythmic agent dofetilide (IC 50 of .010 ⁇ M) and the nonsedating antihistamines astemizole (IC 50 ) of .001 ⁇ M) and terfenadine (IC 50 ) of 0.213 ⁇ M). It is further believed that this blockade of human cardiac K + channels underlies the proarrhythmic effects of the drug observed under certain clinical settings.
• Cisapride In guinea pig ventricular myocytes cisapride elicited a concentration-dependent block (IC 50 of 46.9 ⁇ M) of L-type Ca2 + channels suggesting that the inhibitory effect of cisapride on calcium channels might also contribute to its cardiotoxicity under pathophysiological conditions.
• Cisapride is metabolized by both cytochrome P450 3A4 and cytochrome P450 2D6; however the primary metabolic route is believed to be through cytochrome P450 3A4.
• cisapride When higher than normal dosages of cisapride are used or with concomitant ingestion of imidazole antifungals or macrolide antibiotics, it is believed that cisapride is metabolized to cardiotoxic metabolites through aromatic hydroxylation primarily by cytochrome P450 2D6.
• Astemizole Hismanal ®
• terfenadine Seldane ®
• Astemizole shown below, was commonly used to treat the symptoms associated with seasonal allergic rhinitis and chronic idiopathic urticaria.
• Terfenadine (Seldane ® ), shown below, was commonly used to symptoms associated with seasonal allergic rhinitis such as sneezing, rhinorrhea, pruritus, and lacrimation.
• Astemizole (Hismanal ® ) and terfenadine (Seldane ® ) are metabolized by both cytochrome P450 3A4 and cytochrome P450 2D6, and at least astemizole is believed to be metabolized to cardiotoxic metabolites through aromatic hydroxylation.
• Terfenadine is believed to be metabolized to cardiotoxic metabolites primarily through aliphatic oxidation.
• Terfenadine and astemizole suppress the HERG current with IC 50 of 0.213 uM and 0.001 uM, respectively.
• Sertindole shown below, was an atypical antipsychotic agent commonly used for the treatment of schizophrenia outside of the United States:
• Sertindole (Serlect ® ) was rejected by the Food and Drug Administration because it prolonged the QTc interval and was associated with a significant number of unexplained deaths in clinical trials. Sertindole had been approved in 19 European countries, but more evidence of associated arrhythmias led to its withdrawal in Europe.
• the secondary or tertiary amine molecule adopts a conformation in which the positively-charged nitrogen (N + ) atom is oriented towards an anionic location (COO " ) on the P450 2D6 protein while the aromatic ring is aligned with a relatively planar, hydrophobic region of the protein. It is believed that when this conformation is adopted the nitrogen atom and the metabolic oxidation are in close proximity and metabolism of the drug occurs.
• cytochrome P450 3A4 is located both in the liver and the intestine
• P450 2D6 is located in the liver and not the intestine.
• Metabolic oxidation of drugs and other xenobiotic substances is a first step in a biotransformation that the body relies on to distribute active drug metabolites to tissues and also to eliminate them from the body. In some cases, this metabolic oxidation involves the formation of a pharmacologically active metabolite, and in other cases it involves the formation of hydroxylated metabolites through oxidation of an aromatic ring. Although metabolic oxidation to pharmacologically active metabolites is essential, metabolism of secondary and tertiary amine-containing drugs to hydroxymetabolites by cytochrome P450 2D6 and cytochrome P450 3A4 has serious cardiotoxicity implications to patients, particularly at high oral doses.
• the analogs of imipramine that were tested were designed to have the positively charged nitrogen atom removed from the active site of CYP2D6.
• the three approaches were adjustment of alkyl chain length, alkyl bond rigidity (restricted bond rotation) and removing the positive charge on the tertiary nitrogen atom using the prodrug imipramine-N-oxide.
• Halliday et al. reported that removal of the positively charged nitrogen atom of imipramine from the active site of CYP2D6 either by lengthening the alkyl chain length or altering the pKa of imipramine with using imipramine-N-oxide abolished the metabolism of imipramine by CYP2D6 to the hydroxymetabolite.
• This prodrug is rapidly converted in the systemic circulation to imipramine which is then metabolized under much lower systemic plasma concentrations to the active form
• the piperidine chemical group with its tertiary amine in cisapride, astemizole, sertindole, trazadone, nefazadone, buspirone and terfenadine contributes to cardiac conduction disturbances and orientation of the drugs within the binding sites of the cytochrome enzymes responsible for the responsible metabolism of these drugs by aromatic or cycloalkyl hydroxylation.
• the chemically related piperazine chemical group with its tertiary amine contributes to cardiac conduction disturbances and orientation of the drugs within the binding sites of the cytochrome enzymes responsible for the responsible metabolism of these drugs by for aromatic or cycloalkyl hydroxylation.
• Pharmacologic agents containing a piperazine group known to cause cardiac conduction disturbances include buclizine, buspirone, cyclizine, doxazosin, fluphenazine, gepirone, hydroxyzine, itraconazole, ketoconazole, loxapine, meclizine, olanzapine, perphenazine, quetiapine, trazadone, nefazadone and ziprasidone.
• the chemical structures of a series of pharmacological compounds containing a piperazine moiety and having antihistamine activity are shown below:
• Fluoroquinolone antibiotics are pharmacologic agents containing a piperazine group known to cause serious cardiac conduction disturbances and torsade de pointes.
