CN104364241A - Compositions and methods for suppression of carbonic anhydrase activity - Google Patents

Abstract

Provided are the compounds of formula (I) or its pharmaceutical acceptable salts, as well as polymorphs, solvates, enantiomers, stereoisomers and hydrates thereof. The pharmaceutical compositions comprising an effective amount of compounds of formula (I), and methods for treating or preventing or modulating carbonic anhydrase activity in a disease may be formulated for oral, buccal, rectal, topical, transdermal, transmucosal, intravenous, parenteral admimstration, syrup, or injection. Such compositions may be used to treatment of glaucoma, epileptic seizures, Idiopathic intracranial hypertension (pseudotumor cerebri), altitude sickness, cystinuria, periodic paralysis and dural ectasia, congestive heart failure, drug induced edema, diuretic, intermittent claudication resulting from obstructed arteries in the limbs, and vascular dementia.

Description

Compositions and methods for inhibiting carbonic anhydrase activity

Priority

This application claims the benefit of indian provisional patent application No.1810/CHE/2012, filed on 8/5/2012, and relies on the entire disclosure of this provisional patent application for all purposes and is incorporated by reference into this application.

Technical Field

The present disclosure relates generally to compounds and compositions for inhibiting carbonic anhydrase activity. More particularly, the present invention relates to treating a subject with a pharmaceutically acceptable dose of a compound, stereoisomer, enantiomer, crystal, ester, salt, hydrate, prodrug or mixtures thereof.

Background

Carbonic anhydrases (CAs; also known as carbonic anhydrases EC 4.2.1.1) are metalloenzymes ubiquitous in prokaryotes and eukaryotes encoded by four evolutionarily unrelated gene families. Catalysis of CO by CAs₂Simple physiological reactions to bicarbonate ions and protons. Most active sites of CAs contain zinc ions (Zn) necessary to catalyze the reaction²⁺). CA responses are involved in many physiological and pathological processes, including respiration and CO₂And bicarbonate transport between metabolic tissue and lung; pH and CO₂The homeostasis of (a); electrolyte secretion in various tissues and organs; biosynthetic reactions (e.g., gluconeogenesis, lipogenesis, and uric acid formation); bone resorption; calcification; and tumorigenicity.

Many CA isozymes involved in these processes are important therapeutic targets, and they have the potential to be inhibited for the treatment of numerous diseases including edema, glaucoma, obesity, cancer, epilepsy, and osteoporosis. Two major classes of CA inhibitors (CAIs) are known: metal-complexing anions and unsubstituted sulfonamides, and their bioisosteres. CAIs include the traditional inhibitors acetazolamide, methazolamide, isoxaflutole, thiothiazine and dichlorsulphanilamide.

Reduced compounds (thiols) are less bulky and exhibit superior CA inhibitory activity (in the low nanomolar range) compared to the corresponding sterically hindered disulfides, which are difficult to access into the limited space of the active site of the enzyme and have low bioavailability and poor pharmacokinetics with common side effects such as numbness of the toes, taste disturbances, dyskinesias, paresthesia and blurred vision of the face and extremities.

Management of acute lesions often relies on addressing the underlying pathology and symptoms of the disease. There is a need in the art for new compositions to treat or delay the progression of the onset of carbonic anhydrase activity and its associated complications.

Disclosure of Invention

The present invention provides compounds, compositions containing these compounds, and methods of using them to treat, prevent and/or ameliorate the effects of conditions, such as complications or diseases, manifested as carbonic anhydrase activity.

The present invention herein provides compositions comprising formula I or a pharmaceutically acceptable salt thereof. The invention also provides pharmaceutical compositions comprising one or more compounds of formula I or intermediates thereof together with one or more pharmaceutically acceptable carriers, vehicles or diluents. These compositions can be used to inhibit carbonic anhydrase activity and its associated complications.

In certain embodiments, the present invention relates to compounds and compositions of formula I, or a pharmaceutically acceptable salt thereof,

wherein,

R¹each independently represent D, H,

R²Each independently represent

a is independently 2, 3 or 7;

each b is independently 3, 5 or 6;

e is independently 1, 2 or 6;

c and d are each independently H, D, -OH, -OD, C₁To C₆Alkyl, -NH of₂or-COCH₃；

R³Independently H, D, methyl, F, Cl, ethyl or acetyl.

In exemplary embodiments, examples of compounds of formula I are listed below:

the present application also provides kits comprising any of the pharmaceutical compositions disclosed herein. The kit may comprise instructions for use in inhibiting carbonic anhydrase activity or its associated complications.

Also disclosed are pharmaceutical compositions comprising a pharmaceutically acceptable carrier and any of the compounds described herein. In some aspects, the pharmaceutical composition is formulated for systemic administration, oral administration, sustained release, parenteral administration, injection, subcutaneous administration, or transdermal administration.

Here, the present application further provides kits comprising the pharmaceutical compositions described herein. The kit may further comprise instructions for use in inhibiting carbonic anhydrase activity or its associated complications.

The compositions described herein have several uses. The present application provides methods for treating diseases or disorders associated with diseases or disorders that are mediated by carbonic anhydrase activity or manifested as neurodegenerative diseases, neurological disorders, metabolic conditions or disorders, metabolic syndrome, chronic diseases or disorders; methods of treating a patient suffering from hyperinsulinemia, insulin resistance, glucose intolerance, liver disease, cancer, respiratory, blood, skeletal, cardiovascular, renal, skin, neurological or ocular complications.

Detailed Description

Definition of

As used herein, the following terms and phrases shall have the meanings as set forth below. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art.

