Orally bioavailable

One of the most popular orally active penicillins in present clinical use is amoxicillin (12). Its oral effectiveness and broad spectrum of activity against common pathogens as well as its better absorption than its closest precedent competitor, ampicillin (14), largely accounts for this. Higher blood and tissue levels of antibiotics is another means of dealing with resistance. In an attempt to achieve yet further improvements in oral bioavailability and hence blood and ti.ssue levels of amoxicillin, the prodmg fumoxicillin (13) is prepared from amoxicillin (12) by treatment with furfural [3]. The imine moiety is less basic than the primary amine so that the isoelectric point of fumoxicillin is more on the acid side than is that of amoxicillin. 

In order to enhance the oral bioavailability of oximonam (104), a prodrug has been made by esterification of the carboxyl group with the t-butyl ester of hydroxyacetic acid (105). The product is prodrug gloximonam (106) [31], Gloximonam is efficiently converted to oximonam in the body by metabolic processes. 

Most ACE inhibitors are prodrugs, with the exceptions of captopril, lisinopril, and ceranapril. Prodrugs exert improved oral bioavailability, but need to be converted to active compounds in the liver, kidney, and/or intestinal tract. In effect, converting enzyme inhibitors have quite different kinetic profiles with regard to half time, onset and duration of action, or tissue penetration. 

Very recently, the further screening of new benzy-loxyphenyl derivatives revealed a highly potent NCX inhibitor, named YM-244769. This orally bioavailable compound is more potent inhibiting NCX3 than NCX1 and NCX2 in the reverse mode, but it is not active on the forward mode of operation of the three antiporter isofoims. (Table 4)... 

Diclofenac is an exceedingly potent COX inhibitor slightly more efficacious against COX-2 than COX-1. Its absorption from the gastrointestinal tract varies according to the type of pharmaceutical formulation used. The oral bioavailability is only 30-80% due to a first-pass effect. Diclofenac is rapidly metabolised (hydroxylation and conjugation) and has a plasma half-life of 1.5 h. The metabolites are excreted renally and via the bile. 

Pharmacokinetic studies demonstrated good oral bioavailability of maraviroc and a terminal half-life of 16-23 h following multiple dosing (Abel et al. 2003 Walker et al. 2005). Single doses of up to 900 mg and multiple doses of up to 300 mg BID for 28 days were well tolerated (Abel et al. 2003 Russell et al. 2003 Walker et al. 2005). In Phase 2a studies, treatment-naive HIV-1 patients with R5 virus who received maraviroc monotherapy at doses ranging from 25 mg QD to 300 mg BID for 10 days experienced a median viral load reduction of 1.64 log jg copies/mL and... 

Two orally bioavailable compounds that target HIV-1 attachment have been described. BMS-806 and BMS-043 bind to gpl20 (reviewed by Kadow et al. 2006) and demonstrate variable activity when tested in vitro against panels of virus isolates (Lin et al. 2003). BMS-043 has shown efficacy in short-term monotherapy studies... 

Traditionally, in pursuit of their structure-activity relationships, medicinal chemists had focused almost exclusively on finding compounds with greater and greater potency. However, these SARs often ended up with compounds that were unsuitable for development as pharmaceutical products. These compounds would be too insoluble in water, or were not orally bioavailable, or were eliminated too quickly or too slowly from mammalian bodies. Pharmacologists and pharmaceutical development scientists for years had tried to preach the need for medicinal chemists to also think about other factors that determined whether a compound could be a medicine. Table 1.1 lists a number of factors that determine whether a potent compound has what it takes to become a drug. Experimentally, it was difficult to quantitate these other factors. Often, the necessary manpower resources would not be allocated to a compound until it had already been selected for project team status. 

To maximize safety and therapeutic efficacy, potential drugs are required to be highly specific for their protein target and orally bioavailable. In addition, for a drug candidate to reach the market, it must be patentably novel. A computational approach therefore needs to find novel compounds with well-defined pharmacological properties from the vast space of possible organic compounds ( chemical space ). 

Veber DF, Johnson SR, Cheng H-Y, Smith BR, Ward KW, Kopple KD. Molecular properties that influence the oral bioavailability of drug candidates. J Med Chem 2002 45 2615-23. 

Unity resulted in 4234 hits. After application of several filters and clustering of the remaining 1975 molecules, compounds from 18 of the 27 clusters were screened in Xenopus oocytes. One compound with an IC50 of 5.6pM belonged to a new class of Kvl.5 blockers and exhibited a favorable pharmacokinetic profile. After further optimization, compound 73 (IC50 = 0.7pM Fig. 16.9) resulted, with good oral bioavailability in rats [145]. 

Sparreboom A, van Asperen J, Mayer U, Schinkel AH, Smit JW, Meijer DK, et al. Limited oral bioavailability and active epithelial excretion of paclitaxel (Taxol) caused by P-glycoprotein in the intestine. Proc Natl Acad Sci USA 1997 94 2031-5. 

Veber, D., Johnson, S., Cheng, H., Smith, B., Ward, K., Kopple, K. D. Molecular properties that infiuence the oral bioavailability of drug candidates. /. Med. Chem. 2002, 45, 2615-2623. 

Yoshida, F., Topliss, J. G. QSAR model for drug human oral bioavailability. J. Med. Chem. 2000, 43, 2575-2585. 

Part 2 lead optimization affording selective, orally bioavailable compounds with potent anti-HIV activity. Eioorg. Med. Chem. Lett. 2001, 11, 2741-2745. 

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