• Fluoroquinolone antibiotics approved for marketing and having a secondary amine on the piperazine ring include norfloxacin, lomefloxacin, ciprofloxacin, enoxacin, gatifloxacin, sparfloxacin, temafloxacin, grepafloxacin and moxifloxacin.
• fluoroquinolone agents have already been removed from the market because of life- threatening cardiac conduction disturbance or torsade de pointes.
• the chemical structures of a series of fluoroquinolone compounds containing a secondary amine on the piperazine moiety are shown below:
• Fluoroquinolone antibiotics approved for marketing and having a secondary amine on the piperidine ring include moxifloxacin as shown below:
• It is a further object of the invention is to provide non-cardiotoxic prodrugs of pharmacologically active compounds having modulated cytochrome P 450 metabolism.
• a further object of the invention is to provide non-cardiotoxic prodrugs that will modify the physicochemical properties of tertiary amine-containing drugs such that these drugs will exhibit reduced binding to the CYP2D6 metabolizing enzymes during first-pass absorption.
• a further object of the invention is to provide non-cardiotoxic prodrugs that can be hydrolyzed in the plasma after absorption and be converted directly to the therapeutically active form of the parent compounds.
• a further object of the invention is to provide non-cardiotoxic prodrugs that lower the pKa of the tertiary amine group to a level such that the majority of the tertiary amine is uncharged at physiological pH (pH 7.4).
• imipramine has pKa of 9.5 and is completely ionized as it is transported through the gastrointestinal tract. After oral ingestion, imipramine is rapidly and completely absorbed from the small intestine, with peak plasma concentration within two to five hours.
• Imipramine is subject to extensive first-pass metabolism in the liver, and is eliminated by demethylation to the active metabolite, desipramine and to a lesser extent by aromatic hydroxylation to 2- hydroxyipramine. Desipramine, in turn, is metabolized by aromatic hydroxylation to 2- hydroxydesipramine.
• the systemic availability of imipramine in healthy subjects ranges from 27% to 80% and the corresponding first-pass metabolism ranges from 20% to 73%.
• Imipramine-N-oxide a nitrogen-atom prodrug of imipramine which has a pKa of about 4.7, has a systemic availability of about 100% after oral administration suggesting that there is no first pass effect. Both preclinical and clinical studies have shown that the cardiotoxicity of imipramine-N-oxide is significantly reduced over that of imipramine.
• enzyme-labile compounds having the formula
• R 1 and R 2 are independently hydrogen, alkyl having from 1 to about 7 carbon atoms, aryl, aralkyl, and cycloalkyl having from about 3 to about 6 carbon atoms
• Y is (CH 2 )n where n is from 0 to 2
• Z is alkyl, alkoxy, alkoxy, aryloxy, or alkylaryloxy where m is from 0 to about 4
• R 3 is selected from the group consisting of substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted alkylaryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted alkylaryloxy, substituted or unsubstituted indole, substituted or unsubstituted phenothiazine, substituted or unsubstituted dibenzoxazepine, substituted or unsubstituted dibenzathiazepine
• the compounds of the present invention are useful as gastrointestinal, antiinfective, antidepressant, antihistaminic, antipsychotic, antineoplastic and cardiovascular therapeutic agents.
• enzyme-labile prodrugs having a modified ionization potential (pKa) of the nitrogen atoms such that they are significantly less basic than on the highly basic nitrogen atoms of the parent drugs.
• pKa modified ionization potential
• chemical modifications of the highly basic that amines include formation of phosphoramidates which are stable toward hydrolysis in the intestine and plasma.
• Phosphoramidates are non-toxic organophosphorous compounds containing phosphorous-nitrogen bonds.
• organophosphorous compounds of the present invention are enzyme-labile and are selectively hydrolyzed after passage through the intestine to the pharmacologically active drug moiety.
• esters, phosphonates and peptide bonds which are hydrolyzed by esterases, phosphatases and peptidases in the intestine, enterocytes, hepatic cells and plasma
• the organophosphorous compounds of the present invention are stable in the intestine and the enterocytes and plasma.
• enzyme-labile prodrugs of the secondary and tertiary amine moiety that mask the enzyme(s) primarily responsible for the production of these hydroxymetabolites in the liver.
• enzyme-labile prodrugs of secondary and tertiary amine-containing drugs that are not substrates of cytochrome P450 CYP2D6.
• enzyme-labile prodrugs of secondary and tertiary amine-containing drugs having minimal capacity for aromatic hydroxylation or first-pass metabolism to the cardiotoxic hydroxymetabolites.
• enzyme-label prodrugs are expected to be rapidly converted in the systemic circulation to the pharmacologically active form of the secondary and tertiary amine-containing drugs which are then metabolized under much lower systemic plasma concentrations that are not as likely to produce severe cardiotoxicity.
• enzyme-labile prodrugs modulate the physicochemical properties of secondary and tertiary amine-containing drugs such that these drugs do not bind to the cytochrome P450 2D6 metabolizing enzymes during first-pass absorption at physiological pH.
