Organic Chemistry Quiz: Paracetamol and Quinine Synthesis
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Questions and Answers

What is the IUPAC name of Paracetamol?

  • N-acetyl-para-aminophenol
  • N-(4-hydroxyphenyl)-acetamide (correct)
  • Tylenol
  • Acetaminophen
  • What is the primary concern associated with high levels of methaemoglobinemia?

  • Respiratory issues
  • Liver and kidney damage (correct)
  • Skin rashes
  • Stomach ulcers
  • Who were the first researchers to demonstrate that acetanilide is metabolized to paracetamol?

  • Stork and Kondo
  • Axelrod and Brodie (correct)
  • Woodward and Doering
  • Rabe and Kindler
  • What is a primary reason for the numerous names associated with Paracetamol?

    <p>Multiple manufacturers. (D)</p> Signup and view all the answers

    What is the primary mechanism of action for paracetamol in reducing fever?

    <p>Inhibition of cyclooxygenase (COX) enzymes in the brain (A)</p> Signup and view all the answers

    Which of these enzymes is responsible for the metabolism of paracetamol into its major metabolites, sulfate and glucuronide conjugates?

    <p>None of the above (D)</p> Signup and view all the answers

    What is the alkylating metabolite of paracetamol that can cause toxicity in the liver?

    <p>N-acetyl-p-benzo-quinone imine (NAPQI) (B)</p> Signup and view all the answers

    How does acetylcysteine help treat paracetamol overdose?

    <p>It stimulates the production of more glutathione. (C)</p> Signup and view all the answers

    Which of these factors can lower the toxic dose of paracetamol?

    <p>Concomitant alcohol consumption (D)</p> Signup and view all the answers

    What is the main route of excretion of paracetamol's inactive metabolites?

    <p>Through the kidneys (A)</p> Signup and view all the answers

    Which of these statements is TRUE about paracetamol metabolism?

    <p>Paracetamol is metabolized into both active and inactive metabolites. (C)</p> Signup and view all the answers

    Which of the following is NOT a symptom of paracetamol overdose?

    <p>Increased blood pressure (A)</p> Signup and view all the answers

    Which of the following infectious diseases has the highest case fatality rate?

    <p>Rabies (D)</p> Signup and view all the answers

    What is the primary mode of transmission for malaria?

    <p>Bites from infected female Anopheles mosquitos (B)</p> Signup and view all the answers

    In the WHO African Region, what percentage of global malaria cases were reported in 2023?

    <p>94% (D)</p> Signup and view all the answers

    What is the plant from which quinine is derived?

    <p>Cinchona tree bark (A)</p> Signup and view all the answers

    What is the approximate number of estimated malaria deaths worldwide in 2023?

    <p>597,000 (D)</p> Signup and view all the answers

    Who is credited with the naming of the Cinchona bark?

    <p>Carolus Linnaeus (C)</p> Signup and view all the answers

    Besides quinine, what other medicinal alkaloid is found in Cinchona bark that has an effect on the heart?

    <p>Quinidine (D)</p> Signup and view all the answers

    What was the main conclusion that Dr. Samuel Hahnemann made after taking large doses of Peruvian bark?

    <p>'Like cures like' (B)</p> Signup and view all the answers

    What discovery is Alphonse Laveran known for in relation to malaria?

    <p>The motile parasite responsible for malaria (A)</p> Signup and view all the answers

    Which of the following options describes quinine?

    <p>An analgesic and antipyretic compound (C)</p> Signup and view all the answers

    Which chemists are credited with isolating quinine from the cinchona tree?

    <p>Pierre Joseph Pelletier and Joseph Caventou (D)</p> Signup and view all the answers

    What chemical formula represents quinine?

    <p>C20H24N2O2 (D)</p> Signup and view all the answers

    What is one of the key properties of quinine that contributes to its pairing with tonic water?

    <p>Bitterness (B)</p> Signup and view all the answers

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    Flashcards

    Five Deadliest Infectious Diseases

    Infectious diseases with the highest mortality rates.

