WO2016011943A1 - 新的苯并二氮杂䓬类衍生物及其用途 - Google Patents
新的苯并二氮杂䓬类衍生物及其用途 Download PDFInfo
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- WO2016011943A1 WO2016011943A1 PCT/CN2015/084770 CN2015084770W WO2016011943A1 WO 2016011943 A1 WO2016011943 A1 WO 2016011943A1 CN 2015084770 W CN2015084770 W CN 2015084770W WO 2016011943 A1 WO2016011943 A1 WO 2016011943A1
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- KGZDFKIUQVXETE-SFHVURJKSA-N CCOC(CC[C@@H](c1ncc(C)[n]1-c(cc1)c2cc1Br)N=C2c1ncccc1)=O Chemical compound CCOC(CC[C@@H](c1ncc(C)[n]1-c(cc1)c2cc1Br)N=C2c1ncccc1)=O KGZDFKIUQVXETE-SFHVURJKSA-N 0.000 description 1
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- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07D—HETEROCYCLIC COMPOUNDS
- C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
- C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
- C07D487/04—Ortho-condensed systems
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/06—Anti-spasmodics, e.g. drugs for colics, esophagic dyskinesia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P23/00—Anaesthetics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/08—Antiepileptics; Anticonvulsants
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/20—Hypnotics; Sedatives
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/22—Anxiolytics
Definitions
- the present invention relates to novel benzodiazepines derivatives and pharmaceutically acceptable salts thereof, processes for their preparation and uses. Background technique
- Benzodiazepines are widely used clinically for anti-anxiety, sedation and hypnosis.
- midazolam has been widely used for clinical sedation, hypnosis, analgesia, anti-epilepsy, anxiolytic and general anesthesia.
- midazolam When midazolam is introduced into the human body as an anesthetic, it can be oxidized to ⁇ -hydroxymidazolam by the cytochrome P450 3A4 isoenzyme.
- the oxide still has pharmacological activity, so the anesthetic action is long and the recovery is slow. Therefore, the development of novel benzodiazepine water-soluble derivatives with fast induction time and short maintenance time has been the focus of pharmaceutical chemists.
- the drug has a short induction time, a low incidence of respiratory depression, and a short recovery time of consciousness, which has been widely concerned by the pharmaceutical industry.
- a short induction time a low incidence of respiratory depression
- a short recovery time of consciousness which has been widely concerned by the pharmaceutical industry.
- Five patients had prolonged recovery time the blood levels of rimidronium in these 5 patients were high, but the cause of the high was unknown (http: ⁇ www.paion.de/images/stories/investoren/êtonne/
- the inventors designed and synthesized a new class of water-soluble benzodiazepine derivatives, which have low toxicity after metabolism in vivo, and have fast onset and short maintenance time. , quick recovery and other advantages.
- the compound of the formula of the present invention or a pharmaceutically acceptable salt thereof is characterized in that it does not produce methanol and/or formic acid after being metabolized in the body.
- the pharmaceutically acceptable salt of the compound of formula (I) of the invention has the formula (la):
- A is an acid which can form a salt with a nitrogen containing a lone pair of electrons.
- a in formula (la) is a pharmaceutically acceptable acid.
- a pharmaceutically acceptable salt of a compound of formula D of the invention may also be represented by the formula:
- A is selected from the group consisting of HCl, HBr, acetic acid (AcOH), propionic acid (EtCOOH), sulfuric acid, phosphoric acid, carbonic acid, methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, lactic acid, Succinic acid, maleic acid, fumaric acid, tartaric acid, citric acid, malic acid, and any combination thereof.
- A is selected from the group consisting of HCl, HBr, methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, and any combination thereof.
- the compound of formula (I) of the invention is used to provide anesthesia.
- a compound of the formula of the invention, or a pharmaceutically acceptable salt thereof is used to provide sedation.
- the invention relates to the use of a compound of formula (I) or a pharmaceutically acceptable salt thereof for the manufacture of a medicament for the administration of anesthesia, in particular for preoperative anesthesia, induction of anesthesia and maintenance of anesthesia.
- the drug is administered intravenously.
- the invention relates to a method for providing anesthesia to an individual, the method comprising administering to the individual a compound of formula (I) or a pharmaceutically acceptable salt thereof.
- the compound of formula (I) or a pharmaceutically acceptable salt thereof is administered intravenously.
- the invention relates to the use of a compound of formula (I) or a pharmaceutically acceptable salt thereof for the manufacture of a medicament for providing sedation.
- the medicament is administered intravenously.
- the invention relates to a method for providing sedation to an individual, the method comprising administering to the individual a compound of formula (I) or a pharmaceutically acceptable salt thereof.
- the compound of formula (I) or a pharmaceutically acceptable salt thereof is administered intravenously.
- the present invention is also a pharmaceutical composition comprising a compound of formula (I), or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
- the pharmaceutically acceptable salt of the present invention is a salt of an acid with a lone pair of electron-containing nitrogen in the compound, for example, a salt formed with an inorganic or organic acid.
- the "pharmaceutically acceptable salt" of the compound of the present invention may be a salt formed with an inorganic acid, for example, a salt formed with the following inorganic acid: hydrochloric acid (HC1), hydrobromic acid (HBr), Hydroiodic acid, sulfuric acid, pyrosulfuric acid, phosphoric acid or nitric acid; or a salt formed with an organic acid, for example, a salt formed with the following organic acids: methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, formic acid, acetic acid , acetoacetic acid, pyruvic acid, trifluoroacetic acid, propionic acid, butyric acid, caproic acid, heptanoic acid, undecanoic acid, lauric acid, benzoic acid, salicylic acid, 2-(4-hydroxybenzoyl)benzoic acid
- the pharmaceutically acceptable salt of the compound of the invention has the formula:
- A is one or more selected from the group consisting of HC1, HBr, acetic acid, propionic acid, sulfuric acid, phosphoric acid, carbonic acid, methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, lactic acid, and dibutyl Acid, maleic acid, fumaric acid, tartaric acid, citric acid or malic acid; particularly preferably one or more selected from the group consisting of HC1, HBr, methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, p-toluene acid.
