Test 1 Med Chem for Adrenocorticoids & Sex Hormones Flashcards
Classes of steroidal hormones
2 classes:
- Adrenocorticoids
- Glucocorticoids
- Mineralocorticoids
- Gonadal Steroids
- Androgens
- Estrogens
- Progestogens
Steroid Nomenclature and structure
Adrenocorticoid steroid production location
and types of adrenocorticoids
- Adrenal glands: Located above the kidneys.
- Medulla: Inner core; secretes catecholamines (epinephrine)
- Cortex: Synthesizes steroid hormones (adrenocorticoids)
- Adrenocorticoids
- Glucocorticoids:
- Regulate carbohydrate, lipid, and protein metabolism
- Mineralocorticoids:
- Influence salt balance and water retention
- Glucocorticoids:
- Many naturally occurring and semisynthetic analogues exhibit both glucocorticoid (GC) and mineralocorticoid (MC) action
Adrenocorticoid biosynthesis pathway
- Cholesterol is the precursor molecule
- Cholesterol→pregnenolone
- Pregnenolone can take 2 paths
- Pregnenolone→progesterone→intermediates→aldosterone
- Pregnenolone→intermediates→hydrocortisone
Adrenocorticoids: General SAR
Hydrocortisone vs Aldosterone
- Similarities:
- Carbonyl group @ C3
- Double bond (C4 and C5)
- -OH @ C11
- Hydroxymethylketone (-CO-CH2-OH) on C17
- Differences:
- Hydrocortisone has 17-a OH
- Aldosterone has an aldehyde FG at C13
List of Adrenocorticoids
Hydrocortisone (glucocorticoid with mineralo-properties)
Fludrocortisone (used as mineralocorticoid)
Prednisolone (glucocorticoid)
Triamcinolone (glucocorticoid)
Dexmethasone (glucocorticoid)
Hydrocortisone Esters
Different formulations: useful for different routes of administration/sites of action
Hydrocortisone
- R=H
- Well absorbed orally.
- Bioavailability: 95%;
- Biologic t½ 8 to 12 hours
Hydrocortisone acetate
- R=Acetate
- Systemic absorption from intra-articular injection sites in 24 to 48 hours
Hydrocortisone cypionate
- R=Cypionate
- Used orally for slower absorption from the GIT
- contains a lipophilic side chain→ slows absorption
Hydrocortisone sodium phosphate
- R=sodium phosphate
- Hydrolyzed by phosphatases
- t1/2 < 5 minutes
- IV or IM. (highly ionic molecule → rapid solubility)
Hydrocortisone butyrate and valerate
- R=butyrate or vlerate
- used topically
Hydrocortisone Metabolism
- 11 ß-hydroxysteroid dehydrogenase (oxidation)→inactive cortisone
- 5 ß-reductase (reduction)→inactive 5 ß-dihydrocortisol→3à- hydroxysteroid dehydrogenase→inactive urocortisol
Fludrocortisone
- 9à-fluoro hydrocortisone analogue
- A potent corticosteroid (compared to hydrocortisone)
- Widely used as mineralocorticoid (more mineralocorticoid properties than hydrocortisone due to Fluoro group)
- Promotes increased reabsorption of sodium and loss of potassium from renal distal tubules
- Biologic t½: 18-36 hrs (Increased half-life compared to hydrocortisone)
- DOA: 1-2 days
- Use: Adrenocortical insufficiency in Addison’s disease
- Not classified as a glucocorticoid, even though it has properties – may lead to edema
Prednisolone
-
Double bond @ 1 and 2
- ↑ GC activity
- Does not have significant MC activity
- Biologic t½: 18-36 hrs
- Ester forms: acetate, tert-butyl acetate, sodium phosphate
Prednisolone Metabolism
- Major metabolites utilize CYP450: 6ß- and 16à-hydroxy are primarily excreted as active glucuronide conjugates (several hydroxy groups) in the urine
Triamcinolone
- glucocorticoid
- Low BA: 23%
- Does not have significant MC activity
- Biologic t½: 18-36 hrs
- DOA: 1.0-1.5 days
- Esters: Administered IM or intraarticularly for a prolonged release
- Triamcinolone diacetate has a DOA from 1 to 8 weeks
Dexmethasone
-
16a-methyl group
- Increases the anti-inflammatory activity by increasing lipophilicity and receptor affinity. About 5 x as active as prednisolone
- Biologic t½: 36-54 hrs
- DOA: ~ 3 days
- What is Betamethasone? (Perhaps it is slightly more active than dexamethasone) – contains a beta-methyl group @ 16 position