    Malaria

    A tropical disease caused by parasites transmitted through infected mosquitoes.

    Cinchona

    The genus of trees that produce quinine, a drug used for malaria treatment.

    Quinine

    An alkaloid found in Cinchona bark that interferes with malaria parasite reproduction.

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    "Like Cures Like"

    The principle behind homeopathy, where a substance that causes symptoms in a healthy person can be used to treat the same symptoms in a sick person.

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    Samuel Hahnemann

    The founder of homeopathy who developed the idea of "like cures like" after taking large doses of quinine and experiencing malaria-like symptoms.

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    Medicinal Chemistry

    The scientific study of the relationship between chemical structure and biological activity.

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    Mortality Rate

    The number of deaths caused by a specific disease in a population.

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    Total Synthesis

    The process of creating a complex molecule from simpler ones, often starting from scratch.

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    Isomerisation

    A specific type of chemical reaction where a molecule is rearranged into a different structure.

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    Quinotoxine

    A compound derived from quinine, used in the synthesis of quinine.

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    Stork/Woodward Controversy

    A controversy surrounding the priority and accuracy of the first total synthesis of quinine.

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    Homomeroquinene

    A specific molecule that served as a key intermediate in a disputed quinine synthesis.

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    Quinine Synthesis

    An important milestone in organic chemistry, indicating the successful creation of a complex molecule from simpler ones.

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    Discovery of the Malaria Parasite

    The discovery of the organism responsible for causing malaria, a significant advancement in understanding the disease.

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    Chiral Resolution

    The process of resolving a racemic mixture (equal amounts of enantiomers) into its individual enantiomers, separating the mirror-image forms of a chiral molecule.

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    Stereoselective Quinine Synthesis

    A specific type of quinine synthesis utilizing a stereoselective approach, which emphasizes controlling the formation of specific stereoisomers during the synthesis.

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    Paracetamol

    A chemical compound used as an analgesic (pain reliever) and antipyretic (fever reducer), commonly known as acetaminophen in the United States.

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    International Nonproprietary Name (INN)

    The official name assigned to a drug by the World Health Organization (WHO), typically in the Latin language, to standardize international usage.

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    Acetanilide

    A chemical compound that was initially used as an analgesic and antipyretic but was later discovered to cause methemoglobinemia, a potentially serious side effect.

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    Methemoglobinemia

    A condition where the iron in red blood cells is oxidized to a form that cannot carry oxygen effectively, leading to tissue oxygen deficiency.

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    How does Paracetamol work?

    Paracetamol is a pain reliever and fever reducer that works by inhibiting the COX enzyme in the brain. This action reduces inflammation and pain signals.

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    How is Paracetamol metabolized?

    Paracetamol is metabolized in the liver primarily into inactive sulfate and glucuronide conjugates, which are then excreted by the kidneys.

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    What is NAPQI?

    A small amount of Paracetamol is metabolized by CYP2E1 and CYP1A2 enzymes in the liver. This process produces a toxic metabolite called NAPQI.

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    How is NAPQI toxicity prevented normally?

    NAPQI is usually quickly detoxified by glutathione in the liver. However, in overdose situations, the detoxification pathway becomes saturated, leading to liver damage.

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    What happens when the liver can't detoxify NAPQI?

    When Paracetamol overdose overwhelms the liver's detoxification system, NAPQI accumulates, causing damage to liver cells. This can lead to liver failure and death.

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    How does Acetylcysteine treat Paracetamol overdose?

    Acetylcysteine is a medication used to treat Paracetamol overdose. It works by replenishing the liver's supply of glutathione, helping detoxify NAPQI.

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    How does alcohol affect Paracetamol?

    Alcohol consumption can lower the toxic dose of Paracetamol. This means that the same amount of Paracetamol can be more dangerous when alcohol is involved.

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    What happens if Paracetamol overdose is not treated?

