| PATENT ASSIGNEE'S COUNTRY | USA |
| UPDATE | 12.99 |
| PATENT NUMBER | This data is not available for free |
| PATENT GRANT DATE | 14.12.99 |
| PATENT TITLE |
Val-pro containing .alpha.-keto oxadiazoles as serine protease inhibitors |
| PATENT ABSTRACT |
The present invention relates to certain substituted oxadiazole tripeptides, which are useful as inhibitors of human neutrophil elastase (HNE) for the treatment of HNE-mediated processes implicated in conditions such as adult respiratory distress syndrome, septic shock and multiple organ failure. A series of studies also have indicated the involvement HNE in myocardial ischemia-reperfusion injury, emphysema. HNE-mediated processes are implicated in other conditions such as arthritis, periodontal disease, glomerulonephritis, dermatitis, psoriasis, cystic fibrosis, chronic bronchitis, atherosclerosis, Alzheimer's disease, organ transplantation, corneal ulcers, and invasion behavior of malignant tumors. |
| PATENT INVENTORS | This data is not available for free |
| PATENT ASSIGNEE | This data is not available for free |
| PATENT FILE DATE | 03.06.98 |
| PATENT REFERENCES CITED |
Edwards, P. D., et al. "Peptidyl Alpha-Ketoheterocyclic Inhibitors of Human Neutrophil Elastase. 3. In Vitro and in Vivo Potency of a Series of Peptidyl Alpha-Ketobenzoxazoles," J. Med. Chem. 38, 3972-3982 (1995). Edwards, P. D., et al. "Nonpeptic Inhibitors of Human Neutrophil Elastase. 7. Design, Synthesis, and in Vitro Activity of a Series of Pyridopyrimidine Trifluoromethyl Ketones," J. Med. Chem. 39, 1112-1124 (1996). Edwards, P. D., et al. "Peptidyl Alpha-Ketoheterocyclic Inhibitors of Human Neutrophil Elastase. 2. Effect of Varying the Heterocyclic Ring on in Vitro Potency," J. Med Chem. 38, 76-85 (1995). Veale, C. A., et al. "Non-peptidic Inhibitors of Human Leukocyte Elastase. 4. Design, Synthesis, and in Vitro and in Vivo Activity of a Series of Beta-Carbolinone-Containing Trifluoromethyl Ketones," J. Med. Chem. 38, 86-97 (1995). Veale, C. A., et al. "Nonpeptidic Inhibitors of Human Leukocyte Elastase. 5. Design, Synthesis, and X-ray Crystallography ofa Series of Orally Active 5-Aminopyrimidin-6-one-Containing Trifluoromethyl Ketones," J. Med. Chem. 38, 98-108 (1995). Goddard, C. J., "Antiinflammatory 1-Phenylpyrazole-4-Heteroarylalkanoic Acids," J. Heterocyclic Chem., 28, 1607-1612 (1991). LaMattina, J. L., et al. "Utility of p-Nitrophenyl 3-Bromo-2,2-diethoxypropionate (NPBDP) in Heterocyclic Synthesis," J. Org. Chem. 49, 4800-4805 (1984). Unangst, P. C., et al. "Novel 1,2,4-Oxadiazoles and 1,2,4-Thiadiazoles as Dual 5-Lipoxygenase and Cyclooxygenase Inhibitors," J. Med. Chem. 35, 3691-3698 (1992). Kitatani, K., et al. "A Novel Oxazole Synthesis Utilizing Tungsten(VI) Catalyzed Decomposition of Alpha-Diazo Carbonyl Compounds in Nitriles," Tet. Lett. 16, 1531-1532 (1974). Wiley, R. H., "Chemistry of the Oxazoles," Chem. Rev. 37, 401-442 (1945). Davidson, D., et al. "The Action of Ammonia on Benzoin," J. Org. Chem. 2, 328-334 (1937). Wiegand, Edwin E., et al. "Polyphosphoric Acid Cyclization of Acetamidoketones to 2,5-Dimethyl-1,3-oxazoles," Synthesis 12, 648-649 (1970). Wasserman, H.H., et al. "The Oxazole-Triamide Rearrangement. Application To Peptide Synthesis," Tet. Lett. 23, 3831-3834 (1982). Cornforth, J. W., et al. "A New Synthesis of Oxazoles and Iminazoles including its Application to the Preparation of Oxazole." J. Chem. Soc. 96-102 (1947). Cornforth, J. W., et al. "Synthesis of Oxazoles from Ethyl Acetoacetate. Ring-fission of Some Oxazole-5-carboxylic Acids." J. Chem. Soc. 93-98 (1953). Bernstein, P. R., et al. "Nonpeptidic Inhibitors of Human Leukocyte Elastase. 3. Design, Synthesis, X-Ray Crystallographic Analysis, and Structure--Activity Relationships for a Series of Orally Active 3-Amino-6-phenylpyridin-2-one Trifluoromethyl Ketones," J. Med. Chem. 37, 3313-3326 (1994). Brown, F. J., et al. "Design of Orally Active, Non-Peptidic Inhibitors of Human Leukocyte Elastase," J. Med. Chem. 37, 1259-1261 (1994). Warner, P., et al. "Non-peptidic Inhibitors of Human Leukocyte Elastase. 