The compounds of the present invention may exist in the form of pharmaceutically acceptable salts. The compounds of the invention may also be present in the form of pharmaceutically acceptable esters (i.e., the methyl and ethyl esters of the acids of formula I to be used as prodrugs). The compounds of the present invention may also be solvated, i.e. hydrated. The solvation may take place or take place during the manufacturing process, i.e. due to the hygroscopic nature of the initial anhydrous compound of formula I (hydration).

Compounds having the same molecular formula but differing in nature or in the order of their atomic connections or in the arrangement of their atoms in space are referred to as "isomers". Isomers that differ in their arrangement in atomic space are referred to as "stereoisomers". Diastereomers are stereoisomers that have opposite configurations at one or more chiral centers than enantiomers. Stereoisomers with one or more asymmetric centers that mirror each other but are not superimposable are referred to as "enantiomers". When a compound has an asymmetric center, for example, if one carbon atom is attached to four different groups, it is possible to form a pair of enantiomers. Enantiomers can be characterized by their absolute configuration of the asymmetric center or centers and are described and designated as dextrorotatory or levorotatory (i.e., designated as (+) or (-) isomers, respectively) by the R and S ordering rules of Cahn, Ingold and Prelog, or by the way the molecule rotates the plane of polarized light. Chiral compounds may exist as a single enantiomer or as a mixture thereof. Mixtures containing equal proportions of enantiomers are referred to as "racemic mixtures".

As used herein, the term "metabolic condition" refers to an inborn error of metabolism (or a genetic metabolic condition), which is a genetic disease caused by a defect in one or more metabolic pathways; in particular, the function of the enzyme is affected, resulting in a deficiency or complete absence of the enzyme.

In some embodiments, the molecular conjugates comprise a compound selected from the group consisting of R-lipoic acid (CAS No.1200-22-2), salsalate (CAS No.552-94-3), acetylcysteine (CAS No.616-91-1), eicosapentaenoic acid (CAS No.10417-94-4), docosahexaenoic acid (CAS No. 6217-54-5).

The term "polymorph" as used herein is art-recognized and refers to one crystal structure of a given compound.

The phrases "parenteral administration" and "parenterally administered" as used herein refer to modes of administration (e.g., injection) other than enteral and topical administration, and include, without limitation, intravenous, intramuscular, intrapleural, intravascular, intrapericardial, intraarterial, intrathecal, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid, intraspinal and intrasternal injection and infusion.

The "patient", "subject" or "host" to be treated by the subject methods may refer to humans or non-human animals such as primates, mammals, and vertebrates.

The phrase "pharmaceutically acceptable" is art-recognized. In certain embodiments, the term includes compositions, polymers, and other materials and/or dosage forms that are, within the scope of sound medical judgment, suitable for use in contact with the tissues of mammals, humans and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.

The phrase "pharmaceutically acceptable carrier" is art-recognized and includes, for example, pharmaceutically acceptable materials, compositions or vehicles, such as liquid or solid fillers, diluents, solvents or encapsulating materials, involved in carrying or transporting any of the subject compositions from one organ or portion of the body to another organ or portion of the body. Each carrier must be "acceptable" in the sense of being compatible with the other ingredients of the subject composition and not injurious to the patient. In certain embodiments, the pharmaceutically acceptable carrier is non-pyrogenic. Some examples of pharmaceutically acceptable carriers that can be used include: (1) sugars such as lactose, glucose and sucrose; (2) starches, such as corn starch and potato starch; (3) cellulose and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; (4) powdered tragacanth; (5) malt; (6) gelatin; (7) talc; (8) cocoa butter and suppository waxes; (9) oils such as peanut oil, cottonseed oil, sunflower oil, sesame oil, olive oil, corn oil and soybean oil; (10) glycols, such as propylene glycol; (11) polyols such as glycerol, sorbitol, mannitol and polyethylene glycol; (12) esters, such as ethyl oleate and ethyl laurate; (13) agar; (14) buffering agents such as magnesium hydroxide and aluminum hydroxide; (15) alginic acid; (16) pyrogen-free water; (17) isotonic saline; (18) ringer's solution (Ringer's solution); (19) ethanol; (20) a phosphate buffer solution; and (21) other non-toxic compatible materials used in pharmaceutical formulations.

The term "prodrug" is intended to include compounds that are converted under physiological conditions to the therapeutically active agents of the present invention. A common method of making prodrugs is to include selected moieties that hydrolyze under physiological conditions to release the desired molecule. In other embodiments, the prodrug is converted by the enzymatic activity of the host animal.

The term "prophylactic or therapeutic" treatment is art-recognized and includes the administration of one or more subject compositions to a host. If administered prior to clinical manifestation of the undesired condition (e.g., disease or other undesired state of the host animal), the treatment is prophylactic, i.e., protects the host from developing the undesired condition; whereas if administered after exhibiting an undesirable condition, the treatment is therapeutic (i.e., intended to reduce, alleviate or stabilize an existing undesirable condition or side effects thereof).

The term "predicting" as used herein refers to assessing the probability (i.e. mortality) that a patient with the relevant disease will suffer from an abnormality or complication and/or end platelet aggregation or failure and/or death within a specified future time window (prediction window). The mortality may be caused by the central nervous system or complications. The prediction window is the time interval over which the subject will develop one or more of the above complications based on the predicted probability. The prediction window may be the total remaining life of the object when analyzed by the method of the present invention.

