Phosphorylation, adenosine agents

Tenofovir disoproxil fumarate (Viread) is a prodrug of tenofovir, a phosphorylated adenosine nucleoside analogue, and is the only available agent of its class. It is converted by cellular enzymes to tenofovir diphosphate, which competes with deoxyadenosine triphosphate (dATP) for access to reverse transcriptase and causes chain termination following its incorporation. Tenofovir was approved as part of a combination therapy for HIV in adults who failed treatment with other regimens it appears to be effective against HIV strains that are resistant to NRTIs. The pharmacokinetic properties of tenofovir are provided in Table 51.2. 

The first pharmacological agent shown to activate AMPK was 5-aminoimidazole-4-carboxamide (AICA) riboside, also known as acadesine. This adenosine analogue is taken up into cells by adenosine transporters and phosphoiylated by adenosine kinase to the mono-phosphorylated form, AICA ribotide or ZMP. ZMP accumulates inside cells to higher concentrations than the concentration of AICA riboside present in the medium, and it mimics both effects of AMP on AMPK system (allosteric activation and inhibition of... 

Although initially and abortively developed for treatment of HIV infection, adefovir has been recently approved, at lower and less toxic doses, for treatment of HBV infection. Like tenofovir (see Antiretroviral Agents), adefovir is a nucleotide analog. As an analog of adenosine monophosphate, adefovir is phosphorylated by cellular kinases to the active disphosphate metabolite it then competitively inhibits HBV DNA polymerase and results in chain termination after incorporation into the viral DNA. 

Similar use has been made of trifluoroacetic anhydride in the preparation of the cyclic 2,3-phosphate of adenosine from adenosine 2-phosphate the latter appears to be converted into the unsymmetrical anhydride, which then acts as an internal phosphorylating agent toward the C-3-hydroxyl group. Treatment of the product with ethanolic ammonia removed the... 

The alkylxanthines (e.g. the methylxanthines aminophylline and theophylline) are rarely employed as diuretic agents but are commonly used as bronchodilators. Aminophylline is metabolized to its active metabolite theophylline after oral administration and increases cytosolic cyclic adenosine monophosphate (cAMP) by the inhibition of phosphodiesterase, the enzyme responsible for the degradation of cAMP. cAMP is an important intracellular messenger involved in the phosphorylation of cytosolic and membrane-bound proteins however, its effect in the kidneys remains unclear. The diuretic effect of theophylline is modest and appears to be mediated by both an increase in cardiac output, leading to increases in RBF and GFR, and a direct tubular effect, leading to... 

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