    Without proper treatment, symptoms of liver failure can appear 16 to 36 hours after a Paracetamol overdose. This can lead to death due to acute liver failure.

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    Study Notes

    Medicinal Chemistry Introduction

    • Medicinal chemistry is a branch of chemistry focused on drug discovery and design.
    • Course number CH456, © 2025, James H. Gerlach

    Five Deadliest Infectious Diseases

    • Rabies: Essentially 100% case fatality rate.
    • Ebola haemorrhagic fever: 83% case fatality rate.
    • Marburg haemorrhagic fever: 80% case fatality rate.
    • H5N1 avian influenza: ~60% case fatality rate.
    • Nipah virus: 40% to 70% case fatality rate.

    Share of Total Disease Burden by Cause, World 2021

    • Data measured in Disability-Adjusted Life Years (DALYs).
    • DALYs measure the total disease burden from lost years of life due to death and years lived with disability.
    • Cardiovascular diseases account for a significant portion, at 14.9%.
    • Respiratory infections and TB account for 12.1%

    Share of Total Disease Burden by Cause, Canada 2021

    • Data measured in DALYs (Disability-Adjusted Life Years)
    • Cancer accounts for 16.6% of the disease burden
    • Cardiovascular diseases account for 13.1%
    • Musculoskeletal disorders account for 11.3%

    Disease Burden from Communicable, Maternal, Neonatal and Nutritional Diseases, World

    • Data from 1990 to 2021 in millions of DALYs (Disability-Adjusted Life Years)
    • Respiratory infections and TB, maternal disorders, nutritional deficiencies, other infectious diseases, HIV/AIDS and STIs, Malaria and neglected tropical diseases, enteric infections, neonatal disorders are presented in the graph

    Disease Burden from Communicable, Maternal, Neonatal and Nutritional Diseases, Canada

    • Data from 1990 to 2021 in thousands of DALYs (Disability-Adjusted Life Years)
    • Respiratory infections and TB, maternal disorders, nutritional deficiencies, other infectious diseases, HIV/AIDS and STIs, Malaria and neglected tropical diseases, enteric infections, neonatal disorders are presented in the graph

    Deaths from Infectious Diseases, 1980 to 2021, World

    • The annual number of deaths from HIV/AIDS, diarrhea, malaria, respiratory infections, and all other infectious diseases.
    • Shows a decreasing trend from 1980 to 2021.

    Deaths from Infectious Diseases, 1980 to 2021, Canada

    • Estimated annual number of deaths from HIV/AIDS, diarrhea, malaria, respiratory infections, and all other infectious diseases.
    • Shows an increasing trend from 1980 to 2021.
    • Information about TB deaths and mortality rates for the period of 2000-2020 is presented
    • Data displayed using a log scale for both the number of deaths and mortality rates.

    The Deadliest and Most Communicable Diseases

    • Information about different communicable diseases, their case fatality rates, and their contagiousness is presented
    • Diseases such as Rabies, Ebola, Avian Flu, Plague, and MERS are presented
    • The primary transmission methods of each disease is provided (e.g., airborne, bites, body fluids, etc.).
    • Information on contagiousness is provided (Ro - Basic Reproduction Number)
    • Various diseases such as HIV, Malaria, Measles are listed

    Malaria is the Disease Responsible Historically for the Most Worldwide Deaths

    • Malaria is a life-threatening disease caused by parasites transmitted by infected female Anopheles mosquitoes.
    • In 2023, there were an estimated 263 million cases globally.
    • An estimated 597,000 deaths in 2023 from malaria.
    • The WHO African Region has a disproportionately high burden of malaria, with 94% of cases and 95% of deaths in 2023.

    Countries with Indigenous Cases of Malaria in 2000 and Their Status by 2023

    • A map visualizes regions with indigenous malaria cases in 2000 and their status in 2023.