The term "treating" is art-recognized and includes preventing the occurrence of a disease, disorder, or condition in an animal that may be predisposed to developing such a disease, disorder, and/or condition but has not yet been diagnosed as having the disease, disorder, or condition; inhibiting the disease, disorder, or condition, e.g., arresting the development of the disease, disorder, or condition; and alleviating the disease, disorder, or condition, e.g., causing regression of the disease, disorder, and/or condition. Treatment of a disease or condition includes alleviation of at least one symptom of a particular disease or condition, even without affecting the underlying pathophysiology, such as treatment of glaucoma, seizures, idiopathic increased intracranial pressure (pseudoencephaloma), altitude sickness, cystinuria, periodic paralysis and dural dilatation, congestive heart failure, drug-induced edema, intermittent claudication and vascular dementia caused by vascular occlusion of the extremities, improvement of blood flow through peripheral vessels and thus aid in blood circulation in the arms and legs (i.e. intermittent claudication) and brain (and thus use in vascular dementia), peyronie's disease and neurological damage, prevention of stroke and for the control of sickle cell disease, treatment of high mountain-induced nausea and headaches (altitude sickness), and has been shown to alleviate mortality in acute alcoholic and non-alcoholic steatohepatitis and alcoholic liver disease, Reducing the severity of fibrotic lesions induced by radiation therapy of breast cancer, intravenous treatment of cytokine release syndrome, type 1 and type 2 diabetes, asthma, bronchiectasis, neuroprotective properties, vasodilation, alzheimer's disease, dementia, stroke, and treatment of endometriosis. By administering an agent, even where such agent does not treat the cause of the condition, it is also useful for treating venous disease in a subject. The term "treatment" as used herein includes curative, preventative (e.g., prophylactic), adjuvant and palliative treatment.

The phrase "therapeutically effective amount" is a term recognized in the art. In certain embodiments, the term refers to the amount of a salt or composition disclosed herein that produces some desired effect at a reasonable benefit/risk ratio applicable to any medical treatment. In certain embodiments, the term refers to an amount necessary or sufficient to eliminate or reduce a medical condition over a period of time. The effective amount may vary depending on factors such as the disease or condition being treated, the particular targeting construct being administered, the size of the subject, or the severity of the disease or condition. One of ordinary skill in the art can empirically determine an effective amount of a particular composition without undue experimentation.

In certain embodiments, the pharmaceutical compositions described herein are formulated in a manner such that the compositions can be delivered to a patient in a therapeutically effective amount as part of a prophylactic or therapeutic treatment. The desired amount of the composition to be administered to a patient will depend on the absorption, inactivation, and excretion rates of the drug as well as the delivery rate of the salt and composition from the subject composition. It is noted that dosage values may also vary with the severity of the condition to be alleviated. It is to be further understood that for any particular subject, the specific dosage regimen will be adjusted over time according to the individual need and the professional judgment of the person administering or instructing the administration of the composition. In general, the dosage will be determined using techniques known to those skilled in the art.

In addition, the optimum concentration and/or amount or dosage of any particular salt or composition may be adjusted to accommodate variations in the treatment parameters. These treatment parameters include the clinical use to which the formulation is administered (e.g., the site of treatment), the type of patient (e.g., human or non-human, adult or pediatric), and the nature of the disease or condition.

In certain embodiments, the dosage of the subject compositions provided herein can be determined by reference to the plasma concentration of the therapeutic composition or other encapsulating material. For example, the maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve from 0 to infinity may be used.

The term "sustained release" when used in reference to a pharmaceutical composition or other material is art-recognized. For example, a subject composition that releases a substance over time may exhibit sustained release characteristics as opposed to a single bolus (bolus) type administration that makes a full dose of the substance bioavailable at a time. For example, in particular embodiments, upon contact with bodily fluids (including blood, spinal fluid, mucous secretions, lymph fluids, or the like), one or more pharmaceutically acceptable excipients may undergo gradual or delayed degradation (e.g., by hydrolysis) over a sustained or extended period of time (as compared to a single bolus release) while releasing any substances (e.g., therapeutic agents and/or bioactive salts and/or compositions) contained therein. Such release may allow for prolonged delivery of a therapeutically effective amount of any of the therapeutic agents disclosed herein.

The phrases "systemic administration," "peripheral administration," and "peripheral administration" are art-recognized and include administration of the subject compositions, therapeutic drugs, or other materials at a site remote from the site of treatment of the disease. For administration of an agent for treating a disease, unless administered directly into the central nervous system (e.g., by subcutaneous administration), even if the agent is subsequently distributed systemically, it may be referred to as "local", "local" or "regional" administration, entering the patient's body system, and thereby undergoing metabolic and like processes.

The phrase "therapeutically effective amount" is a term recognized in the art. In certain embodiments, the term refers to the amount of a salt or composition disclosed herein that produces some desired effect at a reasonable benefit/risk ratio applicable to any medical treatment. In certain embodiments, the term refers to an amount necessary or sufficient to eliminate or reduce a medical condition over a period of time. The effective amount may vary depending on factors such as the disease or condition being treated, the particular targeting construct being administered, the size of the subject, or the severity of the disease or condition. One of ordinary skill in the art can empirically determine an effective amount of a particular composition without undue experimentation.

The present disclosure also contemplates prodrugs of the compositions disclosed herein, as well as pharmaceutically acceptable salts of the prodrugs.

Pharmaceutical compositions comprising a pharmaceutically acceptable carrier are also disclosed, and compositions of the compounds of formula I can be formulated for systemic, topical, or oral administration. The pharmaceutical composition may also be formulated for oral administration, oral solution, injection, subcutaneous administration or transdermal administration. The pharmaceutical composition may further comprise at least one of pharmaceutically acceptable stabilizers, diluents, surfactants, fillers, binders and lubricants.

