Dehydroemetine: Difference between revisions

| IUPAC_name = (11b''S'')-2-<nowiki>[[</nowiki>(1''R'')-6,7-Dimethoxy-1,2,3,4-tetrahydroisoquinolin-1-yl]methyl]-3-ethyl-9,10-dimethoxy-4,6,7,11b-tetrahydro-1''H''-pyrido[2,1-a]isoquinoline

| image = dehydroemetine.png

| CAS_number = 4914-30-1

| ATC_prefix = P01

| ATC_suffix = AX09

| PubChem = 21022

| DrugBank =

| KEGG = D00828

| C=29|H=38|N=2|O=4

| molecular_weight = 478.62 g/mol

| bioavailability =

| protein_bound =

| metabolism =

| excretion =

| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X -->

| pregnancy_US = <!-- A / B / C / D / X -->

| pregnancy_category=

| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled-->

| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII -->

| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C -->

| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V -->

| legal_status =

| routes_of_administration =

'''Dehydroemetine''' is a synthetically produced [[antiprotozoal agent]] similar to [[emetine]] in its anti-amoebic properties and structure (they differ only in a double bond next to the ethyl radical), but it produces fewer side effects. In the United States, it is manufactured by [[Hoffmann–La Roche|Roche]].

Its exact mechanism is not known, but ''[[in vitro]]'' it inhibits translocation.<ref name="isbn0-7484-0168-7">{{cite book |author=Abdi, Y. A. |title=Handbook of drugs for tropical parasitic infections |publisher=Taylor & Francis |location=Washington, DC |year=1995 |pages=47 |isbn=0-7484-0168-7 |oclc= |doi= |accessdate=}}</ref>

It is distributed by the [[Center for Disease Control]] on a [[wiktionary:compassionate use|compassionate use]] basis as an [[investigational drug]] for the treatment of [[metronidazole]]-resistant amoebiasis. <ref name="CDC_EMETINE"> {{cite web

| url=http://www.cdc.gov/ncidod/srp/drugs/formulary.html

| accessdate = 2007-09-09 }} </ref>

# In 1993, the successful treatment of [[cutaneous amebiasis]] in a 7-year old girl with dehydroemetine and metronidazole in Mexico. <ref name="pmid8302738">{{cite journal |author=Magaña-García M, Arista-Viveros A |title=Cutaneous amebiasis in children |journal=Pediatric dermatology |volume=10 |issue=4 |pages=352–5 |year=1993 |pmid=8302738 |doi=10.1111/j.1525-1470.1993.tb00397.x}}</ref>

# A double-blind study of oral dehydroemetine in the treatment of amoebiasis performed at St. Mary's Hospital, Catholic Medical College, Seoul, Republic of Korea in 1973-1974 showed dehydroemetine treatment was effective. A total of 60 patients were treated, 20 with dehydroemetine, 20 with Tiberal, and 20 with metronidazole. One-fourth of the patients treated with dehydroemetine reported adverse reactions, compared to 20% with other drugs, but no patient discontinued therapy due to the reaction. In all three cases, the drug therapy resulted in clearance of the infection, defined as negative results through an O&P exam, in all but 1-2 patients.<ref name="pmid538815">{{cite journal |author=Chun, Chong |title=Amoebic Comparative Double Blind Trials of Tiberal Compared with Metronidazole and Oral dehydroemetine in Oligosymptomatic Amoebiasis|journal=Korean Medical Database| url=http://kmbase.medric.or.kr/Main.aspx?d=KMBASE&m=VIEW&i=0351219740060010097}}</ref>

# A 1979 study of 27 patients treated with dehydroemetine and various other drugs suggested all drug combinations were successful at treating amoebic liver abscesses. <ref name="pmid538815">{{cite journal |author=Peters M, Dietrich M, Bienzle U, Kern P, Mannweiler E |title=Amoebic liver abscess: a retrospective clinical evaluation of twenty-seven cases |journal=Tropenmedizin und Parasitologie |volume=30 |issue=4 |pages=409–16 |year=1979 |pmid=538815 |doi=}}</ref>

# A 1986 in vitro study compared the effects of dehydroemetine, metronidazole, ornidazole, and secnidazole on ''[[Entamoeba histolytica]]''. Metronidazole was found to be most effective, and the other three drugs were of similar effectiveness. <ref name="pmid2883732">{{cite journal |author=Chintana T, Sucharit P, Mahakittikun V, Siripanth C, Suphadtanaphongs W |title=In vitro studies on the sensitivity of local Entamoeba histolytica to anti-amoebic drugs |journal=Southeast Asian J. Trop. Med. Public Health |volume=17 |issue=4 |pages=591–4 |year=1986 |pmid=2883732 |doi=}}</ref>

A 1980 report described the use of dehydroemetine in treatment of [[herpes zoster]], a condition which can produce painful neurological symptoms. The study involved 40 patients, all of whom were over 60, and compared dehydroemetine treatment to another drug. The study reported patients treated with dehydroemetine experienced relief of neuralgia with no changes in cardiovascular functions. <ref name="pmid6102504">{{cite journal |author=Hernandez-Perez E |title=Dehydroemetine therapy for herpes zoster. A comparison with corticosteroids |journal=Cutis; cutaneous medicine for the practitioner |volume=25 |issue=4 |pages=424–6 |year=1980 |pmid=6102504 |doi=}}</ref>

Dehydroemetine has been investigated as a treatment for ''[[Leishmania]]'' infection. <ref name="pmid16732">{{cite journal |author=Al-Khateeb GH, Al-Jeboori TI, Al-Janabi KA |title=In vitro efficacy of some drugs on promastigotes of Leishmania donovani |journal=Chemotherapy |volume=23 |issue=4 |pages=267–75 |year=1977 |pmid=16732 |doi=10.1159/000221994}}</ref>

==References==

[[Category:Alkaloids]]

[[Category:Phenol ethers]]

[[Category:Tetrahydroisoquinolines]]

[[Category:Pyridoisoquinolines]]