- the compound of the invention or a pharmaceutically acceptable salt thereof From:
- rimidazolam CNS 7056 ie, remimidazole methyl ester:
- carboxylesterase 1 hCES1M the carboxylesterase 1 hCES1M as the inactive substance rimidazolam acid CNS 7054 , formula and methanol.
- Methanol is highly toxic (Sneyd JR. New drugs and technologies, intravenous anaesthesia is on the move (again), British Journal of Anaesthesia. 2010, 105 (3): 246-54), which is further metabolized to formic acid, after It is more toxic (Tephly TR. The toxicity of methanol, [J].
- CNS 7056 Formula (III) CNS 7054 Formula (II) HCOOH
- Ono Company uses rimamidazole for a long time in the ICU sedation process, its metabolite methanol is easily oxidized to formic acid, formic acid easily accumulates in the body and inhibits hCESl, which causes the metabolism of rimidazole to slow down, which may cause high blood concentration in some patients. s reason.
- the benzodiazepine derivatives of the present invention and pharmaceutically acceptable salts thereof have the characteristics of rapid onset, rapid recovery, low incidence of respiratory depression, and short recovery time of consciousness in vivo. Moreover, after metabolism in the body, no more toxic methanol will be released, and thus formic acid which inhibits its own metabolism will not be produced, and hCES1 will not be inhibited in the body, so that the blood concentration is not high after the patient is infused for a long time, and the recovery time is high. The problem is prolonged, and after stopping the administration, the treated subject can quickly wake up.
- Example 1 Example 1
- the compound of the formula II (: remimidazole acid 4.25 g, 10 mm oi) was dissolved in anhydrous ethanol (100 ml), and concentrated sulfuric acid (0.5 g) was added. The ice bath was removed, and the reaction mixture was stirred at room temperature for 12 hr. The residue was dissolved in ethyl acetate (100 mL). The organic layer was washed with a saturated sodium hydrogen carbonate solution (10 ml * 2) and then washed with brine (30 ml*l). The organic layer was dried over anhydrous sodium sulfate and filtered. The organic solvent was evaporated under reduced pressure to give a colorless oil (yield: 4.1 g, yield: 91%).
- the compound of the formula 11 (: rimidazolidinic acid, 4.25 g, 10 mmol) was dissolved in anhydrous dichloromethane 20mi >, oxalyl chloride Pml) and 1 drop of DMF were slowly added ( ⁇ , ⁇ - Dimethylformamide :), after completion of the dropwise addition, the ice bath was removed, and the reaction mixture was stirred at room temperature for 12 hr. dichloromethane and oxalyl chloride were evaporated under reduced pressure. The residue was dissolved in dichloromethane (20 ml) and added dropwise under ice bath.
- the compound of the formula II (: rimidazolidinic acid, 4.25 g, 10 mmoi) is dissolved in anhydrous dichloromethane (Oml) at room temperature, and DCC (dicyclohexylcarbodiimide) is sequentially added to the dichloromethane. , 3.1 g, 15 mmol) and DMAP (4-indole, hydrazine-dimethylaminopyridine, 244 mg, 2 mmol). After stirring at room temperature for 30 mm, a solution of dichloromethane (0.92 g, 20 mmol) in dichloromethane (5 ml) was added, and the mixture was reacted at room temperature for 16 hours and filtered.
- DCC diclohexylcarbodiimide
- Ethyl rimidazolamate (lg, 2.2 mmol) was dissolved in ethyl acetate (15 ml) at room temperature, and a solution containing p-toluenesulfonic acid (379 mg, 2.2. A white solid appeared. The crystals were stirred for 3 hours in an ice bath, and then filtered. The filter cake was washed with iced ethyl acetate to give 0.9 g.
- Example 6 Preparation of remimidyl urethane methanesulfonate (C4)
- Example 8 Mouse anesthetic efficacy test of rimidazolam and compound C2 C6 C7 C8 C9
- Kunming mice (SPF, Chongqing Medical University Animal Center:) were randomly divided into groups of 6 each; the dose was 9 mg/kg, and the drug was injected through the tail vein for 3-5 seconds. The performance of the animal experiment was recorded by using the disappearance of the righting reflex as the criterion.
- Control can quickly walk normally after waking up
- P-toluenesulfonate can quickly walk normally after waking up
- the righting reflex disappears quickly. After anesthesia, there is a slight respiratory depression, and the limbs are weak or even paralyzed, and the eyes are closed.
- ester p-toluenesulfonate can be raised, and then it can be slowed down, but there is no sense of balance, hemiplegia, and the body appears to swing sideways when walking.
- Remimidazole sulphate is not anesthetic, has a certain sedative effect,
- the prepared GABA a ( Y - aminobutyric acid A ) receptor benzodiazepine site membrane (the living SD rats were decapitated, operated on ice, brain tissue was quickly taken, and 0.05 M Tris-HCl + was added.
- A lmM EDTA solution
- homogenate then add A, lOOOr/mm for 10min, take the upper layer at llOOOr/mm, centrifuge at 30°C for 30mm, discard the supernatant, add solution A to the sediment, mix with vortex Mix well, centrifuge, repeat three times of centrifugation, centrifuge, and discard the supernatant, take the precipitate for use:), disperse and homogenize through a homogenizer with an appropriate amount of homogenate (50mMTns buffer, pH 7.4).
- each reaction tube was separately added to the membrane preparation ⁇ , the homogenate ⁇ total combined tube ( ⁇ ) was added to the ⁇ homogenate, and the non-specific combined tube ( ⁇ ) was added with 100 ⁇ clonazepam (purchased from Jiangsu Enhua) Industry:) (10 ⁇ final concentration 1.0*10_ 5 ⁇ :), each test compound specific binding tube (SB) was added to ⁇ ⁇ test compound (final concentration 1 ( ⁇ 5 ⁇ : ⁇ ; each reaction tube was added with radioactivity Ligand 3 flu-flunitrazepam (purchased from PerkinElmer) ⁇ (final concentration 1 ⁇ ). There are 3 parallel tubes, and each tube is placed on ice when loading.