In many embodiments, the pharmaceutical compositions described herein will comprise the disclosed compounds and compositions to be delivered (formula I) in an amount sufficient to deliver a therapeutically effective amount of the compound or composition of formula I to a patient, as part of a prophylactic or therapeutic treatment. The desired concentration of formula I or a pharmaceutically acceptable salt thereof will depend on the absorption, inactivation, and excretion rates of the drug as well as the delivery rates of the salt and composition from the subject composition. It is noted that dosage values may also vary with the severity of the condition to be alleviated. It is to be further understood that for any particular subject, the specific dosage regimen will be adjusted over time according to the individual need and the professional judgment of the person administering or instructing the administration of the composition. In general, the dosage will be determined using techniques known to those skilled in the art.

In addition, the optimum concentration and/or amount or dosage of any particular compound of formula I can be adjusted to accommodate variations in the treatment parameters. These treatment parameters include the clinical use to which the formulation is administered (e.g., the site of treatment), the type of patient (e.g., human or non-human, adult or pediatric), and the nature of the disease or condition.

The concentration and/or dosage of any compound of formula I can be readily determined by periodic examination of the animal (e.g., mouse) using an appropriate assay to examine a range of concentrations and/or dosages of the substance to be determined. Known methods may also be used to assay local tissue concentration, diffusion rate of salts or compositions, and local blood flow before and after administration of a therapeutic agent formulation disclosed herein. One such method is microdialysis, as described by t.e. robinson et al in Techniques, volume 7, chapter 1, microdialysis in the neurosciences, 1991. Briefly, the method described by Robinson may be implemented as follows. The microdialysis ring is placed in situ in the test animal. Dialysate is pumped through the loop. When a compound of formula I, such as disclosed herein, is injected near the ring, the released drug accumulates in the dialysate in proportion to its local tissue concentration. Thus, the diffusion process of a salt or composition can be determined by a suitable calibration procedure using known concentrations of the salt or composition.

In certain embodiments, the dosage of the subject compounds of formula I provided herein can be determined by reference to the plasma concentration of the therapeutic composition or other encapsulating material. For example, the maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve from 0 to infinity may be used.

In general, in practicing the methods detailed herein, an effective dose of a compound of formula I is a single or divided dose in the range of about 0.01 mg/kg/day to about 100 mg/kg/day, e.g., a single or divided dose in the range of 0.01 mg/kg/day to about 50 mg/kg/day. The compound of formula I may be administered, for example, at a dosage of less than 0.2 mg/kg/day, 0.5 mg/kg/day, 1.0 mg/kg/day, 5 mg/kg/day, 10 mg/kg/day, 20 mg/kg/day, 30 mg/kg/day, or 40 mg/kg/day. The compound of formula I may also be administered to a human patient at a dose of, for example, between 0.1mg and 1000mg, between 5mg and 80mg, or less than 1.0, 9.0, 12.0, 20.0, 50.0, 75.0, 100, 300, 400, 500, 800, 1000, 2000, 5000mg per day. In certain embodiments, the compositions herein are administered in an amount that is less than 95%, 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, or 10% of the compound of formula I required to obtain the same therapeutic benefit.

An effective amount of a compound of formula I as described herein refers to an amount of one of the salts or compositions that is capable of inhibiting or preventing a disease.

An effective amount may be sufficient to prevent, treat, alleviate, halt, inhibit, delay or reverse the progression of, or reduce the severity of, such complications in patients at risk of such complications due to nerve damage or demyelination and/or elevated reactive oxidative-nitrogenated species and/or physiological dysregulation. In this regard, these methods optionally include medical therapeutic (acute) and/or prophylactic (prophylactic) administration. The dosage and time of administration of the composition will, of course, depend on the subject being treated, the severity of the affliction, the mode of administration and the judgment of the prescribing physician. Thus, the dosages given above are a guide due to patient-to-patient variation, and the physician can titrate the dosage of the drug to achieve a treatment that the physician deems appropriate for the patient. In considering the degree of treatment desired, the physician must balance a number of factors, such as the age of the patient, the presence of existing disease, and the presence of other diseases.

The compositions provided by the present application may be administered to a subject in need of treatment by a variety of conventional routes of administration, including oral, topical, parenteral (e.g., intravenous, subcutaneous, or intramedullary injection). Also, the compositions may be administered intranasally, as rectal suppositories, or using "quick" formulations (even if the drug dissolves in the oral cavity without the use of water). Furthermore, the composition may be administered to a subject in need of treatment by controlled release dosage forms, site-specific drug delivery, transdermal drug delivery, patch (active/passive) mediated drug delivery, by stereotactic injection, or in the form of nanoparticles.

The compositions may be administered alone or in combination with a pharmaceutically acceptable carrier, vehicle or diluent, in single or multiple doses. Suitable pharmaceutical carriers, vehicles and diluents include inert solid diluents or fillers, sterile aqueous solutions and various organic solvents. The pharmaceutical composition formed by mixing the above composition with a pharmaceutically acceptable carrier, vehicle or diluent is then easily administered in various dosage forms such as tablets, powders, troches, syrups, injectable solutions and the like. These pharmaceutical compositions may contain additional ingredients, such as flavoring agents, binders, excipients, and the like, if desired. Thus, for the purpose of oral administration, tablets containing various excipients such as L-arginine, sodium citrate, calcium carbonate and calcium phosphate may be used together with various disintegrants such as starch, alginic acid and specific complex silicates, together with binders such as polyvinylpyrrolidone, sucrose, gelatin and gum arabic. In addition, lubricating agents such as magnesium stearate, sodium lauryl sulfate and talc are often used for tableting purposes. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules. Suitable materials for this purpose include lactose or milk sugar and high molecular weight polyethylene glycols. When aqueous suspensions or elixirs are desired for oral administration, the essential active ingredient therein may be combined with various sweetening or flavoring agents, coloring matter or dyes and emulsifying or suspending agents, if desired, together with diluents such as water, ethanol, propylene glycol, glycerin and combinations thereof. The compounds of formula I may also comprise an enteric coating (enterically coated) containing various excipients, as is well known in the pharmaceutical art.