1. The Design and Synthesis of Pyridone-Containing Inhibitors," J. Med. Chem. 37, 3090-3099 (1994). Budavari, Susan (Editor), "The Merck Index" An Encylopedia of Chemicals, Drugs, and Biologicals; Merck & Co., Inc., p. 294 (1989). Damewood, J. R., Jr. et al. "Nonpeptidic Inhibitors of Human Leukocyte Elastase. 2. Design, Synthesis, and in vitro Activity of a Series of 3-Amino-6-arylopyridin-2-one Trifluoromethyl Ketones," J. Med. Chem. 37, 3303-3312 (1994). Skiles, J.W., et al. "Elastase Inhibitors Containing Conformationally Restricted Lactams as P.sub.3 -P.sub.2 Dipeptide Replacements," Bio. & Med. Chem. Ltrs. 3, 773-778 (1993). |
| PATENT PARENT CASE TEXT | This data is not available for free |
| PATENT CLAIMS |
We claim: 1. A compound of the formula ##STR2## wherein X and Y are independently O or N; R.sub.1 is alkyl, .alpha.,.alpha.-dialkylalkylaryl or .alpha.,.alpha.-dialkylalkyl fused aryl-cycloalkyl wherein the cycloalkyl group is optionally substituted with two or more O atoms; R.sub.2 and R.sub.3 are independently H or alkyl; or together form a cycloalkyl ring consisting of 3-5 carbons optionally substituted with one or more heteroatoms selected from O, S or N wherein N is optionally substituted with H or alky; and R.sub.4 is alkyloxycarbonyl. 2. The compound of claim 1 wherein X is N and Y is O. 3. The compound of claim 2 wherein R.sub.4 is methyloxycarbonyl. 4. The compound of claim 3 wherein R.sub.2 is isopropyl and R.sub.3 is H. 5. The compound of claim 4 wherein R.sub.1 is alkyl. 6. The compound of claim 4 wherein R.sub.1 is .alpha.,.alpha.-dialkylalkylaryl. 7. The compound of claim 6 wherein R.sub.1 is .alpha.,.alpha.-dimethylbenzyl. 8. A compound of claim 7: Methyloxycarbonyl-L-valyl-N-[1-(2-[5-(.alpha.,.alpha.-dimethylbenzyl) oxadiazolyl]carbonyl)-2-(S)-methylpropyl]-L-prolinamide. 9. The compound of claim 4 wherein R.sub.1 is .alpha.,.alpha.-dialkylalkyl fused aryl-cycloalkyl wherein the cycloalkyl group is substituted with two O atoms. 10. A method of inhibiting at least one serine protease comprising administering to a host in need of such inhibition an effective amount of a compound of claim 1. 11. The method of claim 10 wherein the serine protease is elastase. 12. The method of claim 11 wherein the elastase is human neutrophil elastase. 13. A composition comprising one or more compounds of claim 1 and a pharmaceutically acceptable carrier. -------------------------------------------------------------------------------- |
| PATENT DESCRIPTION |
BACKGROUND OF THE INVENTION The serine proteases are a class of enzymes, which includes elastase, chymotrypsin, cathepsin G, trypsin and thrombin. These proteases have in common a catalytic triad consisting of Serine-195, Histidine-57 and Aspartic acid-102 (chymotrypsin numbering system). Human neutrophil elastase (HNE) is a proteolytic enzyme secreted by polymorphonuclear leukocytes (PMNs) in response to a variety of inflammatory stimuli. This release of HNE and its extracellular proteolytic activity are highly regulated and are normal, beneficial functions of PMNs. The degradative capacity of HNE, under normal circumstances, is modulated by relatively high plasma concentrations of .alpha..sub.1 -proteinase inhibitor (.alpha..sub.1 -PI). However, stimulated PMNs produce a burst of active oxygen metabolites, some of which (hypochlorous acid for example) are capable of oxidizing a critical methionine residue in .alpha..sub.1 -PI. Oxidized .alpha..sub.1 -PI has been shown to have limited potency as an HNE inhibitor and it has been proposed that alteration of this protease/antiprotease balance permits HNE to perform its degradative functions in localized and controlled environments. Despite this balance of protease/antiprotease activity, there are several human