• the nitrogen atoms on these enzyme-labile prodrugs are significantly less basic (pKa ⁇ 5.4) than on the highly basic nitrogen atoms of the parent drugs (pKa ⁇ 9.5). Because these prodrugs are enzyme-labile, they can be hydrolyzed in the body after absorption directly to the non-cardiotoxic therapeutically active compounds.
• chemical modification of the highly basic amines of known cardiotoxic drugs includes formation of phosphoramidates whose hydrolysis is primarily restricted to the liver and are stable in the intestine and plasma.
• Phosphoramidates are organophosphorous compounds containing phosphorous-nitrogen bonds.
• a partial list of therapeutic compounds having a highly basic nitrogen atom that have reported cases of QT interval prolongation, torsade de pointes or both and their corresponding pKa values include the following: dextromethorphan (9.20), methadone (8.25), propoxyphene (8.91), tramadol (9.41), amoxapine (7.60), citalopram (9.50), clomipramine (9.50), desipramine (10.40), doxepin (8.00), duloxetine (10.00), escitalopram (9.60), femoxetine (9.00), fluoxetine (8.70), maprotiline (10.20), mianserin (8.26), mirtazapine (8.10), nefazodone (7.90), nortriptyline (10.10), paroxetine (9.90), selegiline (7.53), sertraline (9.50), venlafaxine (9.40), zimeldine (8.00), astemizole (9.90), azelast
• the pharmaceutical formulations comprise phosphoramidate-based prodrugs having pKa of less than about 5.4.
• the pharmaceutical formulations comprise phosphoramidate-based prodrugs having pKa values in the range from about 1 to about 5.
• the phosphoramidate-based prodrugs have a pKa less than 4. It will be appreciated by those skilled in the art that this reduction in pKa represents a considerable difference in the proportion of positively charged amines present at physiological pH compared to the highly basic amine parent drugs. Pharmaceutical compounds in accordance with the present invention have considerable similarity because of the similar pharmacologic requirements for therapeutic activity.
• the chemical structures of the enzyme-labile prodrugs can be characterized by a few general structure types.
• the first type include those containing cyclic aliphatic groups such as piperidine and piperazine containing a secondary or tertiary nitrogen atom such as found in amoxapine, and another type includes those having and alkylamine group such as found in imipramine.
• R 1 and R 2 are independently hydrogen, alkyl having from 1 to about 7 carbon atoms, aryl, aralkyl, and cycloalkyl having from about 3 to about 6 carbon atoms
• Y is (CH 2 )n where n is from 0 to 2
• Z is alkyl, alkoxy, alkoxy, aryloxy, or alkylaryloxy where m is from 0 to about 4
• R 3 is selected from the group consisting of substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted alkylaryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted alkylaryloxy, substituted or unsubstituted indole, substituted or unsubstituted phenothiazine, substituted or unsubstituted dibenzoxazepine, substituted or unsubstituted dibenzathiazepine
• R 1 and R 2 are independently hydrogen, alkyl having from 1 to about 7 carbon atoms, aryl, aralkyl, and cycloalkyl having from about 3 to about 6 carbon, X is oxygen, nitrogen or carbon, and m is from 0 to about 3.
• Another type of compound in accordance with the present invention has the formula
• R 3 is a group having the formula
• R 6 is hydrogen, alkyl, aryl or aralkyl
• R 7 is hydrogen, alkyl, aralkyl, cycloalkyl, alkylcycloalkyl, alkylsulfonylcycloalkyl, alkylsulfonylaryl, alkylsulfonylaminoalkyl or alkylsulfonylalkyl
• R 8 is hydrogen, carbonyl or a direct bond.
• Preferred compounds in accordance with this embodiment of the present invention include those where R 3 has the formula
• R 7 is preferably selected form the group consisting of:
• the compounds have the formula
• R3 where R 3 is a group having the formula
• R 9 and R 11 are hydrogen, alkyl, aryl, alkylaryl, cycloalkyl or together form a cyoalkyl or cycloheteroalkyl group
• R 10 is hydrogen, alkyl or a carboxylic acid group
• R 12 and R 13 are independently hydrogen, halogen, alkyl, alkoxy or amino.
• V is carbon or nitrogen
• W is carbon, nitrogen or oxygen
• U is carbon or nitrogen
• B is a single or double bond
• R 14 and R 15 are independently hydrogen, halogen, or alkyl.
• V is carbon or nitrogen
• W is carbon, nitrogen or oxygen
• U is carbon or nitrogen
• B is a single or double bond
• R 15 and R-i ⁇ are independently hydrogen, halogen or alkyl.
• the compounds have the formula
• R 6 is hydrogen, alkyl, alkylaryl or aralkyl
• R 7 is hydrogen, alkyl, aralkyl, cycloalkyl, alkylcycloalkyl, alkylsulfonylcycloalkyl, alkylsulfonylaryl, alkylsulfonylaminoalkyl or alkylsulfonylalkyl.
• Another type includes those containing short linear aliphatic chains depending from a nitrogen atom such as those found with imipramine.