For parenteral administration, solutions of the compositions may be prepared, for example, in sesame or peanut oil, aqueous propylene glycol, or sterile aqueous solutions may be used. Such aqueous solutions should be suitably buffered if necessary, and the liquid diluent should first be made isotonic with sufficient physiological saline or glucose. These particular aqueous solutions are particularly suitable for intravenous, intramuscular, subcutaneous and intraperitoneal administration. In this connection, the sterile aqueous medium used can be readily obtained by standard techniques known to those skilled in the art.

A formulation such as a tablet may contain, for example, 10 to 100, 50 to 250, 150 to 500mg or 350 to 800mg, for example 10, 50, 100, 300, 500, 700, 800mg of a compound of formula I as disclosed herein, for example a compound of formula I or a pharmaceutically acceptable salt of a compound of formula I.

Generally, a composition as described herein can be administered orally or parenterally (e.g., intravenously, intramuscularly, subcutaneously, or intramedullary). Local administration may also be indicated, for example, where the patient is suffering from a gastrointestinal disorder that prevents oral administration, or when the attending physician determines that it is most appropriate to apply the drug to the surface of a tissue or organ. Site-specific administration may also be indicated, for example, when a higher dose is required at the target tissue or organ. For buccal administration, the active composition may take the form of tablets or lozenges formulated in conventional manner.

The dose administered will depend on the nature of the metabolic disease; the type of host involved (including its age, health and weight); the kind of concurrent therapy (if any); treatment frequency and treatment ratio.

Illustratively, the dosage levels of the active ingredients administered, based on the body weight of the host, are: intravenous, 0.1 to about 200 mg/kg; intramuscular injection, 1 to about 500 mg/kg; orally, 5 to about 1000 mg/kg; intranasal instillation, 5 to about 1000 mg/kg; spray, 5 to about 1000 mg/kg.

Expressed in terms of concentration, the active ingredient may be included in the compositions of the invention at a concentration of from about 0.01 to about 50% w/w of the composition for topical use at the periphery of the skin, intranasally, in the throat, in the bronchi, intravaginally, rectally, or in the eye; preferably from about 1 to about 20% w/w of the composition; for parenteral use, however, the concentration may be from about 0.05 to about 50% w/v of the composition; preferably from about 5 to about 20% w/v.

The compositions of the present invention are preferably presented for administration to humans and animals in unit dosage forms containing appropriate amounts of the active ingredient, such as tablets, capsules, pills, powders, granules, suppositories, sterile injectable solutions or suspensions, sterile non-injectable solutions or suspensions, and oral solutions or suspensions, and the like. For oral administration, it may be prepared in the form of solid or liquid unit doses.

As discussed above, the tablet core contains one or more hydrophilic polymers. Suitable hydrophilic polymers include, but are not limited to, water swellable cellulose derivatives, polyalkylene glycols, thermoplastic polyalkylene oxides, acrylic polymers, hydrocolloids, clays, gelling starches, swelling cross-linked polymers, and mixtures thereof. Examples of suitable water swellable cellulose derivatives include, but are not limited to, sodium carboxymethylcellulose, cross-linked hydroxypropyl cellulose, hydroxypropyl cellulose (HPC), hydroxypropyl methyl cellulose (HPMC), hydroxyisopropyl cellulose, hydroxybutyl cellulose, hydroxyphenyl cellulose, hydroxyethyl cellulose (HEC), hydroxypentyl cellulose, hydroxypropyl ethyl cellulose, hydroxypropyl butyl cellulose, and hydroxypropyl ethyl cellulose, and mixtures thereof. Examples of suitable polyalkylene glycols include, but are not limited to, polyethylene glycol. Examples of suitable thermoplastic polyalkylene oxides include, but are not limited to, poly (ethylene oxide). Examples of suitable acrylic polymers include, but are not limited to, potassium methacrylate-divinylbenzene copolymers, polymethyl methacrylate, high molecular weight crosslinked acrylic acid homopolymers and copolymers (e.g., commercially available from Noveon Chemicals under the name CARBOPOL^TMHigh molecular weight crosslinked acrylic acid homopolymers and copolymers). Examples of suitable hydrocolloids include, but are not limited to, alginate, agar, guar gum, locust bean gum, kappa carrageenan, iota carrageenan, tara gum, gum arabic, tragacanth gum, pectin, xanthan gum, gellan gum, maltodextrin, galactomannan, umbilicin (pusstulan), laminarin, scleroglucan, gum arabic, inulin, pectin, gelatin, welan gum, and the likeGums (whelan), neutral gums, zoogles (zooglan), methylene blue, chitin, cyclodextrins, chitosan and mixtures thereof. Examples of suitable clays include, but are not limited to, montmorillonites such as bentonite, kaolin, and hectorite; magnesium trisilicate; magnesium aluminum silicate; and mixtures thereof. Examples of suitable gelling starches include, but are not limited to, acid-hydrolyzed starch, swollen starches such as sodium starch glycolate and derivatives thereof, and mixtures thereof. Examples of suitable swellable cross-linked polymers include, but are not limited to, cross-linked polyvinylpyrrolidone, cross-linked agar, and cross-linked sodium carboxymethyl cellulose, and mixtures thereof.