disease states in which a breakdown of this control mechanism is implicated in the pathogenesis of the condition. Improper modulation of HNE activity has been suggested as a contributing factor in adult respiratory distress syndrome, septic shock and multiple organ failure. A series of studies also have indicated the involvement of PMNs and neutrophil elastase in myocardial ischemia-reperfusion injury. Humans with below-normal levels of .alpha..sub.1 -PI have an increased probability of developing emphysema. HNE-mediated processes are implicated in other conditions such as arthritis, periodontal disease, glomerulonephritis, dermatitis, psoriasis, cystic fibrosis, chronic bronchitis, atherosclerosis, Alzheimer's disease, organ transplantation, corneal ulcers, and invasion behavior of malignant tumors. There is a need for effective inhibitors of HNE as therapeutic and as prophylactic agents for the treatment and/or prevention of elastase-mediated problems. SUMMARY OF THE INVENTION The present invention provides compounds of the formula: ##STR1## wherein X and Y are independently O or N; R.sub.1 is alkyl, .alpha.,.alpha.-dialkylalkylaryl or .alpha.,.alpha.-dialkylalkyl fused aryl-cycloalkyl wherein the cycloalkyl group is optionally substituted with two or more O atoms; R.sub.2 and R.sub.3 are independently H or alkyl; or together form a ring consisting of 3-5 carbons optionally substituted with one or more heteroatoms selected from O, S or N wherein N is optionally substituted with H or alkyl; and R.sub.4 is alkyloxycarbonyl. Preferably, compounds of the present invention comprise a 1,2,4-oxadiazole (i.e., X is O; Y is N) or 1,3,4 oxadiazole ring (i.e., X is N; Y is O). In one preferred embodiment of the invention, R.sub.1 is alkyl, such as tert-butyl. In another embodiment, R.sub.1 is .alpha.,.alpha.-dialkylalkylaryl, such as an .alpha.,.alpha.-dimethylbenzyl group. In still another embodiment, R.sub.1 is .alpha.,.alpha.-dialkylalkyl fused aryl-cycloalkyl wherein the cycloalkyl group is substituted with two O atoms, such as an .alpha.,.alpha.-dimethyl-(3,4-methylenedioxy)benzyl group. In yet another preferred embodiment, R.sub.2 and R.sub.3 are independently alkyl, such as isopropyl, or H. Preferably, R.sub.2 is isopropyl and R.sub.3 is H. As used herein, the term "optionally substituted" means, when substituted, mono to fully substituted. As used herein, the term "independently" means that the substituents may be the same or different. As used herein, the term "alkyl" means C.sub.1 -C.sub.15, and preferably C.sub.1 -C.sub.8. It will be understood that the alkyl group may be linear or branched. As used herein, the term ".alpha.,.alpha.-dialkylalkylaryl" means that the alkyl groups are substituted at the a-positions to the oxadiazole ring or to the aryl group or both. One such example is an .alpha.,.alpha.-dialkylbenzyl, wherein the .alpha.-substituents are preferably methyl, ethyl or propyl. A specific example is .alpha.,.alpha.-dimethylbenzyl. The term ".alpha.,.alpha.-dialkylalkyl fused aryl-cycloalkyl" is defined to mean that the alkyl groups are substituted at the .alpha.-positions to the oxadiazole ring or to the aryl group, and a cycloalkyl is fused to the aryl ring. One such example of an ".alpha.,.alpha.-dialkylalkyl fused aryl-cycloalkyl" is an .alpha.,.alpha.-dialkyl-3,4-methylenedioxybenzyl group, wherein the .alpha.-substituents are preferably methyl, ethyl or propyl. A specific example includes the .alpha.,.alpha.