- Inhibition rate (I %) (total binding tube cpm - compound cpm) / (total binding tube cpm - non-specific binding tube cpm) x l00% o inhibition rate (: 1%:) ⁇ 95% is associated with the corresponding receptor Strong and sexual.
- the IC 5Q of each compound was calculated by the logit method.
- Example 11 Rat plasma decomposition experiment of rimidazole and compound C2
- the remimidazole and the compound C2 were respectively prepared into a physiological saline solution of 1 mg/ml, and respectively 0.1 ml of the solution was added to 1 ml of rat plasma (from the living Kunming species, SPF, Chongqing Medical University Animal Center:), and thoroughly mixed. , placed in a constant temperature water bath at 37 ° C. Immediately after sampling at different time points, 2 ml of acetonitrile was added, shaken, and centrifuged at 10,000 rpm. The supernatant was taken for HPLC detection. The results are as follows:
- Example 12 Rat anesthesia ED 5 . And LD 5 . Determination and TI index
- LD 5Q and ED 5Q were calculated from the LD 5Q and ED 5 () values.
- Example 13 Determination of induction time and recovery time of intravenous anesthesia in rats
- Kunming rats (SPF, Nanjing Qinglong Mountain Animal Breeding Center) were grouped into male and female, 10 in each group; the dose was 2*ED 5Q (ED 5Q is the value measured in Example 12), tail Intravenous injection, complete injection within 10 seconds. Record the time when the rat's righting reflex disappeared (: latency:) and recovery time Between (duration).
- the compound of the present invention or a pharmaceutically acceptable salt thereof can produce an effective anesthetic effect on rats, and the induction time is about 2.8 times faster than that of remiamimidazole, and there is no significant difference between the recovery time and the remimidazole.
- the affinity of the compound C2 for the GABA A receptor benzodiazepine site is lower than that of the remimidazole
- the log P of the compound C2 is higher than that of the remimidazole, which is faster than the remimidazole (: The induction time is short:) more ED 5Q is low) through the blood-brain barrier to better exert anesthesia or sedation.
- Example 14 Determination of rabbit anesthesia ED 5Q
- the ED 5Q value of rabbit anesthesia was determined by sequential method. Take healthy and qualified New Zealand white rabbits (SPF grade, Cangzhou Zizi Culture Center), inject the drug into the ear veins at a uniform rate, and inject for 30 seconds. A preliminary pre-test was performed to find the approximate dose (dosing volume) that would cause anesthesia (or death:) of the animal as an intermediate dose at the time of the formal experiment. With a group spacing of 0.8, 2-3 dose groups were set up and down respectively. The disappearance or death of righting reflex is used as a judgment indicator for pharmacodynamics or toxicity. In the case of a formal experiment, administration is first started from an intermediate dose.
- New Zealand white rabbits SPF grade, Cangzhou Zizi Culture Center
- male and female 8 in each group; dose is 2*ED 5Q (ED 5Q is the value measured in Example 14), ear edge Intravenous injection, 30 seconds continuous injection.
- the time (induction time) and recovery time (duration) at which the rabbit's righting reflex disappeared was recorded.
- Example 16 Compound rabbit long-term infusion test
- New Zealand white rabbits (SPF grade, Cangzhou Zizi Culture Center:), male and female, each group of 10; rabbit intravenous infusion, the compound was 3*ED 5Q (ED 5Q value measured in Example 14 Values:)
- the infusion was performed with the appropriate dose as the maintenance dose, and the infusion time was 30 mm.
- the infusion rate was adjusted appropriately according to the performance of the rabbit during the infusion to allow the rabbits to maintain a comparable depth of anesthesia.
- the effects of long-term infusion of the two groups on rabbits were observed, and the time from the stop of administration to the recovery of righting reflex was recorded.
- the compound of the present invention or a pharmaceutically acceptable amphibian thereof has a definite anesthetic effect, and the anesthetic effect on cynomolgus monkey is stronger than that of remiamimidazole at 3 mg/kg.
- the compound of the present invention and a pharmaceutically acceptable salt thereof have the characteristics of rapid onset, rapid recovery, low incidence of respiratory depression, and short recovery time of consciousness; and the subject is rapidly awakened after stopping the administration. , has obvious anesthetic effect.
- the benzodiazepine derivative of the present invention and a pharmaceutically acceptable salt thereof have the characteristics of quick action and rapid recovery as an intravenous anesthetic.
- benzodiazepine derivatives of the present invention and pharmaceutically acceptable salts thereof can also be used in combination with opioids for sedation.
- all numbers expressing quantities of ingredients, ratios, conditions, etc., used in the specification (including claims) are to be understood as being modified by the term "about” under all conditions. Accordingly, unless indicated to the contrary, the numerical parameters are approximate and may vary depending upon the desired characteristics of the invention.
- a person skilled in the art will recognize many equivalents of the specific embodiments of the invention described herein, and the scope of the appended claims. Many modifications and variations of the present invention are possible without departing from the spirit and scope.
- the specific embodiments described herein are offered by way of example only and are not intended to be limiting. The true scope and spirit of the invention are shown by the appended claims, and the description and embodiments are merely exemplary.
