Trimethaphan

Identification

Generic Name
Trimethaphan
DrugBank Accession Number
DB01116
Background

A nicotinic antagonist that has been used as a ganglionic blocker in hypertension, as an adjunct to anesthesia, and to induce hypotension during surgery.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 365.512
Monoisotopic: 365.168759122
Chemical Formula
C22H25N2OS
Synonyms
  • Thimethaphan
  • Trimetaphan
  • Trimetaphanum

Pharmacology

Indication

For the controlled reduction of blood pressure during surgery and in the treatment of hypertensive emergencies.

Pharmacology
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Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Trimethaphan is indicated for production of controlled hypotension during surgery to reduce bleeding into the surgical field and also for rapid reduction of blood pressure in the treatment of hypertensive emergencies, especially in patients with acute dissecting aneurysm, and in the emergency treatment of pulmonary edema in patients with pulmonary hypertension associated with systemic hypertension.

Mechanism of action

Trimethaphan is a ganglionic blocking agent prevents stimulation of postsynaptic receptors by competing with acetylcholine for these receptor sites. Additional effects may include direct peripheral vasodilation and release of histamine. Trimethaphan's hypotensive effect is due to reduction in sympathetic tone and vasodilation, and is primarily postural.

TargetActionsOrganism
ANeuronal acetylcholine receptor subunit alpha-10
antagonist
Humans
Absorption

Not Available

Volume of distribution

Not Available

Protein binding

Not Available

Metabolism
Not Available
Route of elimination

Not Available

Half-life

Not Available

Clearance

Not Available

Adverse Effects
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Toxicity

Not Available

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AcebutololAcebutolol may increase the hypotensive activities of Trimethaphan.
AceclofenacThe therapeutic efficacy of Trimethaphan can be decreased when used in combination with Aceclofenac.
AcemetacinThe therapeutic efficacy of Trimethaphan can be decreased when used in combination with Acemetacin.
AcetazolamideThe risk or severity of adverse effects can be increased when Acetazolamide is combined with Trimethaphan.
Acetyl sulfisoxazoleThe risk or severity of adverse effects can be increased when Acetyl sulfisoxazole is combined with Trimethaphan.
Acetylsalicylic acidAcetylsalicylic acid may decrease the antihypertensive activities of Trimethaphan.
AclidiniumThe serum concentration of Aclidinium can be increased when it is combined with Trimethaphan.
AlclofenacThe therapeutic efficacy of Trimethaphan can be decreased when used in combination with Alclofenac.
AldesleukinAldesleukin may increase the hypotensive activities of Trimethaphan.
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Trimethaphan.
Interactions
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Food Interactions
Not Available

Products

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Product Ingredients
IngredientUNIICASInChI Key
Trimethaphan camsylate8W556014K968-91-7HALWUDBBYKMYPW-STOWLHSFSA-M
International/Other Brands
Arfonad

Categories

ATC Codes
C02BA01 — Trimetaphan
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as thienoimidazolidines. These are heterocyclic compounds containing a thiophene ring fused to an imidazolidine ring. Thiophene is 5-membered ring consisting of four carbon atoms and one sulfur atom. Imidazolidine is 5-membered saturated ring of three carbon atoms, and two nitrogen centers at the 1- and 3-positions.
Kingdom
Organic compounds
Super Class
Organoheterocyclic compounds
Class
Thienoimidazolidines
Sub Class
Not Available
Direct Parent
Thienoimidazolidines
Alternative Parents
Imidazolidinones / Benzene and substituted derivatives / Thiophenes / Thiolanes / Ureas / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds / Organic oxides / Hydrocarbon derivatives
show 2 more
Substituents
Aromatic heteropolycyclic compound / Azacycle / Benzenoid / Carbonic acid derivative / Carbonyl group / Hydrocarbon derivative / Imidazolidine / Imidazolidinone / Monocyclic benzene moiety / Organic cation
show 10 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
sulfonium compound (CHEBI:9728)
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
6G8X656T45
CAS number
7187-66-8
InChI Key
CHQOEHPMXSHGCL-UHFFFAOYSA-N
InChI
InChI=1S/C22H25N2OS/c25-22-23(14-17-8-3-1-4-9-17)19-16-26-13-7-12-20(26)21(19)24(22)15-18-10-5-2-6-11-18/h1-6,8-11,19-21H,7,12-16H2/q+1
IUPAC Name
3,5-dibenzyl-4-oxo-8λ⁴-thia-3,5-diazatricyclo[6.3.0.0²,⁶]undecan-8-ylium
SMILES
O=C1N(CC2=CC=CC=C2)C2C[S+]3CCCC3C2N1CC1=CC=CC=C1