-dimethyl-3,4-methylenedioxybenzyl group. As used herein, the term alkyloxycarbonyl means alkyl--O--C(O)-- wherein the meaning of alkyl is defined above. One such example of an alkyloxycarbonyl is methyloxycarbonyl and is defined by the formula CH.sub.3 --O--C(O)--. BRIEF DESCRIPTION OF DRAWING FIG. 1 is a schematic representation of the synthetic scheme for the Boc protected amino alcohol intermediates used in the invention. FIG. 2 is a schematic representation of the synthetic scheme for the compounds of the invention. FIG. 3 shows structural representations of certain embodiments of the invention. DETAILED DESCRIPTION The compounds of the present invention have been found to be potent inhibitors of the serine protease human neutrophil elastase (HNE). They are reversible inhibitors that presumably form a transition state intermediate with the active site serine residue. The compounds are characterized by their low molecular weights, high selectivity with respect to HNE and stability regarding physiological conditions. Therefore, the compounds can be implemented to prevent, alleviate and/or otherwise treat diseases, which are mediated by the degradative effects associated with the presence of HNE. Their usage is of particular importance as they relate to various human treatment in vivo but may also be used as a diagnostic tool in vitro. The present invention provides, but is not limited to, specific embodiments set forth in the Examples as well as those set forth below. The nomenclature for the embodiments is as follows (although embodiments disclosed indicate the stereochemistry of the 2-methylpropyl group as having the (S)-configuration, it will be understood that both the enantiomerically pure (R) and racemic (R,S) configurations are within the scope of the invention): Example 1 Methyloxycarbonyl-L-valyl-N-[1-(2-[5-(tert-butyl)-oxadiazolyl]carbonyl)-2- (S)-methylpropyl]-L-prolinamide Example 2 Methyloxycarbonyl-L-valyl-N-[1-(2-[5-(.alpha.,.alpha.-dimethylbenzyl)-oxad iazolyl]carbonyl)-2-(S)-methylpropyl]-L-prolinamide Example 3 Methyloxycarbonyl-L-valyl-N-[1-(2-[5-(.alpha.,.alpha.-dimethyl-3,4-methyle nedioxybenzyl)-1,3,4-oxadiazolyl]carbonyl)-2-(S)-methylpropyl]-L-prolinamid e The compounds of the present invention are not limited to use for inhibition of human elastase. Elastase is a member of the class of enzymes known as serine proteases. This enzyme class also includes, for example, chymotrypsin, cathepsin G, trypsin and thrombin. These proteases have in common a catalytic triad consisting of Serine-195, Histidine-57 and Aspartic acid-102 (chymotrypsin numbering system). The precise hydrogen bond network that exists between these amino acid residues allows the Serine-195 hydroxyl to form a tetrahedral intermediate with the carbonyl of an amide substrate. The decomposition of this intermediate results in the release of a free amine and the acylated enzyme. In a subsequent step, this newly formed ester is hydrolyzed to give the native enzyme and the carboxylic acid. It is this carboxyl component that helps characterize the specificity for the enzyme. In the example in which the carboxyl component is a peptide, the alpha-substituent of the amino acid is predominately responsible for the specificity toward the enzyme. Utilizing the accepted nomenclature by Schechter and Berger (Biochem. Biophy. Res. Commun., 27:157 (1967) and Biochem. Biophys. Res. Commun., 32:898 (1968)), the amino acid residues in the substrate that undergo the cleavage are defined as P.sub.1 . . . P.sub.n toward the N-terminus and P.sub.1 '. . . P.sub.n ' toward the C-terminus. Therefore, the scissile bond is between the P.sub.1 and the P.sub.1 ' residue of the peptide subunits. A similar nomenclature is utilized for the amino acid residues of the enzyme that make up the binding pockets accommodating the subunits of the substrate, where the binding pocket for the enzyme is designated by S.sub.1 . . . S.sub.n instead of P.sub.1 . . . P.sub.n as for the substrate. The characteristics for the P.sub.1 residue defining serine proteinase specificity is well established. The proteinases may be segregated into three subclasses: elastases, chymases and tryptases based on these differences in the P.sub.1 residues. The elastases prefer small aliphatic moieties such as valine whereas the chymases and tryptases prefer large aromatic hydrophobic and positively charged residues respectively. One additional proteinase that does not fall into one of these categories is propyl endopeptidase. The P.sub.1 residue defining the specificity is a proline. This enzyme has been implicated in the progression of memory loss in Alzheimer's patients. Inhibitors consisting of .alpha.