Kimed
Kimed
There are many examples which show that the introduction of a steric
factor near a basic or acidic group in a biologically active molecule can
modify greatly the character and duration of action of the parent molecule';
similar changes can result from the introduction of lipophilic or hydrophilic
groups at any position in the molecule. These introduced groups in addition
to altering the potential 'fit' at an active site in an enzyme or target organ,
can also alter the distribution, metabolism and excretion of the molecules
because of the attendant changes in values and rate of lipid solubility
characteristics. In the observed biological response in the whole animal, it is
difficult to assign quantitative aspects to the various influences except in the
case of differences in activity of those enantiomorphs which have been
proved not to be distributed differently; some approaches which may help
to clarify this complex situation will be described later.
A few examples, drawn mainly from work in my laboratories, will suffice
to show the influence on biological action of the introduction of even small
chemically inert groups into a biologically active molecule. Normethadone
has analgesic and antitussive action; the introduction of a correctly orientated
ac-methyl group to give (—)-methadone leads to enhanced analgesic activity',
whereas the incorrectly orientated group gives (H-)-methadone which is
virtually devoid of analgesic activity but in which the antitussive activity of
the parent is retained (Figure 1). Because the distribution and rate of metab-
olism of these enantiomorphs is very similar, the introduction of the
ac-methyl group may be regarded as enhancing or inhibiting the interaction
of the molecule with analgesic receptor sites depending upon the geometry
of the added group. The cough reflex receptors may be regarded as showing
little stereo-selectivity for the methadone enantiomorphs. Similar arguments
may be used to explain the differences in CNS activity of the isomers
produced by introducing a methyl group adjacent to the nitrogen centre of
fi-phenylethylamine to give the stimulant (+)-amphetamine and non-
stimulant (—) -amphetamine, since these enantiomorphs exhibit only very
small differences in their distribution and metabolism pattern in animals
and man2.
The introduction of a correctly orientated fl-methyl group into the
acetylcholine molecule, to give the L-(+)-isomer, has little effect on the ob-
served muscarinic activity but the incorrectly orientated group in the
(—) -isomer virtually abolishes activity (Table 1); the introduction of the
methyl group into the ac-position leads to substantial reduction of the activity
231
ARNOLD H. BECKETT
÷CH3group
(CH3)2 NCH2C (CH3)2NCHCH2C—C
cH3
N or methadone Methadone
(-)- isomer enhanced activity
(+)- isomer much reduced activity
L -(+)—Acetyl-13-methylcholine 0— (—)—Acety1--methyfthotine
(10) (21.0)
0 H CH3 CH3H 0
CH3\ (CH3)3NHCH3
D— (+)—AcetyH-methy1choLine L— (—)-Acetyt -i- methyfthotine
(28) (230)
Acetylcholine 49 100
(1)-Acetyl-fl-methylcholine iodide 180 46
L-(+)-Acetyl-13-methylchOline iodide 100 54
D-(---)-Acety1--methylcho1ine — weak inhibition
(+)Acetyl-oc-methylcho1ine iodide 63 92
L-(-—)-Acetyl-ot-methylcholine iodide 67 97
n-(-+-)-Acetyl-oc-methylcholine iodide 67 78
Data frorri Beckett ci a!.
Rate of hydrolysis
(butyrylcholine-100) using
Acylcholine
Purified horse enzyme Horse serum Human serum
Acetyl 44 46 47
Propionyl 71 — 69
Butyryl 100 100 100
Pentanoyl — — 80j
Hexanoyl — — 46t
Heptanoyl
L-Butyryl-cc-methyl
—
81
—
93
4t
93
D-Butyryl-st-methyl 66 78 79
L-Butyryl-fl-methyl 45 55 50
D-Butyryl-/-methyl 0 0 0
Data from Beckett ci a!. except where marked with a dagger.
1 Data from Davies ci a!.
233
ARNOLD H. BEOKETT
Table 4. Influence of size of alkyl group (= 2-position in muscarine)
on muscarinic activity
(Cat blood pressure; number of molecules equivalent to 1 molecule of
acetylcholine)
2-Substituent Mu:arine Muscarone Dioxolane Furan
OH3 03 023 16 2
C2H5 — — — 120
OH3 10
C,H7 3700
Data from Cohen el at. 1956; Fourneau e at. 1945; Waser, 1958, 1962.
= number of molecules equivalent to 1 molecule of acetylcholine.