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Abstract
本发明涉及新的苯并二氮杂䓬类衍生物及其药学可接受的盐及其制备方法和用途。本发明的苯并二氮杂䓬类衍生物及其药学上可接受的盐具有明显的麻醉效果,且在体内的毒性很低,从而提高了用药的安全性。本发明的苯并二氮杂䓬类衍生物及其药学上可接受的盐具备镇静、催眠和麻醉作用,可以用作镇静、催眠和麻醉药物。
Description
新的苯并二氮杂草类衍生物及其用途 相关申请的交叉引用
本申请要求 2014年 7月 23日提交的题为"一类苯二氮草类衍生物及其 用途"的第 201410352439.0号中国专利申请的优先权,该申请的公开内容整 体援引加入本文。 技术领域
本发明涉及新的苯并二氮杂草类 (benzodiazepines)衍生物及其药学可 接受的盐、 其制备方法和用途。 背景技术
苯并二氮杂草类药物在临床上广泛用于抗焦虑、 镇静和催眠。 作为第 一个水溶性苯并二氮杂草类衍生物, 咪达唑仑已经广泛用于临床镇静、 催 眠、 镇痛、 抗癫痫、 抗焦虑和全身麻醉。 当咪达唑仑作为麻醉药输入人体 后, 可被细胞色素 P450 3A4同工酶氧化为 α-羟基咪达唑仑。该氧化物仍具 有药理活性, 因而麻醉作用时间长, 苏醒慢。 因此研发麻醉诱导时间快、 维持时间短的新型苯并二氮杂草类水溶性衍生物一直为药物化学家所重 视。
1999年, 葛兰素公司设计并合成了瑞咪唑仑 (CNS7056, 式 (III)):
式 (III)
该药诱导时间短, 呼吸抑制发生率低, 意识恢复时间短, 受到药学界 广泛关注。 但是, 2013年在 49例 ICU病人镇静的 11期临床实验中, 发现
5例病人苏醒时间延长。经检测, 这 5例病人瑞咪唑仑血药浓度偏高, 但偏 高原因不明 (http:〃 www.paion.de/images/stories/investoren/finanznachrichten/
2014/en/japantelco.pdf)。 2014 年, 小野公司以瑞咪唑仑代谢情况不明为由 终止了该药的开发。
为了解决现有技术中存在的问题, 发明人设计并合成一类新的水溶性 苯并二氮杂草类衍生物, 其在体内代谢后的毒性很低, 并且具有起效快, 维持时间短, 恢复迅速等优点。
发明内容
在第一方面, 本发 上可接受的盐:
在上述第一方面的一实施方案中, 本发明的式 的化合物或其药学上 可接受的盐的特征在于, 其在体内代谢后, 不会产生甲醇和 /或甲酸。
在上述第一方面的另一实施方案中, 本发明的式 (I)的化合物的药学上 可接受的盐具有式 (la):
其中 A为可与含孤对电子的氮成盐的酸。
在 ·具体实施方案中, 式 (la)中的 A为药学上可接受的酸。
其中 A如上文所定义。
在本文中, 式la)和式 (la')具有相同的含义并且可以互换使用。
在一具体实施方案中, A选自 HC1、 HBr、乙酸 (AcOH)、丙酸 (EtCOOH)、 硫酸、 磷酸、 碳酸、 甲磺酸、 乙磺酸、 苯磺酸、 对甲苯磺酸、 乳酸、 丁二 酸、 马来酸、 富马酸、 酒石酸、 柠檬酸、 苹果酸及其任意组合。 在进一步 优选的实施方案中, A选自 HC1、 HBr、 甲磺酸、 乙磺酸、 苯磺酸、 对甲苯 磺酸及其任意组合。
在另一实施方案中, 本发明的式 (I)的化合物或其药学上可接受的盐用 于提供麻醉。
在进一步的实施方案中, 本发明的式 的化合物或其药学上可接受的 盐用于提供镇静。
在第二方面, 本发明涉及式 (I)的化合物或其药学上可接受的盐在制备 用于提供麻醉的药物中的应用, 特别是在术前麻醉、 诱导麻醉以及维持麻 醉中的应用。 在一优选实施方案中, 通过静脉内给药所述药物。
在上述第二方面的一实施方案中, 本发明涉及一种用于向个体提供麻 醉的方法, 所述方法包括向所述个体给药式 (I)的化合物或其药学上可接受 的盐。 在该方法的一优选实施方案中, 静脉内给药式 (I)的化合物或其药学 上可接受的盐。
在第三方面, 本发明涉及式 (I)的化合物或其药学上可接受的盐在制备 用于提供镇静的药物中的应用。 在一优选实施方案中, 通过静脉内给药所 述药物。
在上述第三方面的一实施方案中, 本发明涉及一种用于向个体提供镇 静的方法, 所述方法包括向所述个体给药式 (I)的化合物或其药学上可接受 的盐。 在该方法的一优选实施方案中, 静脉内给药式 (I)的化合物或其药学 上可接受的盐。
在第四方面, 本发明还涉及一种药物组合物, 其包含式 (I)的化合物或 其药学上可接受的盐以及药学上可接受的载体。 具体实施方式
药学可接受的盐
根据本发明的一实施方案, 本发明的药学可接受的盐为酸与化合物 中的含孤对电子的氮形成的盐, 例如与无机酸或有机酸形成的盐。
根据本发明的另一实施方案, 本发明化合物的"药学可接受的盐"可以 是与无机酸形成的盐, 例如与以下无机酸形成的盐: 盐酸 (HC1)、 氢溴酸 (HBr), 氢碘酸、 硫酸、 焦硫酸、 磷酸或硝酸; 或者与有机酸形成的盐, 例 如与以下有机酸形成的盐: 甲磺酸、 乙磺酸、 苯磺酸、 对甲苯磺酸、 甲酸、 乙酸、 乙酰乙酸、 丙酮酸、 三氟乙酸、 丙酸、 丁酸、 己酸、 庚酸、 十一垸 酸、 月桂酸、 苯甲酸、 水杨酸、 2-(4-羟基苯甲酰基)苯甲酸、 樟脑酸、 肉桂 酸、 环戊垸丙酸、 二葡糖酸、 3-羟基 -2-萘甲酸、 烟酸、 扑酸、 果胶酯酸、 过硫酸、 3-苯基丙酸、苦味酸、特戊酸、 2-羟基乙磺酸、衣康酸、氨基磺酸、 三氟甲磺酸、 十二垸基硫酸、 2-萘磺酸、 萘二磺酸、 樟脑磺酸、 柠檬酸、 酒石酸、 硬脂酸、 乳酸、 草酸、 丙二酸、 琥珀酸、 苹果酸、 肥酸、 藻酸、 马来酸、 富马酸、 D-葡糖酸、 扁桃酸、 抗坏血酸、 葡庚酸、 甘油磷酸、 天 冬氨酸、 磺基水杨酸、 半硫酸或硫氰酸。
根据本发明的另一实施方案, 本发明的化合物的药学可接受的盐具有 如下通式:
其中, A为选自以下的一种或多种: HC1、 HBr、 乙酸、 丙酸、 硫酸、 磷酸、 碳酸、 甲磺酸、 乙磺酸、 苯磺酸、 对甲苯磺酸、 乳酸、 丁二酸、 马 来酸、 富马酸、 酒石酸、 柠檬酸或苹果酸; 特别优选为选自以下的一种或 多种: HC1、 HBr、 甲磺酸、 乙磺酸、 苯磺酸、 对甲苯磺酸。
在本发明的一优选实施方案中, 本发明的化合物或其药学可接受的盐
选自:
瑞咪唑仑酸乙酯 (化合物 Cl),
瑞咪唑仑酸乙酯对甲苯磺酸盐 (化合物 C2),
瑞咪唑仑酸乙酯苯磺酸盐 (化合物 C3),
瑞咪唑仑酸乙酯甲磺酸盐 (化合物 C4), 和
瑞咪唑仑酸乙酯乙磺酸盐 (化合物 C5)。 本发明的有益效果
不意图为任何理论所束缚, 认为尽管瑞咪唑仑CNS 7056, 即瑞咪唑仑 酸甲酯:)具有许多优点, 但是其在体内由羧酸酯酶 1 hCESlM弋谢为非活性 物质瑞咪唑仑酸CNS 7054, 式 和甲醇。 甲醇具有较大的毒性 (Sneyd JR. New drugs and technologies, intravenous anaesthesia is on the move (again), British Journal of Anaesthesia. 2010,105 (3): 246-54), 会被进一步代谢为甲 酸, 后者的毒性更大 (Tephly TR. The toxicity of methanol, [J]. Life Sci, 1991, 48(11): 1031-1041), 且在体内代谢缓慢, 易累积 (Roe. Species differences m methanol oisoning, [ J]. Crit Rev Toxicol, 1982, 10(4): 275-286)。
CNS 7056式(III) CNS 7054式(II) HCOOH 本发明人进行了 CNS 7056的体外肝细胞代谢实验,并且出人意料地发 现, 当肝细胞培养液中甲酸加入量为 0.1%^/\ 时, CNS 7056的代谢被完全 抑制。 因此, 小野公司在 ICU镇静过程中长期使用瑞咪唑仑, 其代谢物甲 醇易氧化为甲酸, 甲酸在体内易积蓄并抑制 hCESl , 致使瑞咪唑仑代谢减 缓, 可能是造成部分患者血药浓度偏高的原因。
相比之下, 本发明的苯并二氮杂草类衍生物及其药学上可接受的盐, 在体内具有起效快, 恢复快, 呼吸抑制发生率低, 意识恢复时间短等特点,
并且在体内代谢后不会释放出毒性较大的甲醇, 进而不会产生抑制自身代 谢的甲酸, 体内 hCESl不会受到抑制, 因而不会造成病人长期输注后, 血 药浓度偏高, 苏醒时间延长的问题, 并且在停止给药以后, 处理的对象能 够快速苏醒。 实施例
为了使本发明的目的、 技术方案更加清楚, 下面对本发明的优选实施 例进行详细的描述。 要说明的是, 以上实施例只用于本发明进一步说明, 不能理解为对本发明保护范围的限制, 本领域的技术人员根据本发明的上 述内容作出的一些非本质的改进和调整均属于本发明的保护范围。 本发明 所用原料及试剂均为市售产品。 制备例
实施例 1: 制备瑞咪唑仑酸乙酯 (C1)
在冰浴下, 将将式 II的化合物 (:瑞咪唑仑酸 4.25g, 10mmoi >溶于无水 乙醇 (lOOml)中, 加入浓硫酸0.5g)。撤去冰浴, 将反应混合物在室温下搅拌 12小时, 减压挥去乙醇。 将残余物用乙酸乙酯 (100ml)溶解。 将有机层用饱 和碳酸氢钠溶液洗涤 (10ml*2次),再用饱和食盐水洗涤 (30ml*l)。将有机层 用无水硫酸钠干燥, 过滤。 减压挥去有机溶剂, 得无色油状物 4.1g, 收率 91%。
MASS [M+H]+=454.1
JH-NMR (500 MHz, CDCl3)5:8.52(s,lH),8.06(s,lH),7.92 (dd,lH),7.78 (d,2H),7.63 (s,lH),7.57 (s,lH),7.43 (s,lH),4.32 (s,lH),4.08 (s,2H), 2.46 (s,2H), 2.34 (d,5H),1.17 (m,3H). 实施例 2: 制备瑞咪唑仑酸乙酯 (CI)
在冰浴下, 将式 11的化合物 (:瑞咪唑仑酸, 4.25g, lOmmol)溶于无水二 氯甲垸20mi >中, 缓慢滴加草酰氯 Pml)和 1滴 DMF (Ν,Ν-二甲基甲酰胺:), 滴加完毕后, 撤去冰浴, 将反应混合物在室温下搅拌 12小时, 减压挥去二 氯甲垸和草酰氯。 将残余物溶于二氯甲垸 (20ml), 在冰浴条件下滴入含有
DMAP(1.83g, 15mmol)和乙醇 (lml)的无水二氯甲垸溶液 (15ml)中, 然后在 冰浴下反应 4小时。将有机层用依次用饱和碳酸氢钠溶液洗涤 10ml*2 >和饱 和食盐水 (30ml*l)洗涤, 用无水硫酸钠干燥, 过滤。 减压挥去有机溶剂, 得 无色油状物 4.2g, 收率 92.7%。 实施例 3: 制备瑞咪唑仑酸乙酯 (C1)
在室温下, 将式 II的化合物 (:瑞咪唑仑酸, 4.25g, 10mmoi>溶于无水二 氯甲垸 Oml)中, 依次向二氯甲垸中加入 DCC(二环己基碳二亚胺, 3.1g, 15mmol)和 DMAP (4-Ν,Ν-二甲氨基吡啶, 244mg, 2mmol)。 在室温下搅拌 30mm后, 加入含有乙醇 (0.92g, 20mmol)的二氯甲垸溶液 (5ml), 在室温下 反应 16小时, 过滤。 将滤液依次用饱和碳酸氢钠溶液洗涤 10ml*2 >和饱和 食盐水 (30ml*l)洗涤后, 用无水硫酸钠干燥, 过滤。 减压挥去有机溶剂, 将 残余物用柱层析分离 (乙酸乙酯:石油醚 =1:1), 得到无色油状物 3.8, 收率 83.8%。 实施例 4: 制备瑞咪唑仑酸乙酯对甲苯磺酸盐 (化合物 C2)
在室温下, 将瑞咪唑仑酸乙酯 (lg, 2.2mmol)溶于乙酸乙酯 (15ml)中, 向混合物中加入含有对甲苯磺酸 (379mg, 2.2moi:>的乙酸乙酯溶液 (lml), 有 白色固体出现。 冰浴搅拌析晶 3小时, 然后过滤。 将滤饼用冰的乙酸乙酯 洗涤, 得瑞咪唑仑酸乙酯甲磺酸盐 0.9g。
MASS [M+H]+=454.05.