• R 1 and R 2 are independently hydrogen, alkyl having from 1 to about 7 carbon atoms including but not limited to methyl, ethyl, propyl, butyl, isobutyl, and pentyl, aryl including but not limited to phenyl and pyridinyl, aralkyl such as benzyl, and cycloalkyl having from about 3 to about 6 carbon atoms including but not limited to cyclopropyl, cyclobutyl, cyclopentyl, and cyclohexyl, A is a lower alkyl, lower heteroalkyl, carbonyl or cycloalkyl, X is 0 or 1, R 1 and R 2 are independently hydrogen, alkyl having from 1 to about 7 carbon atoms, aryl, aralkyl, and cycloalkyl having from about 3 to about 6 carbon atoms, R 20 is hydrogen, phenyl or lower alkyl, and R 21
• the compounds have the formula
• A is a lower alkyl, lower heteroalkyl or cycloalkyl
• R 20 is hydrogen, phenyl or lower alkyl
• R 2 i is a group having the formula
• V is carbon or nitrogen
• W is carbon, nitrogen or oxygen
• U is carbon or nitrogen
• R 23 and R 24 are independently hydrogen, halogen, alkyl or alkoxy
• B is a single or double bond.
• the compounds have the formula
• A is a lower alkyl, lower heteroalkyl or cycloalkyl
• R 20 is hydrogen, phenyl or lower alkyl
• R 2 i is a group having the formula
• V is carbon or nitrogen
• W is carbon, nitrogen or oxygen
• U is carbon or nitrogen
• R 23 and R 24 are independently hydrogen, halogen, alkyl or alkoxy
• B is a single or double bond.
• the compounds have the formula
• A is a lower alkyl, lower heteroalkyl or cycloalkyl
• R 20 is hydrogen, phenyl or lower alkyl
• R 21 is a group having the formula
• V is carbon or nitrogen
• U is carbon or nitrogen
• R 23 and R 24 are independently hydrogen, halogen, alkyl or alkoxy
• B is a single or double bond.
• the compounds have the formula
• A is a lower alkyl, lower heteroalkyl or cycloalkyl
• R 20 is hydrogen, phenyl or lower alkyl
• R 21 is a group having the formula
• V is carbon or nitrogen
• R 6 is hydrogen, alkyl, aryl or aralkyl
• R 7 is hydrogen, halogen, aralkyl, cycloalkyl, alkylcycloalkyl, alkylsulfonylcycloalkyl, alkylsulfonylaryl, alkylsulfonylaminoalkyl or alkylsulfonylalkyl.
• the compounds have the formula
• A is a lower alkyl, lower heteroalkyl or cycloalkyl
• R 20 is hydrogen, phenyl or lower alkyl
• R 26 is hydrogen, alkyl, alkoxy, alkylaryl, alkenylaryl, halogen, halogen-substituted alkyl, alkylaryloxy, alkanoyl, arylalkanoyl, or a group having the formula
• R 27 R 28 and R 2g are independently substituted or unsubstituted alkyl, substituted or unsubstituted aryl, substituted or unsubstituted aralkyl, substituted or unsubstituted alkylaryl, substituted or unsubstituted cycloalkyl or substituted or unsubstituted heterocycloalkyl, and R 25 is hydrogen, hydroxy, alkyl, alkylaryl, aryl, cycloalkyl or heteroaryl.
• the compounds have the formula
• Alkyl refers to a branched or straight chain acyclic alkyl group comprising one to about ten carbon atoms, a haloalkyl group, an alkenyl group, an alkynyl group, a bridged cycloalkyl group, a cycloalkyl group or a heterocyclic ring.
• “Lower alkyl” refers to a branched or straight chain acyclic alkyl group comprising one to about six carbon atoms.
• lower alkyl groups include methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, t-butyl, pentyl, neopentyl, iso-amyl, hexyl, and the like.
• Haloalkyl refers to a lower alkyl group, an alkenyl group, an alkynyl group, a bridged cycloalkyl group, a cycloalkyl group or a heterocyclic ring, to which is appended one or more halogens, as defined herein.
• exemplary haloalkyl groups include trifluoromethyl, chloromethyl, 2-bromobutyl, 1-bromo-2-chloro-pentyl, and the like.
• alkenyl refers to a branched or straight chain C 2 -C 10 hydrocarbon which can comprise one or more carbon-carbon double bonds.
• alkenyl groups include propylenyl, buten-1-yl, isobutenyl, penten-1-yl, 2, 2-methylbuten- 1-yl, 3-methylbuten-1-yl, hexan-1-yl, hepten-1-yl, octen-1-yl, and the like.
• alkynyl refers to an unsaturated acyclic C 2 -C 10 hydrocarbon which can comprise one or more carbon-carbon triple bonds.
• alkynyl groups include ethynyl, propynyl, butyn-1-yl, butyn-2-yl, pentyl-1-yl, pentyl-2-yl, 3- methylbutyn-1-yl, hexyl-1-yl, hexyl-2-yl, hexyl-3-yl, 3,3-dimethyl-butyn-1-yl, and the like.
• Cycloalkyl refers to a saturated or unsaturated cyclic hydrocarbon comprising from about 3 to about 8 carbon atoms. Cycloalkyl groups can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, amino, alkylamino, dialkylamino, arylamino, diarylamino, alkylarylamino, aryl, amidyl, ester, hydroxy, halo, carboxyl, alkylcarboxylic acid, alkylcarboxylic ester, carboxamido, alkylcarboxamido, oxo and nitro.
• cycloalkyl groups include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cyclohexenyl, cycloheptyl and the like.
