Landiolol
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133242-30-5CC1(C)OC[C@@H](COC(=O)CCc2ccc(OC[C@@H](O)CNCCNC(=O)N3CCOCC3)cc2)O1WMDSZGFJQKSLLH-RBBKRZOGSA-NLandiolol is a member of morpholines.
133242-30-5DTXSID10158026CHEMBL1742466CHEBI:135809C - Cardiovascular system
QC - Cardiovascular system
Landiolol has a very short duration of action and a rapid onset and offset of action. It is a cardio-selective drug that produces a negative chronotropic effect with weaker negative inotropic effects and less hypotensive effects compared to other beta blockers. Due to its selectivity towards beta-1 adrenoceptors over beta-2- or beta-3 adrenoceptors, landiolol has reduces heart rate without causing a profound decrease in mean arterial blood pressure. In preclinical and clinical studies, landiolol controlled tachycardia in an ultra-short-acting manner with fast onset and offset of action, while further demonstrating anti-ischemic and cardioprotective effects. Landiolol does not exhibit any membrane-stabilizing activity or intrinsic sympathomimetic activity at the approved recommend dosage in vitro.
Beta (β)-1 adrenoceptors are predominantly found in the myocardium, to which endogenous catecholamines, epinephrine and norepinephrine, bind. These receptors activate intracellular molecules and signalling pathways, such as the stimulatory G protein (Gs) and cyclic AMP. Landiolol is a selective beta-1 adrenoreceptor antagonist that inhibits the positive chronotropic effects of the catecholamines. Landiolol reduces the sympathetic drive, resulting in the reduction of heart rate, decreasing the spontaneous firing of ectopic pacemakers, while slowing the conduction and increasing the refractory period of the atrioventricular node.
Landiolol is primarily metabolized by pseudocholinesterases and carboxylesterases in the plasma. The ester moiety of landiolol is hydrolyzed to release a ketal: this alcoholic component is further cleaved to yield glycerol and acetone, and the carboxylic acid component (metabolite M1), which subsequently undergoes betaoxidation to form metabolite M2 (a substituted benzoic acid). The pharmacological activity of M1 and M2 are negligible, with M1 having less than 1/40th of the pharmacological activity of landiolol. M1 AUC<sub>0-inf</sub> is approximately 12 times greater than landiolol.
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LANDIOLOL
Established Pharmacologic Class [EPC] - beta-Adrenergic Blocker
Mechanisms of Action [MoA] - Adrenergic beta1-Antagonists
Landiolol is a beta-Adrenergic Blocker. The mechanism of action of landiolol is as an Adrenergic beta1-Antagonist.
LANDIOLOL
Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.
Agents used for the treatment or prevention of cardiac arrhythmias. They may affect the polarization-repolarization phase of the action potential, its excitability or refractoriness, or impulse conduction or membrane responsiveness within cardiac fibers. Anti-arrhythmia agents are often classed into four main groups according to their mechanism of action: sodium channel blockade, beta-adrenergic blockade, repolarization prolongation, or calcium channel blockade.
In healthy volunteers, the mean peak plasma concentrations (Cmax) at the dose of 9.3 mcg/kg/min, 18.6 mcg/kg/min, and 37.3 mcg/kg/min were 0.2 mcg/mL, 0.5 mcg/mL, and 1.0 mcg/mL, respectively. In patients with atrial fibrillation or atrial flutter, the Cmax ranged from 0.52 to 1.77 mcg/mL at the dose of 37.3 mcg/kg/min. Landiolol reached steady-state values approximately 15 minutes after initiation of the infusion.
The main route of excretion of landiolol is renal elimination. Approximately 50 to 75% of the landiolol administered dose (approximately half of this as metabolite M1, and 8% as parent) is recovered in urine at four hours and 89 to 99% at 24 hours following a 60 min intravenous infusion.
Landiolol steady state volume of distribution is 0.4 L/kg.
Total body clearance of landiolol is 57 mL/kg/min following a 20-hour continuous landiolol infusion of 37.3 mcg/kg/min.
説明Landiolol was launched as iv infusion for the treatment of tachyarrhythmia during surgery. This structurally related derivative of esmolol can be synthesized in 3 linear steps from 3-(4-hydroxyphenyl)propionic acid by successive esterification followed by alkylation of the phenol function with (2S)-glycidyltosylate and opening of the resulting epoxide by the appropriate amine. Landiolol is an ultra short acting PI-adrenergic blocker more cardioselective (βI/β2 = 255) than esmolol (βi/β2 = 32). It showed 6-8 times greater efficiency compared to esmolol in reducing isoproterenol-induced increase in heart rate and ventricular contraction in anesthetized dogs. In clinical trials, landiolol was effective against a variety of arrhythmias with efficacy seen in patients with atrial fibrillation, proxysmal supraventricular tachycardia, ventricular tachycardia and premature complexes. Landiolol produced a doserelated pharmacokinetic behavior, has a rapid onset of action (10 min.) and is rapidly hydrolyzed to inactive acidic metabolites by esterases after iv administration. This results in an ultra-short half-life (approx. 3 min.) and p-blocade, allowing rapid termination of the drug effect by termination of infusion if side effects occur. Hypertension was the most frequent adverse event and resolved in less than 30 min. after drug withdrawal.