Description
Clidinium is a gastrointestinal muscarinic receptor antagonist (K
i = 3 nM against [
3H]quinuclidinyl benzilate binding in rat colonic enterocytes). Administration of clidinium, at a dose of 1 mg/kg, slows intestinal transit and induces constipation in mice. This clidinium-induced constipation induces serum hyperammonemia and decreases clonic, myoclonic, and tonic seizure thresholds in a murine pentylenetetrazole-induced epilepsy model.
Chemical Properties
White Crystalline Solid
Originator
Librax,Roche,US,1961
Uses
An anticholinergic. Used as an antispasmodic.
Uses
Clidinium inhibits muscarinic action of acetylcholine on postganglionic parasympathetic
effector regions. It is used for treating stomach ulcers.
Application
The United States Food and Drug Administration (FDA) approved the use of this combination, clidinium/chlordiazepoxide, as an adjunct therapy for the treatment of peptic ulcer, irritable bowel syndrome (IBS), and acute enterocolitis.
Definition
ChEBI: The bromide salt of clinidium. It is used for the symptomatic treatment of peptic ulcer disease and also to help relieve abdominal or stomach spasms or cramps due to colicky abdominal pain, diverticulitis, and irritable bowel syndrome.
Manufacturing Process
5.12 g of 1-azabicyclo[2.2.2]-3-octanol were refluxed with a suspension of
0.92 g of finely divided sodium in 50 cc of toluene, until most of the sodium
had reacted (about 4 hours). The thus obtained suspension of the white
amorphous alcoholate was cooled with ice, and reacted with 10.16 g of
diphenylchloroacetyl chloride, which was added in form of a solution in
approximately 40 cc of toluene. The mixture was stirred for 1 hour at room
temperature. Small amounts of unreacted sodium were destroyed with
isopropanol, and 120 cc of 1 N hydrochloric acid were then added, The
mixture was refluxed for 1/2 hour, in order to convert the first formed
product, diphenylchloroacetic acid ester of 1-azabicyclo[2.2.2]-3-octanol, into
the corresponding benzilic acid ester.
The toluene phase was separated and discarded. The aqueous phase, together
with a precipitated water- and toluene-insoluble oil, was made alkaline and
extracted repeatedly with chloroform. The chloroform solution was
concentrated in vacuo. The residue was recrystallized from a mixture of
acetone and ether (alternatively, from chloroform and ether), and formed
needles melting at 164° to 165°C. It was identified as 3-benziloyloxy-1-
azabicyclo[2.2.2]octane.
3-Benziloyloxy-1-azabicyclo[2.2.2]octane methobromide was prepared by
adding 20 cc of a 30% solution of methyl bromide in ether to a solution of 2.5
g of 3-benziloyloxy-1-azabicyclo[2.2.2]octane in 20 cc of chloroform. After
standing for 3 hours at room temperature and 15 hours at +5°C, a crystalline
precipitate had formed. This was filtered off and recrystallized from a mixture
of methanol, acetone, and ether; prisms melting at 240° to 241°C.
brand name
Quarzan (Roche).
Therapeutic Function
Anticholinergic, Antiulcer
General Description
Clidinium bromide, 3-hydroxy-1-methylquinuclidinium bromide benzilate (Quarzan),is a white or nearly white, almost odorless, crystalline powderthat is optically inactive. It is soluble in water and alcohol butonly very slightly soluble in ether and benzene.
Clinical Use
This anticholinergic agent is marketed alone and in combinationwith the minor tranquilizer chlordiazepoxide (Librium)in a product known as Librax. The rationale of the combinationfor the treatment of GI complaints is the use of an anxiety-reducing agent together with an anticholinergic agent,based on the recognized contribution of anxiety to the developmentof the diseased condition. It is suggested for pepticulcer, hyperchlorhydria, ulcerative or spastic colon, anxietystates with GI manifestations, nervous stomach, irritable orspastic colon, and others. Clidinium bromide is contraindicatedin glaucoma and other conditions that may be aggravatedby the parasympatholytic action, such as prostatic hypertrophyin elderly men, which could lead to urinary retention.
Synthesis
Clidinium, 3-benzyloyloxy-1-methylcynuclidinium bromide (14.1.19), is
synthesized by reacting 3-hydroxycynuclidine (14.1.17) with the of benzilic acid chloride
producing the ester (14.1.18), which if further alkylated at the nitrogen atom by methylbromide, giving clidinium (14.1.19) [16].
References
[1] T W ZIMMERMAN H J B. Muscarinic receptors on rat isolated colonic epithelial cells. A correlation between inhibition of [3H]quinuclidinyl benzilate binding and alteration in ion transport.[J]. Gastroenterology, 1982, 83 6: 1244-1251.
[2] LEILA MOEZI Soroor I Fatema Pirsalami. Constipation enhances the propensity to seizure in pentylenetetrazole-induced seizure models of mice[J]. Epilepsy & Behavior, 2015, 44: Pages 200-206. DOI:
10.1016/j.yebeh.2015.01.013
