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[Esters and stereoisomers]

V Nigrovic1, C Diefenbach, H Mellinghoff

  • 1Klinik für Anästhesiologie und operative Intensivmedizin der Universität Zu Köln.

Der Anaesthesist
|April 1, 1997
PubMed
Summary
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Chirality in anesthesia drugs, like enflurane and isoflurane, affects their properties. Cisatracurium, a specific isomer, offers advantages over racemic mixtures due to its potency and reduced histamine release.

Area of Science:

  • Stereochemistry and its impact on drug action.
  • Chirality in medicinal chemistry and pharmacology.

Context:

  • Many anesthetic drugs exist as stereoisomers and racemic mixtures.
  • Understanding stereoisomerism is crucial for drug development and application in anesthesia.

Purpose:

  • To review the concepts of isomers, stereoisomers, chirality, and enantiomers in anesthetic drugs.
  • To highlight the clinical significance of specific stereoisomers, such as cisatracurium.

Summary:

  • Anesthetic agents like enflurane, isoflurane, and ketamine are often racemic mixtures.
  • Cisatracurium, a specific isomer of atracurium, demonstrates improved clinical benefits including higher potency and reduced histamine release.
  • Drug hydrolysis pathways, such as Hofmann elimination and esterase activity, influence drug duration and efficacy.

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Impact:

  • Provides a foundation for understanding stereoisomerism in drug design for anesthesia.
  • Emphasizes the advantages of using specific isomers over racemic mixtures for improved patient outcomes.
  • Informs the selection and application of anesthetic agents based on their stereochemical properties and metabolic pathways.