The carrier may contain one or more suitable excipients for the formulation of tablets. Examples of suitable excipients include, but are not limited to, fillers, adsorbents, binders, disintegrants, lubricants, glidants, release modifying excipients, super disintegrants, antioxidants, and mixtures thereof.

Suitable binders include, but are not limited to: dry binders such as polyvinylpyrrolidone and hydroxypropylmethylcellulose; wet binders, for example water soluble polymers, include hydrocolloids such as gum arabic, alginates, agar, guar gum, locust bean gum, carrageenan, carboxymethylcellulose, tara gum, gum arabic, tragacanth gum, pectin, xanthan gum, gellan gum, gelatin, maltodextrin, galactomannan, umbilicin, laminarin, scleroglucan, inulin, welan gum, neutral gum, gellan gum, carageenan, chitin, cyclodextrin, chitosan, polyvinylpyrrolidone, cellulosics, sucrose and starch, and mixtures thereof. Suitable disintegrants include, but are not limited to, sodium starch glycolate, cross-linked polyvinylpyrrolidone, cross-linked carboxymethylcellulose, starch, microcrystalline cellulose, and mixtures thereof.

Suitable lubricants include, but are not limited to, long chain fatty acids and salts thereof (e.g., magnesium stearate and stearic acid), talc, glycerides, waxes, and mixtures thereof. Suitable glidants include, but are not limited to, colloidal silicon dioxide. Suitable release modifying excipients include, but are not limited to, insoluble edible materials, pH dependent polymers, and mixtures thereof.

Insoluble edible materials suitable for use as release modifying excipients include, but are not limited to, water insoluble polymers and low melting hydrophobic materials, copolymers thereof, and mixtures thereof. Examples of suitable water-insoluble polymers include, but are not limited to, ethyl cellulose, polyvinyl alcohol, polyvinyl acetate, polycaprolactone, cellulose acetate and its derivatives, acrylates, methacrylates, acrylic copolymers, copolymers thereof, and mixtures thereof. Suitable low melting hydrophobic materials include, but are not limited to, fats, fatty acid esters, phospholipids, waxes, and mixtures thereof. Examples of suitable fats include, but are not limited to, hydrogenated vegetable oils such as cocoa butter, hydrogenated palm kernel oil, hydrogenated cottonseed oil, hydrogenated sunflower oil, and hydrogenated soybean oil, free fatty acids and salts thereof, and mixtures thereof. Examples of suitable fatty acid esters include, but are not limited to, sucrose fatty acid esters, mono-, di-, and triglycerides of glycerol, glyceryl behenate, glyceryl palmitostearate, glyceryl monostearate, glyceryl tristearate, glyceryl trilaurate, glyceryl myristate, GlycoWax-932, lauroyl polyethylene glycol-32 glyceride, stearoyl polyethylene glycol-32 glyceride, and mixtures thereof. Examples of suitable phospholipids include phosphatidylcholine, phosphatidylserine (phosphatidylserine), phosphatidylinositol (phosphatidylinositol), phosphatidic acid and mixtures thereof. Examples of suitable waxes include, but are not limited to, carnauba wax, spermaceti wax, beeswax, candelilla wax, shellac wax, microcrystalline wax, and paraffin wax; fat-containing mixtures such as chocolate, and mixtures thereof. Examples of super disintegrants include, but are not limited to, croscarmellose sodium, sodium starch glycolate, and crospovidone (crospovidone). In one embodiment, the tablet core contains up to about 5% by weight of such superdisintegrant.

Examples of antioxidants include, but are not limited to, tocopherol, ascorbic acid, sodium metabisulfite, butylated hydroxytoluene, butylated hydroxyanisole, ethylenediaminetetraacetic acid and ethylenediaminetetraacetate, and mixtures thereof. Examples of preservatives include, but are not limited to, citric acid, tartaric acid, lactic acid, malic acid, acetic acid, benzoic acid, and sorbic acid, and mixtures thereof.

In one embodiment, the immediate release coating has an average thickness of at least 50 microns, for example, from about 50 microns to about 2500 microns (such as from about 250 microns to about 1000 microns). In one embodiment, the immediate release coating is typically compressed to a density in excess of about 0.9g/cc as measured by the weight and volume of the particular layer.

In one embodiment, the immediate release coating comprises a first portion and a second portion, wherein at least one portion contains a second pharmaceutically active agent. In one embodiment, the two parts are in contact with each other at the central axis of the tablet. In one embodiment, the first portion comprises a first pharmaceutically active agent and the second portion comprises a second pharmaceutically active agent.

In one embodiment, the first portion contains a first pharmaceutically active agent and the second portion contains a second pharmaceutically active agent. In one embodiment, one of the portions contains a third pharmaceutically active agent. In one embodiment, one of said portions comprises a second immediate release portion of the same pharmaceutically active agent as contained in the core.

In one embodiment, the outer coating portion is formed into a dry blended material prior to being introduced into the coated core. In another embodiment, the outer coating portion comprises a dry granulation containing the pharmaceutically active agent.

The formulations having the different drug release mechanisms described above may be combined into a final dosage form containing single or multiple units. Examples of multiple units include multilayer tablets, capsules containing tablets, beads or granules in solid or liquid form. In general, immediate release formulations comprise compressed tablets, gels, films, coatings, liquids and granules that can be encapsulated in, for example, gel capsules. Many methods for preparing coatings, coverings, or conjugated drugs are known in the art.

The immediate release dosage unit in the dosage form, i.e., a tablet, multi-drug containing beads, granules or pellets, or a core-coated outer dosage form, contains a therapeutically effective amount of the active agent and conventional pharmaceutical excipients. The immediate release dosage unit may or may not be coated and may or may not be mixed with the delayed release dosage unit (mixed as an encapsulated mixture of particles, pellets or beads containing immediate release drug and particles or beads containing delayed release drug).

