5-HT3 antagonist

Antagonist 5-HT3 receptora
Klasa leka
Formula ondansetrona, prototipnog 5-HT3 antagonista
UpotrebaMučnina i povraćanje
Biološki cilj5-HT3 receptor
ATC kod[[ATC kod {{{ATC prefix}}}|A04AA]]
Spoljašnje veze
MeSHD058831
AHFS/Drugs.comKlase lekova
Potrošački izveštajiBest Buy Drugs

5-HT3 antagonisti su klasa lekova koji deluju kao receptorski antagonisti na 5-HT3 receptoru, podtipu serotoninskog receptora prisutnog u terminalima vagus nerva i pojedinim oblastima mozga. Izuzev alosetrona i cilansetrona, koji se koriste u tretmanu sindroma iritabilnih creva, svi 5-HT3 antagonisti su antiemetici, koji se koriste u prevenciji i tretmanu mučnine i povraćanja. Oni su posebno efektivni u kontroli mučnine i povraćanja uzrokovanih hemoterapijom kancera i smatraju se zlatnim standardom za tu svrhu.[1]

5-HT3 antagonisti se označavaju sufiksom –setron,[2] i klasifikovani su pod kodom A04AA WHO ATC klasifikacije.

Historija

Istorija antagonista 5-HT3 receptora je počela 1957, kad su naučnici sa univerziteta u Edinburgu predložili postojanje dva podtipa serotoninskog receptora, M i D receptora (koji su tako nazvani zato što se njihova funkcija može blokirati morfinom i dibenzilinom respektivno).[3] Kasnije je utvrđeno da je 5-HT3 zapravo M receptor.[4] Tokom 1970-tih, Džon Fozard je ustanovio da su metoklopramid i kokain slabi antagonisti 5-HT3 (5-HT-M) receptora. Fozard i Moris Gitos su sintetisali MDL 72222, prvi potentni i selektivni antagonist 5-HT3 receptora.[5][6] Utvrđeno je da antiemetičko dejstvo metoklopramida delom potiče od njegovog serotoninskog antagonizma.[7]

Dok je Fozard istraživao kokainske analoge, istraživači preduzeća Sandoz su identifikovali jedinjenje ICS 205-930 kao potentan i selektivan antagonist 5-HT3 receptora. Počevši od tog liganda su razvijeni prvi klinički značajni, selektivni antagonisti 5-HT3 receptora, ondansetron i granisetron, koji su odobreni 1991. i 1993, respektivno.[5][8] Razvoj jedinjenja koja su srodna sa MDL 72222 je doveo do plasiranja na tržište tropisetrona 1994. i dolasetrona 1997. godine.[8] Novi i poboljšani antagonist 5-HT3 receptora, palonosetron, je odobren 2003.[8] Razvoj selektivnih antagonista 5-HT3 receptora je doveo do dramatičnog poboljšanja tretmana mučnine i povraćanja.[7] Ondansetron, granisetron, dolasetron i palonosetron su trenutno odobreni u Sjedinjenim Državama, i oni su osnova terapije za kontrolu akutnog povraćanja pri primeni hemoterapijskih agenasa sa umerenim do visokog emetogenog potencijala.[9]

Reference

  1. de Wit R, Aapro M, Blower PR (2005). „Is there a pharmacological basis for differences in 5-HT3-receptor antagonist efficacy in refractory patients?”. Cancer Chemother Pharmacol 56 (3): 231–8. DOI:10.1007/s00280-005-1033-0. PMID 15838653. 
  2. World Health Organization (2006). The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substancesPDF (703  KB). Geneva: WHO Press. Retrieved on 2007-05-15.
  3. GADDUM JH, PICARELLI ZP (September 1957). „Two kinds of tryptamine receptor”. British Journal of Pharmacology and Chemotherapy 12 (3): 323–8. PMC 1509685. PMID 13460238. 
  4. Barnes NM, Hales TG, Lummis SC, Peters JA (January 2009). „The 5-HT3 receptor--the relationship between structure and function”. Neuropharmacology 56 (1): 273–84. DOI:10.1016/j.neuropharm.2008.08.003. PMID 18761359. 
  5. 5,0 5,1 King, Frank D.; Jones, Brian J.; Sanger, Gareth J. (1993). 5-Hydroxytryptamine-3 Receptor Antagonists. CRC Press. str. 2–3. ISBN 978-0-8493-5463-2. 
  6. Galvan, M.; Gittos, M.; Fatmi, M. (October 1996). „DISCOVERY OF 5-HT3 RECEPTOR ANTAGONISTS AND DOLASETRON MESILATE”. EJHP journal (6): 10–11. Arhivirano iz originala na datum 2011-07-20. Pristupljeno 2014-05-06. 
  7. 7,0 7,1 Gan TJ (2005). „Selective serotonin 5-HT3 receptor antagonists for postoperative nausea and vomiting: are they all the same?”. CNS Drugs 19 (3): 225–38. DOI:10.2165/00023210-200519030-00004. PMID 15740177. 
  8. 8,0 8,1 8,2 Billio, Atto; Clarke, Mike J.; Morello, Enrico; Billio, Atto (2006). Billio, Atto. ur. „Comparison of clinical efficacy of serotonin receptor antagonists in highly emetogenic chemotherapy”. Cochrane Database of Systematic Reviews (4). DOI:10.1002/14651858.CD006272. 
  9. Oo TH, Hesketh PJ (April 2005). „Drug insight: New antiemetics in the management of chemotherapy-induced nausea and vomiting”. Nature Clinical Practice Oncology 2 (4): 196–201. DOI:10.1038/ncponc0132. PMID 16264934. 

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