JH-NMR (500 MHz, CDC13): δ 8.54 (d, 1H), 8.09 (d, 1H), 7.96 (dd, 1H), 7.82 (d, 2H), 7.72 (d, 2H), 7.48-7.56 (m, 1H), 7.44 (d, 2H), 7.07 (d, 2H), 4.33 (s 1H), 4.06 (s, 2H), 2.67 (m, 2H), 2.47 (s, 3H), 2.35 (s, 2H), 2.25 (s, 3H), 1.16(m, 3H). 实施例 5: 制备瑞咪唑仑酸乙酯苯磺酸盐 (C3)
以苯磺酸为酸, 按照实施例 4的操作, 可以制得标题化合物。
:例 6: 制备瑞咪唑仑酸乙酯甲磺酸盐 (C4)
以甲磺酸为酸, 按照实施例 4的操作, 可以制得标题化合物。
:例 7: 制备瑞咪唑仑酸乙酯乙磺酸盐 (C5)
以乙磺酸为酸, 按照实施例 4的操作, 可以制得标题化合物。
化合物 C1-C5的具体结构和在生理盐水中溶解度如下:
实施例 8: 瑞咪唑仑以及化合物 C2 C6 C7 C8 C9的小鼠麻醉药效实 验
将昆明种小鼠 (SPF, 重庆医科大学动物中心:)随机分组, 每组 6只; 给 药剂量为 9mg/kg, 通过尾静脉注射药物, 3-5秒钟给完。 以翻正反射消失 为判断标准, 记录动物实验过程中的表现。
实验结果如下:
麻醉动物
编号 化合物名称 给药浓度 动物表现 阳性 瑞咪唑仑 翻正反射消失快, 麻醉后呼吸平稳,
0.9mg/ml 6/6
对照 (CNS 7056) 苏醒后能很快正常行走
瑞咪唑仑酸乙酯 翻正反射消失快, 麻醉后呼吸平稳,
C2 0.9mg/ml 6/6
对甲苯磺酸盐 苏醒后能很快正常行走
翻正反射消失快, 麻醉后有轻微的呼吸抑 瑞咪唑仑酸异丙 制, 苏醒后四肢无力甚至瘫痪, 且闭眼不
C6 0.9mg/ml 6/6
酯对甲苯磺酸盐 能抬头,而后可匍匐慢行,但是无平衡感, 偏瘫, 行走时躯体出现左右摆动现象 瑞咪唑仑酸正丙 无麻醉作用, 有一定镇静作用,
C7 0.9mg/ml 0/6
酯对甲苯磺酸盐 动物表现为四肢无力, 行动迟缓 瑞咪唑仑酸异戊
C8 0.9mg/ml 0/6 无作用
酯对甲苯磺酸盐
瑞咪唑仑酸环己
C9 0.9mg/ml 0/6 无作用
酯对甲苯磺酸盐
由以上结果可知, 化合物 C2对小鼠有麻醉作用; 化合物 C6对小鼠虽 有麻醉作用, 但表现出一定毒性; 化合物 C7-C9对小鼠没有麻醉作用。 实施例 9: 瑞咪唑仑、化合物 C2体外 GABAA受体苯并二氮草类位点亲和 力实验
将制备好的 GABAa( Y -氨基丁酸 A)受体苯并二氮杂草类位点膜 (活体 SD大鼠断头,冰上操作,迅速取脑组织,加入 0.05M Tris-HCl +lmM EDTA 溶液 (A)后匀浆, 然后再加入 A, lOOOr/mm 离心 10min, 取上层液于 llOOOr/mm, 4°C下离心 30mm, 弃上清液, 向沉淀加入 A液, 用旋涡混合 器混匀, 离心, 重复三次离心, 离心完毕, 弃上清液, 取沉淀备用:), 用适 量的匀浆液 (50mMTns缓冲液, pH 7.4)通过匀浆机分散均匀备用。 各反应 管分别加入膜制备物 ΙΟΟμΙ^, 匀浆液 ΙΟΟμΙ^ 总结合管 (ΤΒ)加入 ΙΟΟμΙ^匀 浆液, 非特异性结合管 (ΝΒ)加入 100 μΜ氯硝西泮 (clonazepam, 购自江苏 恩华药业:) (10 μΜ终浓度 1.0*10_5Μ:),各受试化合物特异性结合管 (SB)加入 Ι ΟμΙ受试化合物 (终浓度 1(Τ5Μ:Ι; 各反应管分别加入放射性配体 3Η-氟硝 西泮 (flunitrazepam, 购自 PerkinElmer公司) ΙΟμΙ^ (终浓度 1 ηΜ)。 各反应管
均设 3个平行管, 加样时各管置于冰上。 将各反应管在 4°C下温孵 60 mm。 反应完毕后, 结合的配基通过减压快速过滤 GF/C 玻璃纤维滤纸, 购自 Whatman公司)。将 whatman试纸用 0.5%PEI浸泡,用冰冷的试验缓冲液充 分洗涤, 将滤片取出放到 2ml闪烁杯中, 加入 lml的甲苯闪烁液 (:购自上海 试剂一厂:), 并混匀。 过夜后, 将闪烁瓶放入液闪计数仪 (Wallace 1450 MicroBeta TriLux)计数。
抑制率 (I %)= (总结合管 cpm-化合物 cpm)/ (总结合管 cpm-非特异结合管 cpm)x l00%o抑制率 (:1 %:)≥95%即与相应受体亲和性较强。以 logit法计算各 化合物的 IC5Q。
结果如下:
抑制率%
化合物名称 5 6 7 s 9 10 IC50(nM)
1.0χ 10"5Μ 1.0χ 10"6Μ 1.0χ 10"7Μ 1.0χ 10"8Μ 1.0χ 10"9Μ 1.0χ 10"10Μ 瑞咪唑仑 99.7* 85.5 47.0 15.4 6.8 23.0 15.8
C2 98.0* 81.9 37.7 7.9 9.5 0 118
*表示抑制率≥95%
由以上结果可以看出, 化合物 C2对 GABAA受体苯并二氮杂草类位点 具有较高的亲和力, 与瑞咪唑仑一样为有效的麻醉化合物。 实施例 10: 瑞咪唑仑和化合物 C2的油水分配系数的测定
