Details
| Stereochemistry | MIXED |
| Molecular Formula | C22H25N2OS.C10H15O4S |
| Molecular Weight | 596.8 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 2 / 6 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
CC1(C)[C@@H]2CC[C@@]1(CS([O-])(=O)=O)C(=O)C2.O=C3N(CC4=CC=CC=C4)C5C[S+]6CCCC6C5N3CC7=CC=CC=C7
InChI
InChIKey=HALWUDBBYKMYPW-STOWLHSFSA-M
InChI=1S/C22H25N2OS.C10H16O4S/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;1-9(2)7-3-4-10(9,8(11)5-7)6-15(12,13)14/h1-6,8-11,19-21H,7,12-16H2;7H,3-6H2,1-2H3,(H,12,13,14)/q+1;/p-1/t;7-,10-/m.1/s1
| Molecular Formula | C22H25N2OS |
| Molecular Weight | 365.512 |
| Charge | 1 |
| Count |
|
| Stereochemistry | MIXED |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 4 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
| Molecular Formula | C10H15O4S |
| Molecular Weight | 231.289 |
| Charge | -1 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 2 / 2 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
Trimethaphan (or Trimethaphan camsylate), a ganglionic blocking agent and an antihypertensive drug, was marketed under the brand name Arfonad. Arfonad is indicated to induce systemic arterial hypotension in patients undergoing major surgery and to treat severe systemic hypertension, and in the emergency treatment of pulmonary edema in patients with pulmonary hypertension associated with systemic hypertension. Trimethaphan prevents stimulation of postsynaptic receptors by competing with acetylcholine for these receptor sites. Additional effects may include direct peripheral vasodilation and release of histamine. This drug was discontinued because of the competition from newer drugs that are more selective in their actions and effects.
Approval Year
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | ARFONAD Approved UseHypotension, controlled (induction and maintenance) - Trimethaphan is indicated for production of controlled hypotension during surgery to reduce bleeding into the surgical field. Hypertension (treatment) - Trimethaphan is indicated 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. |
Doses
| Dose | Population | Adverse events |
|---|---|---|
9 mg/min 1 times / day multiple, intravenous Studied dose Dose: 9 mg/min, 1 times / day Route: intravenous Route: multiple Dose: 9 mg/min, 1 times / day Sources: |
unhealthy, 23 to 66 years Health Status: unhealthy Age Group: 23 to 66 years Sex: M+F Sources: |
Disc. AE: Respiratory arrest... AEs leading to discontinuation/dose reduction: Respiratory arrest Sources: |
0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
Other AEs: Yawning, Sensation of warmth... Other AEs: Yawning Sources: Sensation of warmth Nausea Vomiting Pallor Dizziness |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Respiratory arrest | Disc. AE | 9 mg/min 1 times / day multiple, intravenous Studied dose Dose: 9 mg/min, 1 times / day Route: intravenous Route: multiple Dose: 9 mg/min, 1 times / day Sources: |
unhealthy, 23 to 66 years Health Status: unhealthy Age Group: 23 to 66 years Sex: M+F Sources: |
| Dizziness | 0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
|
| Nausea | 0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
|
| Pallor | 0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
|
| Sensation of warmth | 0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
|
| Vomiting | 0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
|
| Yawning | 0.115 mg/kg 1 times / day single, intravenous Studied dose Dose: 0.115 mg/kg, 1 times / day Route: intravenous Route: single Dose: 0.115 mg/kg, 1 times / day Sources: |
pregnant, adult |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Role of the multidomain protein spinophilin in blood pressure and cardiac function regulation. | 2008-10 |
|
| Cerebral blood-flow responses to induced hypotension and to CO2 inhalation in patients with major cerebral artery occlusive disease: a positron-emission tomography study. | 1999-02 |
|
| Effects of trimetaphan-induced deliberate hypotension on human cochlear blood flow. | 1998 |
|
| Differential microcirculation dynamics during deliberate hypotension induced by nicardipine, PGE1 and trimethaphan in rat mesentery. | 1995-11 |
|
| Trimetaphan may cause coronary artery spasm. | 1995-09 |
|
| Cerebral blood flow distribution during induced hypotension with haemorrhage, trimetaphan or nitroprusside in rats. | 1995-06 |
|
| [Effect of deliberate hypotension on renal functions during epidural block plus inhalation anesthesia: a comparison of prostaglandin E1 and trimethaphan]. | 1994-10 |
|
| Epidural blood flow during prostaglandin E1 or trimethaphan induced hypotension. | 1994-04 |
|
| Epidural blood flow during prostaglandin E1 or trimethaphan induced hypotension. | 1993-11 |
|
| Effects of ischemia duration on neurological outcome, CA1 histopathology, and nonmatching to sample learning in monkeys. | 1992-10 |
|
| [Pharmacokinetics of epidurally administered bupivacaine during prostaglandin E1- or trimetaphan-induced hypotension]. | 1992-05 |
|
| Chronic lesion of rostral ventrolateral medulla in spontaneously hypertensive rats. | 1992-02 |
|
| [Effects of induced hypotensive anesthesia on the blood coagulation-fibrinolysis system measured by thrombelastography--comparison between prostaglandin E1 and trimethaphan]. | 1992-01 |
|
| [Baroreceptor reflex response to acute blood loss during induced hypotension--a comparison of sodium nitroprusside, prostaglandin E1 and trimethaphan]. | 1990-05 |
|
| The hemodynamic and metabolic changes in prostaglandin E1-induced hypotension in dogs--a comparative study with trimetaphan-induced hypotension. | 1989-09-01 |
|
| Acute left bundle branch block precipitated by trimethaphan. | 1989-09 |
|
| [Difference in susceptibility between auditory and equilibrium function in rabbits with experimentally-induced transient ischemic attack]. | 1989-02 |
|
| The effect of trimethaphan-induced hypotension on canine spinal cord blood flow. Measurement at different cord levels using radiolabelled microspheres. | 1988-05 |
|
| [Effect of trimethaphan-induced hypotension on carbohydrate metabolism]. | 1986-10 |
|
| The influence of trimethaphan (Arfonad)-induced hypotension with and without spine distraction on canine spinal cord blood flow. | 1986-04 |
|
| [Effect of trimethaphan-induced hypotension on pituitary-adrenocortical function]. | 1986-03 |
|
| Regional blood flows during induced hypotension produced by nitroprusside or trimethaphan in the rhesus monkey. | 1985-08 |
|
| Hemodynamics and myocardial metabolism under deliberate hypotension. An experimental study in dogs. | 1983-12 |
|
| Changes in cardiac output and systemic arterial pressure after insertion of acrylic cement during trimetaphan, sodium nitroprusside and glycerol trinitrate-induced hypotension. A comparison with changes during normotension. | 1983-08 |
|
| [Effect of hypotension induced by trimethaphan and nitroglycerin on intraocular pressure in man]. | 1983-02 |
|
| Profound arterial hypotension in dogs: brain electrical activity and organ integrity. | 1983-01 |
|
| Cerebral and systemic effects of hypotension induced by trimetaphan or nitroprusside in dogs. | 1982-12 |
|
| Trimethaphan-induced hypotension: effect on renal function. | 1982-11 |
|
| Altered osmotic threshold for vasopressin release and impaired thirst sensation: additional abnormalities in Kallmann's syndrome. | 1982-10 |
|
| Autoregulation of myocardial blood flow under controlled hypotension in the dog. | 1982-06 |
|
| [The effects of controlled hypotension induced by prostaglandin E1 and trimethaphan on coronary and systemic hemodynamics and myocardial contractility (author's transl)]. | 1982-04 |
|
| [A comparison of the metabolic effects of hypotension induced by arteriotomy, trimethaphan, nitroprusside, or deep halothane in dog (author's transl)]. | 1981-09 |
|
| Brain blood flow and metabolism after global ischemia and post-insult thiopental therapy in monkeys. | 1979-09-01 |
|
| Postischemic brain oxygenation with barbiturate therapy in rats. | 1979-08 |
|
| Cerebral energy levels during trimethaphan-induced hypotension in the rat: effects of light versus deep halothane anesthesia. | 1979-01 |
|
| [Use of methoxamine in trimethaphan-induced hypotension]. | 1979-01 |
|
| Prolonged apnea following trimethaphan and succinylcholine. | 1979-01 |
|
| [Electrocardiographic changes observed during the use of trimethaphan in the treatment of malignant arterial hypertension]. | 1978-08 |
|
| Selective osmoreceptor dysfunction in the syndrome of chronic hypernatremia. | 1977-04 |
|
| Canine systemic and cerebral effects of hypotension induced by hemorrhage, trimethaphan, halothane, or nitroprusside. | 1977-03 |
|
| Pyramidal tract responses (PTR) during hypoxia and hypotension. | 1976-09-01 |
|
| [The effects of sodiumnitroprusside and trimethaphan induced hypotension on haemodynamics and myocardial oxygen consumption (author's transl)]. | 1976-01 |
Patents
Sample Use Guides
Controlled hypotension during surgery:
Initial: Intravenous infusion, 3 to 4 mg per minute, adjusted according to response. Maintenance: Intravenous infusion, 300 mcg (0.3 mg) to 6 mg per minute.
Hypertensive emergency: Initial: Intravenous infusion, 500 mcg (0.5 mg) to 1 mg per minute, adjusted according to response. Maintenance: Intravenous infusion, 1 to 5 mg per minut
Route of Administration:
Intravenous
| Substance Class |
Chemical
Created
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Edited
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| Record UNII |
8W556014K9
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| Record Status |
Validated (UNII)
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| Record Version |
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NCI_THESAURUS |
C270
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NCI_THESAURUS |
C66886
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100000076923
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Trimetaphan camsilate
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SUB11305MIG
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38680
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C66639
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9729
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DBSALT001381
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C017774
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m11146
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