• Heterocyclic ring or group refers to a saturated, unsaturated, cyclic or aromatic or polycyclic hydrocarbon group having about 3 to about 7 carbon atoms where 1 to about 4 carbon atoms are replaced by one or more nitrogen, oxygen and/or sulfur atoms. Sulfur maybe in the thio, sulfinyl or sulfonyl oxidation state.
• the heterocyclic ring or group can be fused to an aromatic hydrocarbon group.
• Heterocyclic groups can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, amino, alkylamino, dialkylamino, arylamino, diarylamino, alkylarylamino, hydroxy, oxo, thial, halo, carboxyl, carboxylic ester, alkylcarboxylic acid, alkylcarboxylic ester, aryl, arylcarboxylic acid, arylcarboxylic ester, amidyl, ester, carboxamido, alkylcarboxamido, arylcarboxamido, sulfonic acid, sulfonic ester, sulfonamido and nitro.
• heterocyclic groups include pyrrolyl, 3-pyrrolinyl,4,5,6-trihydro-2H-pyranyl, pyridinyl, 1 ,4-dihydropyridinyl, pyrazolyl, triazolyl, pyrimidinyl, pyridazinyl, oxazolyl, thiazolyl, imidazolyl, indolyl, thiophenyl, furanyl, tetrhydrofuranyl, tetrazolyl, 2-pyrrolinyl, 3-pyrrolinyl, pyrrolindinyl, oxazolindinyl 1 ,3-dioxolanyl, 2,6-dioxabicydo[3,3,0]octanyl, 2-imidazonlinyl, imidazolindinyl, 2-pyrazolinyl, pyrazolidinyl, isoxazolyl, isothi
• Aryl refers to a monocyclic, bicyclic, carbocyclic or heterocyclic ring system comprising one or two aromatic rings.
• aryl groups include phenyl, pyridyl, napthyl, quinoyl, tetrahydronaphthyl, furanyl, indanyl, indenyl, indoyl, and the like.
• Aryl groups can be unsubstituted or substituted with one, two or three substituents independently selected from alkyl, alkoxy, amino, alkylamino, dialkylamino, arylamino, diarylamino, alkylarylamino, hydroxy, carboxyl, carboxylic ester, alkylcarboxylic acid, alkylcarboxylic ester, aryl, arylcarboxylic acid, arylcarboxylic ester, alkylcarbonyl, arylcarbonyl, amidyl, ester, carboxamido, alkylcarboxamido, carbomyl, sulfonic acid, sulfonic ester, sulfonamido and nitro.
• substituted aryl groups include tetrafluoro- phenyl, pentafluorophenyl, sulfonamide, alkylsulfonyl, arylsulfonyl, and the like.
• alkylaryl refers to an alkyl group to which is appended an aryl group.
• alkylaryl groups include benzyl, phenylethyl, hydroxybenzyl, fluorobenzyl, fluorophenylethyl, and the like.
• Arylalkyl refers to an aryl radical, attached to an alkyl radical in accordance with the present invention,
• Cycloalkylalkyl refers to a cycloalkyl radical attached to an alkyl radical in accordance with the present invention
• alkoxy refers to RO-, wherein R is an alkyl group in accordance with the present invention.
• alkoxy groups include methoxy, ethoxy, t-butoxy, cyclopentyloxy, and the like.
• Arylalkoxy or alkoxyaryl refers to an alkoxy group, as defined herein, to which is appended an aryl group in accordance with the present invention, In accordance with the present invention, arylalkoxy groups indude benzyloxy, phenylethoxy, chlorophenylethoxy, and the like.
• alkoxyaryl refers to an alkoxy group, in accordance with the present invention, appended to an alkyl group.
• alkoxyaryl groups include methoxymethyl, methoxyethyl, isopropoxymethyl, and the like.
• R 1 is hydrogen, an alkyl having from 1 to about 5 carbon atoms including but not limited to methyl, ethyl, propyl, butyl, isopropyl, isobutyl, and pentyl, an aryl including but not limited to phenyl, aralkyl such as benzyl, or cycloalkyl having from about 3 to about 6 carbon atoms including but not limited to cyclopropyl, cyclobutyl, cyclopentyl, and cyclohexyl.
• R 2 is hydrogen, lower alkyl including but not limited to methoxy and ethoxy. In accordance with a more preferred embodiment of the present invention, R 2 is hydrogen or OCH 3 .
• R 1 and R 2 are independently hydrogen, methyl, ethyl, propyl or phenyl. In accordance with a more preferred embodiment of the present invention, R 1 is methyl, ethyl or phenyl and R 2 Is hydrogen. In accordance with a most preferred embodiment of the present invention, R 1 and R 2 are both ethyl.
• the compounds of the present invention can be administered alone but will generally be administered in admixture with a suitable pharmaceutical excipient, diluent or carrier selected with regard to the intended route of administration and standard pharmaceutical practice.
• a suitable pharmaceutical excipient diluent or carrier selected with regard to the intended route of administration and standard pharmaceutical practice.
• the compounds of the present invention can be administered orally, in the form of tablets, capsules, multiparticulates, elixirs, solutions or suspensions, which may contain flavoring or coloring agents, either for immediate-, delayed-, modified-, sustained-, pulsed- or controlled-release applications.
• Suitable formulations of the compounds of the present invention may be in coated or uncoated form, as desired.