Delayed release formulations are typically formulated as diffusion or osmotic systems, for example, as described in "Remington-The Science and practice of Pharmacy" (20th. Ed., Lippincott Williams & Wilkins, Baltimore, Md., 2000). Diffusion systems are generally composed of one of two devices, a vessel and a matrix, which are well known and described in the art. Matrix devices are typically prepared by compressing the drug together with a slow dissolving polymeric carrier into a tablet dosage form.

The immediate release portion may be incorporated into the delayed release system by coating the delayed release core with an immediate release layer using a coating or compression process, or in a multi-unit system such as a capsule containing delayed and immediate release beads.

The delayed release dosage formulation is made by coating the solid dosage form with a film of a polymer that is insoluble in the acidic environment of the stomach but soluble in the neutral environment of the small intestine. Delayed release dosage units may be prepared, for example, by coating the drug or drug-containing composition with a selected coating material. The drug-containing composition may be a tablet incorporated into a capsule, a tablet used as an inner core in a "coated core" dosage form, or beads, pellets or granules containing multiple drugs incorporated into a tablet or capsule.

A pulsatile release dosage form is one that mimics the multiple dosing process without repeated dosing and typically reduces dosing frequency by at least two times compared to traditional dosed forms of drug (e.g., traditional solid dosage forms that are released as a solution or immediate drug). The pulsatile release process is characterized by either no release (lag time) or a reduced release over a period of time followed by a rapid drug release.

Each dosage form contains a therapeutically effective amount of the active agent. In one embodiment of the dosage form that mimics a twice daily dosing process, about 30 to 70 wt.%, preferably 40 to 60 wt.% of the total amount of active agent in the dosage form is released in the first pulse and about 70 to 30 wt.%, preferably 60 to 40 wt.% of the total amount of active agent in the dosage form is correspondingly released in the second pulse. For dosage forms that simulate a twice-daily dosing regimen, the second pulse is preferably released within about 3 hours to less than 14 hours, more preferably within about 5 hours to 12 hours, after administration.

Another dosage form contains a compressed tablet or capsule containing an immediate release dosage unit containing a drug, a delayed release dosage unit, and optionally a second delayed release dosage unit. In such dosage forms, the immediate release dosage unit contains a plurality of beads, granules, pellets which release the drug in large quantities immediately after oral administration to provide the initial dose. The delayed release dosage unit contains a plurality of coated beads or particles that release the drug about 3 to 14 hours after oral administration to provide a secondary dose.

For transdermal (e.g., topical) administration, dilute sterile aqueous or partially aqueous solutions (typically at concentrations of about 0.1% to 5%) may be prepared, otherwise similar to the injections described above.

Methods of preparing various pharmaceutical compositions containing a particular amount of one or more compounds of formula I or other active agents are known or will be apparent to those skilled in the art in light of this disclosure. For an example of a method for preparing a Pharmaceutical composition, see Remington's Pharmaceutical Sciences (Mack publishing company, Easton, Pa.,19th Edition (1995)).

Furthermore, in certain embodiments, the subject compositions of the present application may be lyophilized or subjected to another suitable drying technique, such as spray drying. The subject compositions may be administered at one time, or may be divided into multiple smaller doses for different periods of time, depending in part on the release rate of the composition and the desired dosage.

Formulations useful in the methods provided herein include those suitable for oral, nasal, topical (including buccal and sublingual), rectal, vaginal, spray and/or parenteral administration. The formulations may conveniently be presented in unit dosage form and may be prepared by any of the methods well known in the art of pharmacy. The amount of the subject composition that can be combined with a carrier material to make a single dose can vary depending on the subject being treated and the particular mode of administration.

Methods of making these formulations or compositions include the step of bringing into association the subject composition with a carrier and, optionally, one or more accessory ingredients. In general, the formulations are prepared by uniformly and intimately bringing into association the subject compositions with liquid carriers, finely divided solid carriers, or both, and then, if necessary, shaping the resulting product.

The compounds of formula I described herein may be administered in the form of an inhaled or nebulized formulation. The inhalation or nebulized formulation may comprise one or more pharmaceutical agents useful in inhalation therapy, such as adjuvants, diagnostic agents, imaging agents, or therapeutic agents. The final spray formulation may, for example, contain 0.005-90% w/w (e.g. 0.005-50%, 0.005-5% w/w or 0.01-1.0% w/w) of drug relative to the total weight of the formulation.

In solid dosage forms for oral administration (capsules, tablets, pills, dragees, powders and granules and the like), the subject compositions are mixed with one or more pharmaceutically acceptable carriers and/or any of the following: (1) fillers or extenders, such as starch, lactose, sucrose, glucose, mannitol, and/or silicic acid; (2) binders such as carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidone, sucrose and/or gum arabic; (3) humectants, such as glycerol; (4) disintegrating agents, such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, specific silicates, and sodium carbonate; (5) slow solvents, such as paraffin; (6) absorption promoters, such as quaternary ammonium compounds; (7) wetting agents, such as acetyl alcohol and glyceryl monostearate; (8) absorbents such as kaolin and bentonite clay; (9) lubricants, such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate and mixtures thereof; and (10) a colorant. In the case of capsules, tablets and pills, the pharmaceutical compositions may also comprise buffering agents. Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using lactose and high molecular weight polyethylene glycols and the like.