    Quinine

    • Cinchona bark contains quinine, an antimalarial drug.
    • The bark is medicinally active containing alkaloids
    • Quinine, interferes with the reproduction of malaria-causing protozoa.
    • Quinidine is an antiarrhythmic drug.
    • The Peruvian bark was brought to Europe in 1640s
    • Quinine was named after the Countess of Chinchon

    Homeopathy and Cinchona

    • The birth of homeopathy was based on Cinchona bark testing.
    • Dr. Samuel Hahnemann was a founder of homeopathy in 1796.
    • He conceived homeopathy while translating Cullen's Materia medica in 1789.
    • Peruvian bark was known to cure intermittent fevers (malaria).
    • Hahnemann developed the "like cures like" principle

    Discovery of the Malaria Parasite

    • Alphonse Laveran discovered the malaria parasite in 1878 while studying blood samples of patients in Algeria.
    • He was a military doctor.
    • He was awarded a Nobel Prize in 1907

    Quinine (Chemical Properties)

    • Quinine is a natural, white crystalline alkaloid.
    • It is antimalarial, analgesic, antipyretic, anti-inflammatory.
    • Bitter taste, used in Gin and Tonic.

    Quinine Total Synthesis

    • Efforts to synthesize quinine took over 150 years.
    • Pelletier and Caventou isolated quinine from the cinchona tree in 1817.
    • Louis Pasteur produced quinotoxine from quinine in 1853.
    • William Perkin attempted quinine synthesis in 1856.
    • Paul Rabe established correct atom connectivity in 1907.
    • Rabe and Kindler synthesized quinine from quinotoxine, reversing the Pasteur chemistry (1918).
    • Woodward and Doering synthesized quinine in 1944, starting from 7-hydroxyisoquinoline.
    • Chloroquine (1934): An antimalarial drug.
    • Amodiaquine (1948): An antimalarial drug.

    Paracetamol (Acetaminophen)

    • Paracetamol is an analgesic and antipyretic drug.
    • IUPAC name: N-(4-hydroxyphenyl)-acetamide.
    • Other names include APAP, para-acetamidophenol.

    Paracetamol Total Synthesis

    • Phenol is nitrated with dilute H2SO4 and NaNO3 to form 4-nitrophenol.
    • Fractionally distilled to obtain the 4-isomer
    • Reduce 4-nitrophenol to 4-aminophenol using NaBH4
    • React 4-aminophenol with acetic anhydride to form Paracetamol

    Paracetamol Mechanism of Action

    • Paracetamol acts via the cyclooxygenase (COX) pathway.
    • It reduces the oxidized form of the COX enzyme to treat fever and pain.
    • May act by inhibiting the COX-3 isozyme.
    • Paracetamol is metabolized to AM404, which may inhibit uptake of anandamide to reduce pain.
    • AM404 may also affect sodium channels in a similar way to local anaesthetics

    Paracetamol Metabolism

    • Primarily metabolized in the liver.
    • Major metabolites are sulfate and glucuronide conjugates, excreted by the kidneys.
    • Minor metabolites are metabolized via the hepatic cytochrome P450 system, mainly CYP2E1 and CYP1A2.
    • Produces the potentially toxic N-acetyl-p-benzo-quinone imine (NAPQI).

    NAPQI Toxicity

    • NAPQI is a potentially toxic metabolite.
    • It's produced in small amounts.
    • Fast detoxification by reacting with glutathione.
    • Overdose can saturate detoxification pathways, leading to liver damage.

    Treating Paracetamol Overdoses

    • A toxic dose of Paracetamol varies from 4-6g.
    • A lethal dose varies from 10-15 g.
    • Concomitant alcohol consumption lowers the toxic dose.
    • Treatment with acetylcysteine, administered within 8 hours, is the best approach.
    • Acetylcysteine replenishes the liver's glutathione supply.

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    Test your knowledge on key concepts related to paracetamol and quinine synthesis as discussed in significant publications. This quiz covers synthesis methods, metabolic pathways, and the historical context of these important compounds in organic chemistry.

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