-keto heterocycles have recently been shown to inhibit propyl endopeptidase (Tsutsumi et al., J. Med. Chem., 37, 3492-3502 (1994)). By way of extension, .alpha.-keto heterocycles as defined herein allow for an increased binding in P' region of the enzyme. TABLE 1 ______________________________________ P.sub.1 Characteristics for Proteinase Specificity Proteinase Class Representative Enzyme P.sub.1 Characteristic ______________________________________ Elastases Human Neutrophil Elastase small aliphatic residues Chymases alpha-Chymotrypsin, aromatic or large hydro- Cathepsin G phobic residues Tryptases Thrombin, Trypsin, positively charged Urokinase, Plasma residues Kallikrein, Plasminogen Activator, Plasmin Other Prolyl Endopeptidase proline ______________________________________ Since the P.sub.1 residue predominately defines the specificity of the substrate, the present invention relates to P.sub.1 -P.sub.n ' modifications, specifically, certain alpha-substituted keto-heterocycles composed of 1,2,4 oxadiazoles and 1,3,4-oxadiazoles. By altering the alpha-substituent to the ketone and, to some extent, the substituent on the heterocycle, the specificity of these compounds can be directed toward the desired proteinase (e.g., small aliphatic groups for elastase). The efficacy of the compounds for the treatment of various diseases can be determined by scientific methods, which are known in the art. The following are noted as examples for HNE mediated conditions: for acute respiratory distress syndrome, the method according to human neutrophil elastase (HNE) model (AARD, 141:227-677 (1990)); the endotoxin induced acute lung injury model in minipigs (AARD, 142:782-788 (1990)); or the method according to human polymorphonuclear elastase-induced lung hemorrhage model in hamsters (European Patent Publication No. 0769498) may be used; in ischemia/reperfusion, the method according to the canine model of reperfusion injury (J. Clin. Invest., 81:624-629 (1988)) may be used. The compounds of the present invention, salts thereof, and their intermediates can be prepared or manufactured as described herein or by various processes known to be present in the chemical art (see e.g., WO 96/16080). Alternatively, the compounds of the present invention may be prepared as described in FIGS. 1 and 2. FIG. 1 relates to the synthesis of the Boc protected amino alcohol intermediates used in the invention. FIG. 2 shows the use of the intermediates for the synthesis compounds of the invention. The 2-substituted 1,3,4-oxadiazoles (3) may be prepared via formation of methyl esters from the corresponding acids (1) utilizing, for example, thionyl chloride and methanol, followed by treatment with hydrazine in a suitable solvent to yield hydrazonic acids (2). Alternatively, esters can be prepared by methods known to one skilled in the art or those methods described in Comprehensive Organic Transformations (R. Larock, VCH Publishers 1989, 966-972). Reaction of (2) with triethyl orthoformate or trimethyl orthoformate and TsOH gives the requisite 2-substituted 1,3,4-oxadiazoles (3). Intermediate (3') can be formed utilizing standard conditions (e.g., butyllithium or other known alkyl lithium reagents, at low temperature in a polar aprotic solvent, and further, if desired, reacting with MgBr.OEt.sub.2) and subsequently added to aldehyde (4) to give alcohol (5). The aldehyde (4) may be prepared via any of three methods as described in FIG. 1. One method reduces the intermediate that is formed between Boc-Val-OH and iso-propylchloroformate with sodium borohydride to give Boc-Valinol (12). In a subsequent