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Questions and Answers
What is the IUPAC name of Paracetamol?
What is the IUPAC name of Paracetamol?
What is the primary concern associated with high levels of methaemoglobinemia?
What is the primary concern associated with high levels of methaemoglobinemia?
Who were the first researchers to demonstrate that acetanilide is metabolized to paracetamol?
Who were the first researchers to demonstrate that acetanilide is metabolized to paracetamol?
What is a primary reason for the numerous names associated with Paracetamol?
What is a primary reason for the numerous names associated with Paracetamol?
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What is the primary mechanism of action for paracetamol in reducing fever?
What is the primary mechanism of action for paracetamol in reducing fever?
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Which of these enzymes is responsible for the metabolism of paracetamol into its major metabolites, sulfate and glucuronide conjugates?
Which of these enzymes is responsible for the metabolism of paracetamol into its major metabolites, sulfate and glucuronide conjugates?
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What is the alkylating metabolite of paracetamol that can cause toxicity in the liver?
What is the alkylating metabolite of paracetamol that can cause toxicity in the liver?
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How does acetylcysteine help treat paracetamol overdose?
How does acetylcysteine help treat paracetamol overdose?
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Which of these factors can lower the toxic dose of paracetamol?
Which of these factors can lower the toxic dose of paracetamol?
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What is the main route of excretion of paracetamol's inactive metabolites?
What is the main route of excretion of paracetamol's inactive metabolites?
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Which of these statements is TRUE about paracetamol metabolism?
Which of these statements is TRUE about paracetamol metabolism?
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Which of the following is NOT a symptom of paracetamol overdose?
Which of the following is NOT a symptom of paracetamol overdose?
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Which of the following infectious diseases has the highest case fatality rate?
Which of the following infectious diseases has the highest case fatality rate?
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What is the primary mode of transmission for malaria?
What is the primary mode of transmission for malaria?
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In the WHO African Region, what percentage of global malaria cases were reported in 2023?
In the WHO African Region, what percentage of global malaria cases were reported in 2023?
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What is the plant from which quinine is derived?
What is the plant from which quinine is derived?
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What is the approximate number of estimated malaria deaths worldwide in 2023?
What is the approximate number of estimated malaria deaths worldwide in 2023?
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Who is credited with the naming of the Cinchona bark?
Who is credited with the naming of the Cinchona bark?
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Besides quinine, what other medicinal alkaloid is found in Cinchona bark that has an effect on the heart?
Besides quinine, what other medicinal alkaloid is found in Cinchona bark that has an effect on the heart?
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What was the main conclusion that Dr. Samuel Hahnemann made after taking large doses of Peruvian bark?
What was the main conclusion that Dr. Samuel Hahnemann made after taking large doses of Peruvian bark?
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What discovery is Alphonse Laveran known for in relation to malaria?
What discovery is Alphonse Laveran known for in relation to malaria?
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Which of the following options describes quinine?
Which of the following options describes quinine?
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Which chemists are credited with isolating quinine from the cinchona tree?
Which chemists are credited with isolating quinine from the cinchona tree?
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What chemical formula represents quinine?
What chemical formula represents quinine?
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What is one of the key properties of quinine that contributes to its pairing with tonic water?
What is one of the key properties of quinine that contributes to its pairing with tonic water?
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Flashcards
Five Deadliest Infectious Diseases
Five Deadliest Infectious Diseases
Infectious diseases with the highest mortality rates.
Malaria
Malaria
A tropical disease caused by parasites transmitted through infected mosquitoes.
Cinchona
Cinchona
The genus of trees that produce quinine, a drug used for malaria treatment.
Quinine
Quinine
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"Like Cures Like"
"Like Cures Like"
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Samuel Hahnemann
Samuel Hahnemann
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Medicinal Chemistry
Medicinal Chemistry
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Mortality Rate
Mortality Rate
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Total Synthesis
Total Synthesis
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Isomerisation
Isomerisation
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Quinotoxine
Quinotoxine
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Stork/Woodward Controversy
Stork/Woodward Controversy
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Homomeroquinene
Homomeroquinene
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Quinine Synthesis
Quinine Synthesis
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Discovery of the Malaria Parasite
Discovery of the Malaria Parasite
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Chiral Resolution
Chiral Resolution
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Stereoselective Quinine Synthesis
Stereoselective Quinine Synthesis
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Paracetamol
Paracetamol
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International Nonproprietary Name (INN)
International Nonproprietary Name (INN)
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Acetanilide
Acetanilide
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Methemoglobinemia
Methemoglobinemia
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How does Paracetamol work?
How does Paracetamol work?
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How is Paracetamol metabolized?
How is Paracetamol metabolized?
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What is NAPQI?
What is NAPQI?
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How is NAPQI toxicity prevented normally?
How is NAPQI toxicity prevented normally?
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What happens when the liver can't detoxify NAPQI?
What happens when the liver can't detoxify NAPQI?
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How does Acetylcysteine treat Paracetamol overdose?
How does Acetylcysteine treat Paracetamol overdose?
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How does alcohol affect Paracetamol?
How does alcohol affect Paracetamol?
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What happens if Paracetamol overdose is not treated?
What happens if Paracetamol overdose is not treated?
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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.
Global Trends in the Estimated Number of TB deaths and the Mortality Rate, 2000-2020
- 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.
Related Antimalarial Drugs
- 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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Description
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.