References

General References
Not Available
Human Metabolome Database
HMDB0015248
KEGG Compound
C07174
PubChem Compound
23576
PubChem Substance
46508994
ChemSpider
22044
BindingDB
82545
RxNav
10828
ChEBI
9728
ChEMBL
CHEMBL1201329
Therapeutic Targets Database
DAP001143
PharmGKB
PA451784
Wikipedia
Trimetaphan_camsilate

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1Active Not RecruitingBasic ScienceMultiple System Atrophy (MSA) / Orthostatic Hypotension / Supine Hypertension1
1CompletedNot AvailableBMI >30 kg/m2 / High Blood Pressure (Hypertension)1
1CompletedNot AvailableMyalgic Encephalomyelitis (ME) / Orthostatic Intolerance / Postural Tachycardia Syndrome1
1CompletedDiagnosticBMI >30 kg/m2 / High Blood Pressure (Hypertension) / Progressive autonomic failure / Shy-Drager Syndrome1
1CompletedOtherEndothelial Dysfunction1
1RecruitingOtherHigh Blood Pressure (Hypertension)1
1RecruitingOtherHigh Blood Pressure (Hypertension) / Hypertension,Essential1
1WithdrawnBasic ScienceInsulin Resistance1
Not AvailableCompletedNot AvailableBMI >30 kg/m21
Not AvailableCompletedNot AvailableHigh Blood Pressure (Hypertension) / Progressive autonomic failure1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
Not Available
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
logP3.473Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.00665 mg/mLALOGPS
logP4.4ALOGPS
logP2.32ChemAxon
logS-4.8ALOGPS
pKa (Strongest Basic)-2ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count1ChemAxon
Hydrogen Donor Count0ChemAxon
Polar Surface Area23.55 Å2ChemAxon
Rotatable Bond Count4ChemAxon
Refractivity105.43 m3·mol-1ChemAxon
Polarizability40.13 Å3ChemAxon
Number of Rings5ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.9641
Blood Brain Barrier+0.9897
Caco-2 permeable-0.5053
P-glycoprotein substrateSubstrate0.6942
P-glycoprotein inhibitor IInhibitor0.6012
P-glycoprotein inhibitor IINon-inhibitor0.6356
Renal organic cation transporterInhibitor0.6812
CYP450 2C9 substrateNon-substrate0.7161
CYP450 2D6 substrateNon-substrate0.6162
CYP450 3A4 substrateNon-substrate0.5152
CYP450 1A2 substrateNon-inhibitor0.5223
CYP450 2C9 inhibitorInhibitor0.5
CYP450 2D6 inhibitorInhibitor0.5134
CYP450 2C19 inhibitorInhibitor0.7361
CYP450 3A4 inhibitorNon-inhibitor0.8947
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.847
Ames testNon AMES toxic0.6511
CarcinogenicityNon-carcinogens0.9545
BiodegradationNot ready biodegradable0.9606
Rat acute toxicity2.3658 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Strong inhibitor0.597
hERG inhibition (predictor II)Inhibitor0.7575
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available

Targets

Drugtargets
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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Antagonist
General Function
Receptor binding
Specific Function
Ionotropic receptor with a probable role in the modulation of auditory stimuli. Agonist binding may induce an extensive change in conformation that affects all subunits and leads to opening of an i...
Gene Name
CHRNA10
Uniprot ID
Q9GZZ6
Uniprot Name
Neuronal acetylcholine receptor subunit alpha-10
Molecular Weight
49704.295 Da
References
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. [Article]
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. [Article]
  3. Kurenny DE, Selyanko AA, Derkach VA, Gmiro VE, Skok VI: Mechanism of long-lasting block of ganglion nicotinic receptors by mono-ammonium compounds with long aliphatic chain. J Auton Nerv Syst. 1994 Aug;48(3):231-40. [Article]
  4. Loiacono R, Stephenson J, Stevenson J, Mitchelson F: Multiple binding sites for nicotine receptor antagonists in inhibiting [3H](-)-nicotine binding in rat cortex. Neuropharmacology. 1993 Sep;32(9):847-53. [Article]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Identical protein binding
Specific Function
Esterase with broad substrate specificity. Contributes to the inactivation of the neurotransmitter acetylcholine. Can degrade neurotoxic organophosphate esters.
Gene Name
BCHE
Uniprot ID
P06276
Uniprot Name
Cholinesterase
Molecular Weight
68417.575 Da
References
  1. Nakamura K, Koide M, Imanaga T, Ogasawara H, Takahashi M, Yoshikawa M: Prolonged neuromuscular blockade following trimetaphan infusion. A case report and in vitro study of cholinesterase inhibition. Anaesthesia. 1980 Dec;35(12):1202-7. [Article]

Drug created on June 13, 2005 13:24 / Updated on May 07, 2021 21:23