将瑞咪唑仑和化合物 C2分别配制成 lmg/ml的水溶液。 各量取 10ml 配制好的溶液,分别加入等体积的正辛醇,将混合物在室温下搅拌 24小时。 分别检测各物质在水中和油中的浓度: logP= -log C正辛醇 /C水:), 瑞咪唑 仑的 logP为 2.62, 化合物 C2的 logP为 3.28。
由油水分配系数可以看出,化合物 C2较瑞咪唑仑更亲油,更容易通过 血脑屏障。 实施例 11: 瑞咪唑仑和化合物 C2的大鼠血浆分解实验
将瑞咪唑仑和化合物 C2分别配制成 lmg/ml的生理盐水溶液, 分别取 0.1ml溶液, 加入到 lml大鼠血浆 (来自活体昆明种, SPF, 重庆医科大学动 物中心:)中, 充分混匀, 置于 37°C恒温水浴中。 不同时间点取样后立即加 入 2ml乙腈, 振摇, 于 10000转 /分离心, 取上清液进行 HPLC检测。
结果如下:
由以上结果可以看出,化合物 C2与瑞咪唑仑在大鼠血浆中有相似的代 谢速率。 实施例 12: 大鼠麻醉 ED5。及 LD5。测定和 TI指数
采用序贯法测定大鼠麻醉 ED5Q (半数有效量)值及 LD5Q (半数致死量) 值。 取健康的雄性 SD大鼠 (SPF, 南京青龙山动物养殖中心:), n=10~20。 通 过尾静脉注射药物, 10秒钟内匀速注完。 实验前经初步预试找出能导致动 物麻醉 (或死亡:)的大致剂量, 作为正式实验时的中间剂量。 采用 0.8的组间 距, 往上往下分别再设 2-3 个剂量组。 正式实验时首先从中间剂量开始给 药, 当动物被麻醉 (或死亡:)时, 则降低一个剂量给药; 若动物未被麻醉 (或 死亡), 则增大一个剂量给药, 至到出现 3-4个反复为止。 分别以翻正反射 消失或死亡为判断指标。用 aot425软件计算 LD5Q及 ED5Q。通过 LD5Q及 ED5() 值计算治疗指数 (TI指数) = LD50/ ED50。
实验结果如下:
从以上结果可见, 本发明的化合物或其药学可接受的盐与瑞咪唑仑一 样, 均能对大鼠产生麻醉作用。 实施例 13: 大鼠静脉推注麻醉诱导时间与苏醒时间测定
将昆明种大鼠 (SPF, 南京青龙山动物养殖中心)分组, 雌雄各半, 每组 10只; 给药剂量为 2*ED5Q (ED5Q值为实施例 12中测得的数值), 尾静脉注 射, 10 秒钟内匀速注完。 记录大鼠翻正反射消失的时间 (:潜伏期:)及恢复时
间 (持续期)。
实验结果如下:
从以上结果可见, 本发明的化合物或其药学可接受的盐对大鼠能产生 有效的麻醉作用,且诱导时间较瑞咪唑仑快约 2.8倍,苏醒时间与瑞咪唑仑 无明显差异。 由以上实施例可知, 化合物 C2虽然对 GABAA受体苯二氮杂草类位点 的亲和力低于瑞咪唑仑, 但是化合物 C2的 logP要高于瑞咪唑仑, 较瑞咪 唑仑更快 (:诱导时间短:)更多 ED5Q低)地通过血脑屏障,从而更好地发挥麻醉 或镇静作用。 实施例 14: 兔子麻醉 ED5Q的测定
采用序贯法测定兔子麻醉的 ED5Q值。 取健康合格的新西兰白兔 (SPF 级, 邳州免子养殖中心 ), 经耳缘静脉匀速注射药物, 30秒钟注射完。 实验 前经初步预试找出能够导致动物麻醉 (或死亡:)的大致剂量 (给药体积 ), 作为 正式实验时的中间剂量。采用 0.8的组间距, 向上向下分别再设 2-3个剂量 组。 以翻正反射消失或死亡作为药效或毒性的判断指标。 正式实验时首先 从中间剂量开始给药。 若动物被麻醉, 则降低一个剂量给药; 若动物未被 麻醉, 则增大一个剂量给药, 直到出现 3-4个反复为止。 分别以翻正反射 消失为判断指标, 用 aot425软件进行 ED5Q的计算。
从以上结果可见, 本发明的化合物或其药学可接受的盐对兔子能产生 麻醉作用, 其半数有效量与瑞咪唑仑相当。
实施例 15: 兔子静脉推注麻醉诱导时间与苏醒时间测定
取新西兰白兔 (SPF级, 邳州免子养殖中心), 雌雄各半, 每组 8只; 给 药剂量为 2*ED5Q (ED5Q值为实施例 14中测得的数值:), 耳沿静脉注射, 30 秒钟匀速注完。 记录兔子翻正反射消失的时间 (诱导时间)及恢复时间 (持续 时间 )。
实验结果如下:
从以上结果可见, 本发明的化合物或其药学可接受的盐对兔子能产生 麻醉作用, 其诱导时间比瑞咪唑仑约快约 2.3倍, 苏醒时间无明显差异。 实施例 16: 化合物兔子静脉长期输注试验
取新西兰白兔 (SPF级, 邳州免子养殖中心:), 雌雄各半, 每组 10只; 兔子静脉输注时,化合物分别以 3*ED5Q(ED5Q值为实施例 14中测得的数值:) 作为诱导剂量, 以合适的剂量作为维持剂量进行输注, 输注时间为 30mm。 根据输注过程中兔子的表现适当的调节输注速度, 以使各兔子维护相当的 麻醉深度。观察两组药物长期输注时对兔子 (呼吸、流涎、屎尿等一般状况:) 的影响, 并记录动物从停止给药到翻正反射恢复的时间。
实验结果如下:
从以上结果可见, 本发明的化合物或其药学可接受的盐持续静滴对兔 子产生麻醉作用。 实施例 17: 对食 «的麻醉药效实验
选取在其他动物实验中药效明显的化合物 C2 进行食蟹猴麻醉药效实 验。实验前通过预实验初步摸索出化合物 C2对食蟹猴的麻醉剂量, 正式实
验中设置不同的剂量, 静脉给药, 60 ± 10s给完, 以动物眼睑反应消失为标 准判断动物是否麻醉, 观察持续期动物表现,评价化合物 C2对食蟹猴的麻 醉作用。