CR3
Glomerulus
Proximal
tubule Active
-Loop of HenLe
Distal tubule
and
collecting duct
21 ,r\/'
j
Time,,h
Figure5. The influence of urinary pH and urine output on the urinary excretion of ampheta-
mine in man, after oral administration of 15 mg (—1--)-amphetamine sulphate (similar patterns
were observed in other subjects).
235
ARNOLD H. BECKETT
46
a)
Subject T.M.J.
52
a
02
a)
C
0
Time,h
Figure 6. Urinary excretion of amphetamine after oral administration of 15 mg dexampheta-
mine sulphate (capsule) while under acidic urinary control [•—I, rate of excretion of
amphetamine; L1—[I1, urine output].
0
ci)
Methylamphetamine a
aC
z
a)
Time,h
Figure 7. Effect of urinary pH and urine output on the urinary excretion of methylampheta-
mine (and its metabolite) in man, after oral administration of 110 mg (+)-methylampheta-
mine (similar patterns were obtained in other subjects).
236
SOME ASPECTS OF DRUG METABOLISM AND DRUG ACTION
Subject E.IT.
B
C)
Li)
-o
m Acidic
urine
E
0a) 6
a)
ci
a)
11)
C 4
E
'0
a)
aE
(V
2
-c
Ia)
0 4 B 16
Time) h
The differences8 in the effect of pH of the urine in man upon changing the
excretion. of amphetamine and the less lipid soluble norpseudoephedrine,
possessing an additional alcoholic hydroxyl group, are shown in Figure 9.
The analogous relationship8 between the excretion of methylamphetamine
and its hydroxy derivative, pseudo-ephedrine, is shown in Figure 10.
Mephentermine is excreted primarily in man unchanged but there is
some demethylation to form phentermine. The ratio of metabolite to un-
changed drug excreted and the pattern of excretion8 depends on the pH of
the urine (Figure 11). When a drug is more extensively metabolised, the
ratio of drug to metabolite can be very sensitive to pH changes in the urine,
e.g. fenfluramine, which is de-ethylated to norfenfluramine8 (see Figure 12).
237
11
a)
C
-o
ci)
-c
a
a'
0
-o
ci,
U)
8-c
c —.
C
0
U
z0,
0 6 18
Ti me,h
Figure 9.
Urinary excretion of norpseudoephedrine and amphetamine from a subject
following oral administration of (+)-norpseudoephedrine. HO ( 25 mg base) and (+)-
amphetamine. HC1 ( 11-05 mg base) in aqueous solution with (a) acidic urine control, and
(b) alkaline urine control [Norpseudoephedrine: 0—0, acidic urine control (pH range
— — —•,
469—508); alkaline urine control (pH range 705—812). Amphetamine:
A— — — A, acidic urine control (pH range 460—481); A—A, alkaline urine control (pH
range 718—825)].
0)
C
-o
a)
a
ci,
0
•0
ci,
U)
En
C
0
8?
U
ci,
0 6 12 16
Time7b
Figure 10. Urinary excretion of pseudoephedrine and methylamphetamine from a subject
following oral administration of (+)-pseudoephedrine. HC1 ( 25 mg base) and (+)-
methylamphetamine. HO ( 12-01 mg base) in aqueous solution with (a) acidic urine
control and (b) alkaline urine control [Pseudoephedrine: 0—0, acidic urine control (pH
range 465—498); •— — — •, alkaline urine control (pH range 7-45—8-05). Methylamphet-
amine: A—A, acidic urine control (pH range 4-59—4-82); A — — — A, alkaline urine control
(pH range 7-18—8-25)].
238
SOME ASPECTS OF DRUG METABOLISM AND DRUG ACTION
/ \\
/
c0 / \\
\.- __\
a)
U
\
xc1 \
zci,
- ----
0 4 8 12 16 20 24 28 32
Time,h
Figure 11. Urinary excretion of mephentermine and its metabolite phentermine after oral
administration of 1411 mg mephentermine sulphate with no urinary pH control (a) and
acidic urine control (b) [Acidic urine control: O—--O, mephentermine; A----A phenter—
mine. No urinary pH control: • — — — •, mephentermine; A — — — A phentermine].
Ia 5
I, ..,_ _•
L ••_______•••%.,_ ,__•_•••'•••...##I_
uncontroUed trial)
C
E
74
C 3
0
a)
0 2
a' 0
U
za) 'C
U
0 4 6 8 10 12 14 16
Time, h
10 100
r 8 80
4)
In
4)
U,
0
•0
0
0
C
6 60
a)
Ca
4)
C-)
C a)
0
0)
L 4 40
U
6) J
a) F
C-)
2 20
0 4 8 12 16 20 24
Time,h
Figure 13. Agreement between computer calculated and experimental excretion data for
amphetamine in man (constant acidic urinary pH).
Under these controlled conditions, it is not only possible to see the effects of
changes in the molecules or the formulation of the drugs but to consider
'models' for drug absorption, metabolism and excretion in the body. Since
intra-subject variations in results are thus very small, and inter-subject
variations are also small unless genetically controlled metabolism or diseased
states are involved6, analogue computer techniques can be utilised9, e.g. see
Figure 23, for amphetamine for single doses, and for repeated doses see
Figure 14. Thus the effect of changes in structure of the drug on the relative
importance of various metabolic routes can be established. From computer
calculations under conditions of acidic urine and then under normal con-
ditions of varying urinary pH (Figure 15) it is possible to establish the
relationship between pH and excretion (or reabsorption) of a particular
drug'° (see Figure 16) and then use an analogue computer to predict the
excretion profile of a drug when only the time and pH of the urine are
measured after the administration of the drug'1; agreement of predicted
values and experimental results are good (see Figure 17).
240
SOME ASPECTS OF DRUG METABOLISM AND DRUG ACTION
10 100
a'
-c
OU 0
C, -o
In
0
-D
F C
6 60 .2
C, C,
(C
0 U
'C
C C,
0
C) 4 40
U
xC) (C
z
C)
2 20
0
0 4 8 12 16 20 24
Time h
Figure 14. Computer curves and experimental data points for the urinary excretion of
amphetamine, after oral administration, of divided doses of (-1- )-amphetamine sulphate in
aqueous solution (subject, A.C.M.).
10
-c 8
C)
U)
00 6
U,
C)
'C 4
5 10 16
Time, h
Figure 15. Computer calculations of the rates of amphetamine as functions of time under
uncontrolled urinary pH conditions (subject 1) [presentation to the kidney, keB*; kidney
reabsorption, dR/dt; urinary excretion, dUJdt].
241
P.A.c.—It
Figure 16.
C
0
U)
U)
C
U)
U
a)
a-
100 0
10 OL7 50
ARNOLD H. BECKETT
55 60
pH
65 70 7'5
I 70
0-
(U
6'
C
D
Computer predictions
—--—•—-- Experimental data
60
-c
U) U)
Lfl
0 0
D -o
4'O
ci) c
CU 0
U)
C 0
0
a)
2O
0 U)
>
U)
CU
6)
F
J
a—)
2 4 68 10 12 14
Time,h
Figure 17. A comparison of computer predicted and actual rates of excretion and cumulative
excretion of amphetamine after oral administration of 15 mg of n (+ )-amphetamine sulphate
in solution.
242
SOME ASPECTS OF DRUG METABOLISM AND DRUG ACTION
buffered solutions is not completely satisfactory as a basis of consideration of
passage of drugs through biological membrane, since the relative order in
which members of a series of drugs are placed frequently depends on the
type of organic phase used. We therefore now use a human membrane for
these studies—the buccal one—and have introduced the 'Buccal Absorption
Test' as a means of classifying the relative partitioning of drugs from solutions
of differing pH values. Basic drugs were classified into four main tyçes on the
result of this test'2 (see Figure 18). Amphetamine gave a different shaped
0 (.1—Amphetamine L4 Norephedrine
90 • (+(—N1 ethylamphetamine A D—Norpseudoephedrine
o Chtorpheniramine x 1)-Nicotine
• (4-1-Methadone
81
'072
ci 63
0
4/
-o 54
(1
45
oJ 36
27
18
9
0
4 5
Buffer pH
Figure 18. Buccal absorption of some basic drugs representing different classes in the Buccal
absorption test.
8(
C
0
0
0U, 5'
U
OD
21
L.0 50 60 70 80 90 100
Buffer pH
Figure 19. The buccal absorption of fenfluramine, ethylamphetamine and .AT-2-hydroxyethyl-
norfenfIuramine within the pH range 4•O—905. Time period for absorption, 5 mm. 1 mg
(base) of each compound was used.
100
o Dimethyl
• Butyl
80 A Propyl
• Ethyl
o Methyl
V —
0
a
0U)
.0
C',
C',
U 40
U
20
3 5 7 9
pH
Figure 20. The buccal absorption of N-substituted amphetamines (subject A.C.M.).