step, the Boc-Valinol is oxidized with SO.sub.3 -Py in DMSO to give aldehyde (4). Another such method takes the Weinreb amide (13) that is prepared from Boc-Val-OH (11) and reduces it to the aldehyde using diisobutylaluminum hydride (DIBAL). Alternatively, one may generate the ester (14) of the amino acid followed by reduction with DIBAL to afford aldehyde (4). As shown in FIG. 2, deprotection of amine (5) using hydrochloric acid in dioxane gives the amino hydrochloride (6), which is then coupled to acid (7) by methods available to one skilled in the art to give intermediate (8). Oxidation using the Swern Oxidation, Dess-Martin's Periodinane or other methods as described in Oxidation in Organic Chemistry (M. Hudlicky, ACS Monograph 186 (1990)) yields the ketone (9). Although the compounds described herein may be administered as pure chemicals, it is preferable to present the active ingredient as a pharmaceutical composition. The invention thus further provides the use of a pharmaceutical composition comprising one or more compounds together with one or more pharmaceutically acceptable carriers thereof and, optionally, other therapeutic and/or prophylactic ingredients. The carrier(s) must be `acceptable` in the sense of being compatible with the other ingredients of the composition and not deleterious to the recipient thereof. Pharmaceutical compositions include those suitable for oral or parenteral (including intramuscular, subcutaneous and intravenous) administration. The compositions may, where appropriate, be conveniently presented in discrete unit dosage forms and may be prepared by any of the methods well known in the art of pharmacy. Such methods include the step of bringing into association the active compound with liquid carriers, solid matrices, semi-solid carriers, finely divided solid carriers or combination thereof, and then, if necessary, shaping the product into the desired delivery system. Pharmaceutical compositions suitable for oral administration may be presented as discrete unit dosage forms such as hard or soft gelatin capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or as granules; as a solution, a suspension or as an emulsion. The active ingredient may also be presented as a bolus, electuary or paste. Tablets and capsules for oral administration may contain conventional excipients such as binding agents, fillers, lubricants, disintegrants, or wetting agents. The tablets may be coated according to methods well known in the art, e.g., with enteric coatings. Oral liquid preparations may be in the form of, for example, aqueous or oily suspension, solutions, emulsions, syrups or elixirs, or may be presented as a dry product for constitution with water or other suitable vehicle before use. Such liquid preparations may contain conventional additives such as suspending agents, emulsifying agents, non-aqueous vehicles (which may include edible oils), or preservatives. The compounds may also be formulated for parenteral administration (e.g., by injection, for example, bolus injection or continuous infusion) and may be presented in unit dose form in ampules, pre-filled syringes, small bolus infusion containers or in multi-dose containers with an added preservative. The compositions may take such forms as suspensions, solutions, or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents. Alternatively, the active ingredient may be in powder form, obtained by aseptic isolation of sterile solid or by lyophilization from solution, for constitution with a suitable vehicle, e.g., sterile, pyrogen-free water, before use. For topical administration to the epidermis, the compounds may be formulated as ointments, creams or lotions, or as the active ingredient of a transdermal patch. Suitable transdermal delivery systems are disclosed, for example, in Fisher et al. (U.S. Pat. No. 4,788,603) or Bawas et al. (U.S. Pat. Nos. 4,931,279, 4,668,504 and 4,713,224). Ointments and creams may, for example, be formulated with an aqueous or oily base with the addition of suitable thickening and/or gelling agents. Lotions may be formulated with an aqueous or oily base and will in general also contain one or more emulsifying agents, stabilizing agents, dispersing agents, suspending agents, thickening agents, or coloring agents. The active ingredient can also be delivered via iontophoresis, e.g., as disclosed in U.S. Pat. Nos. 4,140,122, 4,383,529, or 4,051,842. Compositions suitable for topical administration in the mouth include unit dosage forms such as lozenges comprising active ingredient in a flavored base, usually sucrose and acacia or tragacanth; pastilles comprising the active ingredient in an inert base such as gelatin and glycerin or sucrose and acacia; mucoadherent gels, and mouthwashes comprising the active ingredient in a suitable liquid carrier. When desired, the above-described compositions can be adapted to provide sustained release of the active ingredient employed, e.g., by combination thereof with certain hydrophilic polymer matrices, e.g., comprising natural gels, synthetic polymer gels or mixtures thereof. The pharmaceutical compositions according to the invention may also contain other adjuvants such as flavorings, coloring, antimicrobial agents, or preservatives. It will be further appreciated that the amount of the compound, or an active salt or derivative thereof, required for use in treatment will vary not only with the particular salt selected but also with the route of administration, the nature of the condition being treated and the age and condition of the patient and will be ultimately at the discretion of the attendant physician or clinician. In general, however, a suitable dose will be in the range of from about 0.5 to about 100 mg/kg/day, e.g., from about 1 to about 75 mg/kg of body weight per day, such as 3 to about 50 mg per kilogram body weight of the recipient per day, preferably in the range of 6 to 90 mg/kg/day, most preferably in the range of 15 to 60 mg/kg/day. The compound is conveniently administered in unit dosage form, for example, containing 0.5 to 1000 mg, conveniently 5 to 750 mg, and most conveniently, 10 to 500 mg of active ingredient per unit dosage form. Ideally, the active ingredient should be administered to achieve peak plasma concentrations of the active compound of from about 0.5 to about 75 .mu.M, more preferably, about 1 to 50 .mu.M, and most preferably, about 2 to about 30 .mu.M. This may be achieved, for example, by the intravenous injection of a 0.05 to 5% solution of the active ingredient, optionally in saline, or orally administered as a bolus containing about 0.5-500 mg of the active ingredient. Desirable blood levels may be maintained by continuous infusion to provide about 0.01-5.0 mg/kg/hr or by intermittent infusions containing about 0.4-15 mg/kg of the active ingredient(s). The desired dose may be conveniently presented in a single dose or as divided doses administered at appropriate intervals, for example, as two, three, four or more sub-doses per day. The sub-dose itself may be further divided, e.g., into a number of discrete loosely spaced administrations, such as multiple inhalations from an insufflator or by application of a plurality of drops into the eye. While the invention has been described in connection with specific embodiments thereof, it will be understood that it is capable of further modifications and this application is intended to cover any variations, uses, or adaptations of the invention following, in general, the principles of the invention and including such departures from the present disclosure as come within known or customary practice within the art to which the invention pertains and as may be applied to the essential features hereinbefore set forth, and as follows in the scope of the appended claims. |
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