结果如下:
从以上结果可见, 本发明的化合物或其药学可接受的对食蟹猴有明确 的麻醉作用, 并且在 3mg/kg条件下对食蟹猴的麻醉作用强于瑞咪唑仑。 综上所述, 本发明的化合物及其药学可接受的盐在体内具有起效快, 恢复快, 呼吸抑制发生率低, 意识恢复时间短等特点; 并且在停止给药以 后, 处理对象快速苏醒, 具有明显的麻醉作用。 本发明的苯并二氮杂草类 衍生物及其药学可接受的盐作为静脉麻醉药输入对象体内后同样具有起效 快, 苏醒迅速的特点。 本发明的苯并二氮杂草类衍生物及其药学可接受的 盐还可以与阿片类药物联合用于镇静。 除非另有说明, 本说明书 (包括权利要求书:)中使用的所有表示成分、 比 例、 条件等的量的数字应当理解为在所有条件下受到术语"约"的修饰。 因 此, 除非另有相反的说明, 数值参数为近似值, 并且可以根据通过本发明 的期望特性而变化。 本领域技术人员会认识到本文所述的本发明的具体实 施方案的许多等同物, 并且其涵盖在所附权利要求书的范围内。 可以进行 本发明的许多修改和变化而不背离其精神和范围。 本文所述的具体实施方 案仅通过实例的方式提供, 并不意味着以任何方式限制。 本发明的真正范 围和精神通过所附权利要求书示出, 说明书和实施例仅是示例性的。
Claims
(la)
其中 A为可与含孤对电子的氮成盐的酸, 并优选选自 HC1、 HBr、 甲磺酸、 乙磺酸、 苯磺酸、 对甲苯磺酸及其任意组合。
3. 权利要求 1或 2的化合物或其药学可接受的盐, 其选自瑞咪唑仑酸 乙酯、 瑞咪唑仑酸乙酯对甲苯磺酸盐、 瑞咪唑仑酸乙酯苯磺酸盐、 瑞咪唑 仑酸乙酯甲磺酸盐和瑞咪唑仑酸乙酯乙磺酸盐。
4. 一种药物组合物, 其包含权利要求 1-3中任一项所述的化合物或其 药学可接受的盐以及药学上可接受的载体。
5. 权利要求 1-3中任一项所述的化合物或其药学可接受的盐在制备用 于提供麻醉的药物中的应用。
6. 权利要求 1-3中任一项所述的化合物或其药学可接受的盐在制备用
于提供镇静的药物中的应用。
7. 权利要求 1-3中任一项所述的化合物或其药学可接受的盐与阿片类 药物的组合在制备用于提供镇静的药物中的应用。
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PL15824012T PL3162804T3 (pl) | 2014-07-23 | 2015-07-22 | Nowa pochodna benzodiazepiny i jej zastosowanie |
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EP4086260A1 (en) * | 2017-02-09 | 2022-11-09 | Assia Chemical Industries Ltd. | Solid state forms of remimazolam salts |
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CN108003164A (zh) * | 2017-12-15 | 2018-05-08 | 宜昌人福药业有限责任公司 | 苯并二氮杂*类化合物 |
CN108047229A (zh) * | 2017-12-15 | 2018-05-18 | 宜昌人福药业有限责任公司 | 苯并二氮杂*类化合物 |
CN108033964B (zh) * | 2017-12-28 | 2021-02-09 | 杭州奥默医药股份有限公司 | 一种吡啶基咪唑并苯并二氮杂卓丙酸酯化合物及其合成和应用 |
CN112321594B (zh) * | 2020-12-07 | 2022-05-20 | 扬子江药业集团有限公司 | 一种苯并二氮杂䓬类药物的制备方法 |
CN116102557B (zh) * | 2021-11-09 | 2024-04-26 | 四川大学华西医院 | 苯二氮卓类化合物及其制备方法和在医药上的用途 |
CN114588164B (zh) * | 2022-04-19 | 2023-08-11 | 天津医科大学总医院 | 瑞马唑仑在预防围术期低体温和寒战中的应用 |
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US20170217965A1 (en) | 2017-08-03 |
HUE047450T2 (hu) | 2020-04-28 |
ES2751627T3 (es) | 2020-04-01 |
EP3162804A8 (en) | 2017-08-09 |
EP3162804B1 (en) | 2019-10-09 |
EP3162804A4 (en) | 2018-01-10 |
DK3162804T3 (da) | 2020-01-13 |
PT3162804T (pt) | 2019-12-16 |
US9994578B2 (en) | 2018-06-12 |
CN106804107A (zh) | 2017-06-06 |
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