244
SOME ASPECTS OF DRUG METABOLISM AND DRUG ACTION
codecanoic
o Decanoic
x Octanoic
i Hexanoc
BC • Undecanoic
V Nonanoic
o Heptanoic
Vateric
A Butyric
6(
a
0U)
-U 40
20
5 7
pH
Figure 21. The buccal absorption of straight chain fatty acids (subject A.C.M.).
the p-tertiary butyl derivative 'Ibufenac' and phenylacetic acid (Figure 24)
and the difference between substitution with an alkoxyl group rather than
with the corresponding alkyl group (Figure 25) illustrates the importance of
these changes on the ability of the compound to pass through biological
membranes under various conditions'3.
The changes in the likely reabsorption characteristics of a metabolite
100
•H
CH3
• C2H5
o n-C3H7
A n—C4H9
'
o n—C5H11
n—C6H13
60
C
0
a
0
U)
40
20
3 5 7 9
pH
Figure 22. The buccal absorption of p-alkyl substituted phenylacetic acids (subject A.C.M.).
245
100
• Ci
viBr
80 o
Q 60
0
0
1.0
20
3 9
pH
Figure 23. The buccal absorption of p-halogenated phenylacetic acids.
•H
Me
80 • Et
A t-Bu
d 60
0
0
0
(1
1.0
3 5 7 9
pH
Figure 24. The buccal absorption of p-alkyl substituted phenylacetic acids (subject A.C.M.).
246
SOME ASPECTS OF DRUG METABOLISM AND DRUG ACTION
— Alkyt
Alkoxy
o CH3 and OCH3
8( • n-C3H7 and 0C3H7
3 5 7 9
pH
Figure 25. The buccal absorption ofp-alkyl and p-alkoxy phenylacetic acids (subject A.C.M.),
80
• Methadone
o Metabotite of methadone
70 produced by mono-N-
demethy [ation
• Pethidine
60 o Norpethidine
C
0
50
20
10
0
4•00 500 600 700 800 900
Buffer pH
Figure 26. Buccal absorption of some basic compounds.
247
ARNOLD H. I3EGKETT
versus the parent drug in kidney tubules can be readily shown in the buccal
absorption test (see Figure 26); i.e. the ratio of the metabolites, norpethidine
and 'cyclic normethadone', to the unchanged drugs pethedine and
methadone in the urine, will increase greatly as the pH of the urine is made
less acidic'4, but this will not be the case for the metabolite, amphetamine,
from methylamphetamine (see Figure 16).
The steric, stereochemical and physico-organic features of drugs can thus
influence drug absorption, distribution, metabolism and excretion, and
therefore drug action and the duration of action in a complex inter-related
fashion. If we are to make further progress in structure—activity relationship
of drugs in the whole animal, it is imperative that we attempt to disentangle
the separate parts which contribute to the observed quantitative values of a
biological response.
References
1 A. H. Beckett. Arzneimittel-Forsch. 1, 455 (1959), and refs. cited therein.
2 A. H. Beckett and M. Rowland. J. Pharm. PIzarmac. 17, 628 (1965).
2 A. H. Beckett. N.Y. Acad. of Sci. 144, 675 (1967), and refs. cited therein.
R. 0. Davies et al. Canad. J. Biocliem. Physiol. 30, 545 (1960).
A. H. Beckett and D. S. Hewick, to be published.
'A. H. Beckett and G. T. Tucker. J. Mond. Pharm. 3, 181 (1967), and refs. cited therein.
'A. H. Beckett. Dansk. Tiddskr1ft. Farm. 40, 197 (1966), and refs. cited therein.
8 A. H. Beckett, to be published.
'A. H. Beckett and G. T. Tucker. J. Pharm. Pharmac. 20, 174 (1968).
10 A. H. Beckett, R. N. Boycs and G. T. Tucker. J. Pharm. Pharmac. 20, 269 (1968).
11 A. H. Beckett, R. N. Boyes and G. T. Tucker. J. Pharm. Pharmac. 20, 277 (1968).
12 A. H. Beckett and E. J. Triggs. J. Pharm. Pharmac. 19, 31s (1967).
13 A. H. Beckett and A. C. Moffat. J. Pharm. Pharmac. (1969), in the press.
14 A. H. Beckett and J. F. Taylor, to be published.
248