• Such solid pharmaceutical compositions may contain excipients such as microcrystalline cellulose, lactose, sodium citrate, calcium carbonate, dibasic calcium phosphate, glycine and starch (preferably corn, potato or tapioca starch), disintegrants such as sodium starch glycollate, and certain complex silicates, and granulation binders such as polyvinylpyrrolidone, hydroxypropylmethylcellulose (HPMC), hydroxypropylcellulose (HPC), sucrose, gelatin and acacia. Additionally, lubricating agents such as magnesium stearate, stearic acid, may be included.
• excipients such as microcrystalline cellulose, lactose, sodium citrate, calcium carbonate, dibasic calcium phosphate, glycine and starch (preferably corn, potato or tapioca starch), disintegrants such as sodium starch glycollate, and certain complex silicates, and granulation binders such as polyvinylpyrrolidone, hydroxypropylmethylcellulose (
• E 1354 hydrogen hydrogen ⁇ 2-[1 -(4-Chloro-phenyl)-1 -phenyl-ethoxy]-ethyl ⁇ -methyl- phosphoramidlc acid
• E1355 hydrogen methyl ⁇ 2-[1 -(4-Chloro-phenyl)-1 -phenyl-ethoxy]-ethyl ⁇ -methyl- phosphoramidic acid monomethyl ester
• E1356 methyl methyl ⁇ 2-[1 -(4-Chloro-phenyl)-1 -phenyl-ethoxy]-ethyl ⁇ -methyl- phosphoramidic acid dimethyl ester
• E 1357 phenyl hydrogen ⁇ 2-[1 -(4-Chloro-phenyl)-1 -phenyl-ethoxy]-ethyl ⁇ -methyl- phosphoramidic acid monophenyl ester
• E1358 phenyl methyl ⁇ 2-[1 -(4-Chloro-phenyl)-1
• Ciprofloxacin (Cipro ® )
• Citalopram (Celexa ® )
• Clozapine (Clozaril ® ) Hydroxylated Metabolite
• E1359 hydrogen hydrogen (3-Dibenzo[a,d]cyclohepten-5-ylidene-propyl)-methyl- phosphoramidic acid
• E1360 hydrogen methyl (3-Dibenzo[a,d]cyclohepten-5-ylidene-propyl)-methyl- phosphoramidic acid monomethyl ester
• E1361 methyl methyl (3-Dibenzo[a,d]cyclohepten-5-ylidene-propyl)-methyl- phosphoramidic acid dimethyl ester
• E1362 phenyl hydrogen (3-Dibenzo[a,d]cyclohepten-5-ylidene-propyl)-methyl- phosphoramidic acid monophenyl ester
• E1363 phenyl methyl (3-Dibenzo[a,d]cyclohepten-5-ylidene-propyl)-methyl- phosphoramidic acid methyl ester phenyl ester
• E1056 hydrogen hydrogen [3-(10,11-Dihydro-dibenzo[b,f]azepin-5-yl)-propyl]-methyl- 4.38 3.01 phosphoramidic acid
• E1057 hydrogen methyl [3-(10,11-Dihydro-dibenzo[b,f]azepin-5-yl)-propyl]-methyl- 4.44 4.64 phosphoramidic acid monomethyl ester
• E1058 methyl methyl [3-(10,11 -Dihydro-dibenzo[b,f]azepin-5-yl)-propyl]-methyl- 4.50 3.27 phosphoramidic acid dimethyl ester
• E1059 phenyl hydrogen [3-(10,11-Dihydro-dibenzo[b,f]azepin-5-yl)-propyl]-methyl- 6.21 4.20 phosphoramidic acid monophenyl ester
• E1060 phenyl methyl [3-(
• E1249 hydrogen hydrogen ⁇ 2-[(2,6-Dichloro-phenyl)-phosphono-amino]-phenyl ⁇ -acetic acid
• E1250 hydrogen methyl ⁇ 2-[(2,6-Dichloro-phenyl)-(hydroxy-methoxy-phosphoryl)-amino]- phenylj-acetic acid
• Doxepin (Adapin , Sinequan )
• E1369 hydrogen hydrogen Methyl-[2-(1 -phenyl-1 -pyridin-2-yl-ethoxy)- ethyl]-phosphoramidic acid
• E1370 hydrogen methyl Methyl-[2-(1 -phenyl-1 -pyridin-2-yl-ethoxy)- ethyl]-phosphoramidic acid monomethyl ester
• E1371 methyl methyl Methyl-[2-(1 -phenyl-1 -pyridin-2-yl-ethoxy)- ethyl]-phosphoramidic acid dimethyl ester
• E1372 phenyl hydrogen Methyl-[2-(1 -phenyl-1 -pyridin-2-yl-ethoxy)- ethyl]-phosphoramidic acid monophenyl ester
• E1373 phenyl methyl Methyl-[2-(1 -phenyl-1 -pyridin-2-yl-ethoxy)
• Ephedrine (Broncholate ® )
• Escitalopram (Lexapro ® )
• Halofantrine (Halfan ® )
• Loxapine (Loxitane )
• Methoxyphenamine (Orthoxinine ® )
• E1304 hydrogen hydrogen [2-(2-Methoxy-phenyl)-1-methyl-ethyl]-phosphoramidic 1.56 2.29 acid
• E1305 hydrogen methyl [2-(2-Methoxy-phenyl)-1-methyl-ethyl]-phosphoramidic 1.62 5.68 acid monomethyl ester
• E1306 methyl methyl [2-(2-Methoxy-phenyl)-1-methyl-ethyl]-phosphoramidic 1.68 3.03 acid dimethyl ester
• E1308 phenyl methyl [2-(2-Methoxy-phenyl)-1-methyl-ethyl]-phosphoramidic 3.44 3.61 acid methyl ester phenyl ester
• E1116 hydrogen hydrogen Cyclohexyl-hydroxy-phenyl-acetic acid 3-(ethyl- 2.35 3.67 phosphono-amino)-prop-1 -ynyl ester