- Hydroxy group is replaced with methyl group à more lipophilic (better receptor activity)
- Potency: Dexamethasone >> prednisone >> hydrocortisone
- DOA: Dexamethasone >> prednisone >> hydrocortisone
Adrenocorticoid Antagonists
- Agents that compete for binding to steroid receptors
- Antimineralocorticoid/ MC receptor antagonist
- Spironolactone (Aldactone)
- Antiglucocorticoid/ GC receptor antagonist
-
Mifepristone (Mifeprex)
- Mifepristone is also a progestin antagonist
-
Mifepristone (Mifeprex)
- Antimineralocorticoid/ MC receptor antagonist
Spironolactone
- Structural features: 3-keto-4-ene A ring; 7α-substituent; lactone ring
- Uses:
- Edema from hyperaldosteronism
- Potassium-sparing diuretic; Increased Na+ excretion and K+ retention
- Absorption: Oral: 90 %
- t ½ elimination: Spironolactone: 78-84 minutes; Canrenone: 10-23 hours
- Metabolism: Canrenone (active)
- Does spironolactone bind to other receptors? Yes – binds to steroid receptors
- Adverse effects: Hyperkalemia, Sexual side effects (gynecomastia), Tumorigenic [US Boxed Warning]
Metyrapone
- MOA:
- Inhibits 11b-hydroxylase (stop making hydrocortisone)
- Interfering with cortisol biosynthesis
- Uses:
- To test hypothalamic-pituitary ACTH function
Sex Hormones
- Androgens
- E.g. Testosterone
- Estrogens
- Steroidal
- E.g., Conjugated; Esterified
- Non-steroidal
- E.g., Stilbenes; Phytoestrogens
- Steroidal
- Progestogens
- E.g. Progesterone
Biosynthesis of Sex Hormones
Shift of double bond = isomerase reaction
Estrogens are the only steroids that have an aromatic “A” ring (some exceptions)
How does progesterone differs from testosterone: progesterone has carbonyl @ C17, while testosterone has a hydroxy group
Focus on: aromatase, 5a-reductase
Testosterone→5a-Dihydrotestosterone
- For androgen replacement therapy
- Have both androgenic and anabolic activities
- Why do you want to block the synthesis of 5a-reductase?
- Used in prostate cancer and BPH
- How can you reduce the effects of this molecule (naturally occurring)?
- Block the receptor – give anti-androgens
- Can undergo oxidation→ketone (tertiary alcohols are not oxidizable)
- Why do you want to block the synthesis of 5a-reductase?
Testosterone Derivatives
- Testosterone cypionate
- Testosterone enanthate
- 17a- Methyltestosterone
- Fluoxymesterone (Androxy)
Testosterone Cypionate and Enanthate
- Testosterone Derivatives
- Testosterone esters (17-β esters)
- testosterone enanthate and cypionate are lipophilic
- Add lipophilic side chains to prolong the DOA
- I.M.: Cypionate and enanthate esters
- DOA: ≤2-4 weeks
- Metabolism:
- To DHT via 5a-reductase
- To estradiol (aromatase)
- testosterone enanthate and cypionate are lipophilic
- Testosterone esters (17-β esters)
17a- Methyltestosterone
- Testosterone Derivative
- Increased oral bioavailability (due to addition of methyl group)
-
17a alkyl group
- Reduces susceptibility to oxidative metabolism
- Has the androgenic and anabolic activities of testosterone
Fluoxymesterone
- Testosterone Derivative
- Aka Androxy
-
9α-fluoro group
- ↑ activity
- 20 times anabolic activity of 17a-methyltestosterone
- 10 times the androgenic activity of 17a-methyltestosteone
- t1/2 elimination: 10-100 minutes
- Adverse effect: Sodium and water retention that could lead to edema
5a-reductase Inhibitors
- MOA: Mechanism-based inhibitors (binds permanently)
- Irreversible modification of 5α-reductase.
- Natural substrate of 5a-reductase is testosterone – these molecules contain alpha, beta unsaturated amide
- Uses: benign prostatic hyperplasia
- Finasteride (Proscar)
- Dutasteride (Avodart)
Finasteride
- Proscar
- 5a-reductase inhibitor
- Reduces DHT levels:
- ~ 70% plasma
- ~ 85 to 90% in prostate
- Elimination t1/2 (hours) :
- Reduces DHT levels: