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Single Isomer Versus Racemate: Is There a Difference? Clinical Comparisons in Allergy and Gastroenterology

Published online by Cambridge University Press:  07 November 2014

David A. Flockhart  and
Harold S. Nelson
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Abstract

Many commonly prescribed drugs exist as a mixture of two distinct chiral isomer forms (enantiomers), each with its own unique chemistry, receptor affinity, and pharmacokinetic profile. Much is unknown concerning the clinical utility of these single enantiomers. This review of the stereoisomers of two commonly used drugs—albuterol for asthma and omeprazole for gastroesophageal reflux disease (GERD) and peptic ulcers—examines the improved efficacy, pharmacokinetics, decreased adverse effects, and fewer drug-drug interactions associated with single enantiomers.

Type
Research Article
Information
CNS Spectrums , Volume 7 , Issue S1: The Biological and Clinical Significance of Single Isomers , April 2002 , pp. 23 - 27
Copyright
Copyright © Cambridge University Press 2002

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References

REFERENCES

1.Nelson, HS. Clinical experience with levalbuterol. J Allergy Clin Immunol. 1999;104:S77–S84.CrossRefGoogle ScholarPubMed
2.Mazzoni, L, Naef, R, Chapman, ID, Morley, J. Hyperresponsiveness of the airways to histamine following exposure of guinea pigs to racemic mixtures and distomers of (2-selective sympathomimetics). Pulm Pharmacol. 1994;7:367–376.CrossRefGoogle ScholarPubMed
3.Mitra, S, Mehmet, U, Ugur, O, Goodman, HM, McCullough, JR, Yamaguchi, H. (S)-albuterol increases intracellular free calcium by muscarinic receptor activation and a phospholipase C-dependent mechanism in airway smooth muscle. Mol Pharmacol. 1998;53:347–354.CrossRefGoogle Scholar
4.Koch, P, McCullough, JR, DeGraw, SS, et al.Pharmacokinetics and safety of (R)-, (S)-, and (R,S)- albuterol following nebulization in healthy volunteers. Am J Respir Crit Care Med. 1997;155:A279.Google Scholar
5.Perrin-Fayolle, M. Salbutamol in the treatment of asthma. Lancet. 1995;346:1101.CrossRefGoogle ScholarPubMed
6.Nelson, HS, Bensch, G, Pleskow, WW, et al.Improved bronchodilation with levalbuterol compared with racemic albuterol in patients with asthma. J Allergy Clin Immunol. 1998;102:943–952.CrossRefGoogle ScholarPubMed
7.Gawchik, S, Saccar, MNoonan, C, Reasner, DS, Degraw, SS. The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients. J Allergy Clin Immunol. 1999;103:615–621.CrossRefGoogle ScholarPubMed
8.Spencer, CM, Faulds, D. Esomeprazole. Drugs. 2000;60:321–329.CrossRefGoogle ScholarPubMed
9.Hassan-Alin, M, Andersson, T, Bredberg, E, Rohss, K. Pharmacokinetics of esomeprazole after oral and intravenous administration of single and repeated doses to healthy subjects. Eur J Clin Pharmacol. 2000;56:665–670.CrossRefGoogle ScholarPubMed
10.Abelo, A, Andersson, TB, Antonsson, M, Naudot, AK, Skanberg, I, Weidolf, L. Stereoselective metabolism of omeprazole by human cytochrome P450 enzymes. Drug Metab Dispos. 2000;28:966–972.Google ScholarPubMed
11.Balian, JD, Sukhova, N, Harris, JW, et al.The hydroxylation of omeprazole correlates with S-mephenytoin: a population study. Clin Pharmacol Ther. 1995;57:662–669.CrossRefGoogle ScholarPubMed
12.Ko, JW, Sukhova, N, Thacker, D, Chen, P, Flockhard, DA. Evaluation of omeprazole and lansoprazole as inhibitors of cytochrome P450 isoforms. Drug Metab Dispos. 1997;25:853–862.Google ScholarPubMed
13.Andersson, T, Andren, K, Cederberg, C, Edvardsson, G, Heggelund, A, Lundberg, P. Effect of omeprazole and cimetidine on plasma diazepam levels. Eur J Clin Pharmacol. 1990;39:51–54.CrossRefGoogle ScholarPubMed
14.Lind, T, Rydberg, L, Kyleback, A, et al.Esomeprazole provides improved acid control vs omeprazole in patients with symptoms of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2000;14:861–867.CrossRefGoogle ScholarPubMed