• E1117 hydrogen methyl Cyclohexyl-hydroxy-phenyl-acetic acid 3-[ethyl-(hydroxy- 2.41 399 methoxy-phosphoryl)-amino]-prop-1 -ynyl ester
• E1118 methyl methyl Cyclohexyl-hydroxy-phenyl-acetic acid 3-[(dimethoxy- 2.47 4.44 phosphoryl)-ethyl-amino]-prop-1 -ynyl ester
• E1119 phenyl hydrogen Cyclohexyl-hydroxy-phenyl-acetic acid 3-[ethyl-(hydroxy- 4.18 3.58 phenoxy-phosphoryl)-amino]-prop-1-ynyl
• E1120 phenyl methyl Cyclohexyl-hydroxy
• Phenformin (Dibotin ® )
• E1450 hydrogen methyl [3-(4-Bromo-phenyl)-3-pyridin-3-yI-allyl]-methyI- phosphoramidic acid monomethyl ester
• E1451 methyl methyl [3-(4-Bromo-phenyl)-3-pyridin-3-yl-allyl]-methyl- phosphoramidic acid dimethyl ester
• E1452 phenyl hydrogen [3-(4-Bromo-phenyl)-3-pyridin-3-yl-alIyl]-methyl- phosphoramidic acid monophenyl ester
• E1453 phenyl methyl [3-(4-Bromo-phenyl)-3-pyridin-3-yl-allyl]-methyl- phosphoramidic acid methyl ester phenyl ester
• Desipramine hydrochloride (1 equivalent, 0.5 gram) was added drop wise to a stirred solution of potassium carbonate (2 equivalents, 0.456 gram) in dry DMF at O 0 C. Diethylchlorophosphate (1.2 equivalents, 0.33 ml) which had been dissolved in dry DMF was added drop wise to this mixture and stirred for 12 hours at room temperature. The reaction mixture was quenched with water, extracted with ethyl acetate, the organic layer separated, washed with brine solution and dried over anhydrous sodium sulfate. The dried material was concentrated and purified by column chromatography to provide a pale yellow liquid (yield: 0.33 gram) and analyzed by HPLC (purity 93.1%). The FTIR, MS and 1 H NMR spectra were consistent with the assigned with the empirical formula of C 22 H 3 I N 2 O 3 P.
• Desipramine hydrochloride (1 equivalent, 0.3 gram) was added drop wise to a stirred solution of potassium carbonate (2 equivalents, 0.27 gram) in dry DMF at 0 0 C.
• Methyl chloroform (1.2 equivalents, 0.1 ml) which had been dissolved in dry DMF was added drop wise to this mixture and stirred for 6 hours at room temperature.
• the reaction mixture was quenched with water, extracted with ethyl acetate, the organic layer separated, washed with brine solution and dried over anhydrous sodium sulfate. The dried material was concentrated and purified by column chromatography to provide a pale yellow liquid (yield: 0.18 gram) and analyzed by HPLC (purity 97.7%).
• the FTIR, MS and 1 H NMR spectra were consistent with the assigned with the empirical formula of
• Desipramine hydrochloride (1 equivalent, 0.2 gram) was added drop wise to a stirred solution of potassium carbonate (5 equivalents, 0.45 gram) in dry DMF at 0 ° C.
• Propyl chloroform 1.5 equivalents, 0.1 ml which had been dissolved in dry DMF was added drop wise to this mixture and stirred for 6 hours at room temperature.
• the reaction mixture was quenched with water, extracted with ethyl acetate, the organic layer separated, washed with brine solution and dried over anhydrous sodium sulfate. The dried material was concentrated and purified by column chromatography to provide a yellow liquid (yield: 0.12 gram) and by HPLC (purity 95.7%).
• the FTIR, MS and 1 H NMR spectra were consistent with the assigned structure with the empirical formula of
• Desipramine hydrochloride (1 equivalent, 0.3 gram) was added drop wise to a stirred solution of potassium carbonate (5 equivalents, 0.68 gram) in dry DMF at 0° C.
• Isobutyl chloroform (1.5 equivalents, 0.18 ml) which had been dissolved in dry DMF was added drop wise to this mixture and stirred for 6 hours at room temperature.
• the reaction mixture was quenched with water, extracted with ethyl acetate, the organic layer separated, washed with brine solution and dried over anhydrous sodium sulfate.
• Desipramine hydrochloride (1 equivalent, 0.3 gram) was added drop wise to a stirred solution of potassium carbonate (2.5 equivalents, 0.34 gram) in dry DMF at 0 ° C.
• Octyl chloroform (1.5 equivalents, 0.429 grams) which had been dissolved in dry DMF was added drop wise to this mixture and stirred for 12 hours at room temperature.
• the reaction mixture was quenched with water, extracted with ethyl acetate, the organic layer separated, washed with brine solution and dried over anhydrous sodium sulfate.
• Plasma stability was assessed by incubation of 10 ⁇ M of each compound prepared in Examples 1-5 with human plasma, in duplicate, at ca. 37 0 C with shaking. Each compound prepared in Examples 1-5 was also incubated at 10 ⁇ M in PBS as a control for compound heat stability. Aliquots were removed at 0, 0.5, 1 and 2 hours and stored at -2O 0 C until analysis.
• plasma samples were extracted in 1 part acetonitrile and isolation of the supernatant. Analysis of each compound prepared in Examples 1-5 in plasma extracts was conducted by an LC-MS method at each time interval and quantification was achieved by comparison of the response due to the sample to that of a three point standard curve. Appearance of the parent drug the hydroxymetabolites were also monitored at each time interval. The % degradation following incubation at each time point was calculated by comparison of the parent concentration to that at 0 minutes.
• Sprague-Dawley rat plasma was obtained by collection into sodium EDTA as the anticoagulant, and was stored at ca -20 0 C prior to use. Prior to use, the plasma defrosted and was spun at ca. 3000 rpm for 5 minutes to remove any precipitate. The pH of the plasma was adjusted to pH 7.4 by careful addition of NaH 2 PO 4 buffer.
• Plasma stability was assessed by incubation of 10 ⁇ M of each compound prepared in Examples 1-5 with rat plasma, in duplicate, at ca. 37 0 C with shaking. Each compound prepared in Examples 1-5 was also incubated at 10 ⁇ M in PBS as a control for compound heat stability. Aliquots were removed at 0, 0.5, 1 and 2 hours and stored at - 2O 0 C until analysis.
• each compound prepared in Examples 1-5 was assessed in duplicate by incubation of 10 ⁇ M of each compound at ca. 37 0 C and shaking with each of the following: simulated gastric fluids (saline pH approximately 1, plus pepsin); simulated intestinal fluids (phosphate pH 6 with pepsin); and alkaline phosphatase enhanced simulated intestinal fluids (phosphate pH 6 with pepsin and ⁇ alkaline phosphatase). Aliquots were removed at 0, 0.5, 1 and 2 hours, extracted with one volume of organic solvent and stored at -2O 0 C until analysis.
• simulated gastric fluids saline pH approximately 1, plus pepsin
• simulated intestinal fluids phosphate pH 6 with pepsin
• alkaline phosphatase enhanced simulated intestinal fluids (phosphate pH 6 with pepsin and ⁇ alkaline phosphatase).
• the metabolic stability of each compound prepared in Examples 1-5 was assessed in microsomal preparations obtained from BD Gentest (Woburn, MA).
• the metabolic stability of each compound prepared in Examples 1-5 was assessed in duplicate by incubation of 10 ⁇ M compound with 0.5 mg/mL microsomal protein, 1 mM NADPH in 0.1 M phosphate buffer, pH 7.4 in the presence and absence of a CYP3A4 inhibitor (ketoconazole).
• the reaction mixture was pre-incubated, in the absence of the microsomes, at ca. 37 0 C for 5 minutes, followed by initiation of the incubation by the addition of microsomal protein and maintained at ca. 37 0 C for a further 0, 30 and 60 minutes.
• the % turnover following 60 minutes of incubation was calculated by comparison of the parent concentration to that at 0 minutes.
• the % degradation was calculated in the same manner from the negative control incubations. Appearance of the parent drug and the hydroxymetabolites were also monitored at each time interval.
• each compound prepared in Examples 1-5 was assessed in duplicate by incubation of 10 ⁇ M compound with human hepatocytes after thawing of cryopreserved suspensions.
• the hepatocytes were maintained in Modified Williams' E medium (HMM, Clonetics, MD) supplemented with 0.1 ⁇ M dexamethasone, 0.1 ⁇ M insulin and 0.05 % gentamicin immediately after thawing.
• HMM Modified Williams' E medium
• Each compound prepared in Examples 1-5 was tested by incubation in duplicate with the hepatocyte suspensions (1.0 x10 6 viable cells/mL HHM media) and incubated for 0, 1 , 2 and 4 hours at 37°C at 5% CO 2 . Incubations were terminated by the addition of two volumes of ice-cold methanol, cell debris was removed by centrifugation and the supernatant was stored at approximately -7O 0 C prior to analysis.
• Negative and positive control incubations were performed in duplicate under the same conditions as described for the prodrugs. Negative control incubations: An incubation of each compound prepared in Examples 1-5 in Modified Williams' E media (HHM media), in the absence of hepatocytes was performed alongside the hepatocyte incubations. Positive control incubations: Incubations with a positive control (7-ethoxycoumarin; 100 ⁇ M) was performed with hepatocytes from each species for 1 hour alongside the prodrug incubations. Analysis of metabolic turnover was performed by HPLC. Quantification of the parent compound was achieved by comparison of the sample response to that of a suitable standard curve. The standard curve ranged between ⁇ 1% up to >100% of the dosing concentration. The % turnover following 1 , 2 and 4 hours of incubation was calculated by comparison of the parent concentration to that at 0 minutes.

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