Liquid dosage forms for oral administration include pharmaceutically acceptable emulsions, microemulsions, solutions, suspensions, syrups and elixirs. In addition to the subject compositions, the liquid dosage forms may contain inert diluents commonly used in the art such as, for example, water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, diethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1, 3-butylene glycol, oils (in particular, cottonseed, corn, peanut, sunflower, soybean, olive, castor, and sesame oils), glycerol, tetrahydrofuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan, and mixtures thereof.

In addition to the subject compositions, suspensions may contain suspending agents, for example, ethoxylated isostearyl alcohols, polyoxyethylene sorbitol (polyoxyyethylene sorbent) and sorbitan esters, microcrystalline cellulose, aluminum hydroxide, bentonite, agar-agar, and tragacanth, and mixtures thereof.

Formulations for rectal or vaginal administration may be presented as a suppository, prepared by mixing the subject composition with one or more suitable non-irritating carriers comprising, for example, cocoa butter, polyethylene glycol, a suppository wax or salicylate, and which is solid at room temperature and liquid at body temperature and will therefore dissolve in a suitable body cavity and release the encapsulated compound and composition. Formulations suitable for vaginal administration also include pessaries, tampons, creams, gels, pastes, foams or spray formulations containing such carriers as are known in the art to be suitable for use.

Dosage forms for transdermal administration include powders, sprays, ointments, pastes, creams, lotions, gels, solutions, patches and inhalants. The subject compositions may be mixed under sterile conditions with a pharmaceutically acceptable carrier, and with any preservatives, buffers, or propellants which may be required. For transdermal administration, the complex may contain lipophilic and hydrophilic groups to achieve the desired water solubility and delivery properties.

In addition to the subject compositions, ointments, pastes, creams and gels can contain other carriers, such as animal and vegetable fats, oils, waxes, paraffins, starch, tragacanth, cellulose derivatives, polyethylene glycols, silicones, bentonites, silicic acid, talc and zinc oxide, or mixtures thereof. Powders and sprays can contain, in addition to the subject composition, excipients such as lactose, talc, silicic acid, aluminum hydroxide, calcium silicate, and polyamide powder, or mixtures of these substances. Sprays can additionally contain customary propellants, such as chlorofluorohydrocarbons and volatile unsubstituted hydrocarbons (e.g. butane and propane).

Methods of delivering compositions via transdermal patches are known in the art. Exemplary patches and methods of patch delivery are described in U.S. patent nos. 6,974,588, 6,564,093, 6,312,716, 6,440,454, 6,267,983, 6,239,180 and 6,103,275.

In another embodiment, a transdermal patch may include: a substrate sheet comprising a composite film formed of a resin composition containing 100 parts by weight of a polyvinyl chloride-polyurethane composite and 2-10 parts by weight of a styrene-ethylene-butylene-styrene copolymer; a first adhesive layer on one side of the composite film; a polyalkylene terephthalate film adhered on one side of the composite film by the first adhesive layer; a primer layer comprising a saturated polyester resin and formed on the surface of the polyalkylene terephthalate film; and a second adhesive layer formed on the primer layer, the second adhesive layer comprising a styrene-diene-styrene block copolymer containing a pharmaceutical agent. The method for preparing the substrate slice comprises the following steps: preparing the resin composition; molding the resin composition into a composite film by a calendering method; then adhering a polyalkylene terephthalate film on one side of the composite film through an adhesive layer, thereby forming a substrate sheet; and forming a primer layer comprising a saturated polyester resin on an outer surface of the polyalkylene terephthalate film.

Another type of patch involves introducing the drug directly into a pharmaceutically acceptable adhesive and laminating the drug-containing adhesive to a suitable substrate film, such as a polyester substrate film. The drug should be present at a concentration that does not affect the properties of the adhesive while delivering the desired clinical dose.

Transdermal patches may be passive or active. Currently available passive transdermal drug delivery systems (e.g., nicotine, estrogen, and nitroglycerin patches) deliver small molecule drugs. Many newly developed protein and peptide drugs are too large to be delivered by transdermal patches and can be delivered using, for example, electron assisted (iontophoresis) macromolecular drug technology.

Iontophoresis is a technique used to increase the flux of ionized substances through a membrane by applying an electric current. One example of an iontophoretic membrane is given in us patent numbers 5,080,646 to Theeuwes. The main mechanisms by which iontophoresis enhances the permeation of molecules through the skin are: (a) repelling charged ions from electrodes of the same charge; (b) electroosmosis, which is the response of a counter-ion preferential path when an electric field is applied, through charged pores, convective movement of solvent occurs; or (c) increase the permeability of the skin as a result of the application of an electric current.

In some cases, it may be desirable to administer the composition in the form of a kit, which may include containers for holding the individual compositions, such as divided bottles or separate foil packets. Generally, the kit comprises instructions for administration of the individual components. The form of the kit is particularly advantageous when the individual components are preferably administered in different dosage forms (e.g. oral and parenteral), are administered at different dosage intervals or when the prescribing physician desires to titrate the individual components of the composition.

An example of such a kit is a so-called blister pack. Blister packs are well known in the packaging industry and are widely used for the packaging of pharmaceutical unit dosage forms (tablets and capsules, etc.). Blister packs are typically constructed from a sheet of relatively rigid material covered with a foil of plastic material which may be transparent.

Methods and compositions for inhibiting carbonic anhydrase activity. Provided herein, among other things, is a method of treating a complication or disease manifested by carbonic anhydrase activity comprising administering to a patient in need thereof a therapeutically effective amount of a compound of formula I:

wherein,

R¹each independently represent D, H,

R²Each independently represent

a is independently 2, 3 or 7;

each b is independently 3, 5 or 6;

e is independently 1, 2 or 6;

c and d are each independently H, D, -OH, -OD, C₁To C₆Alkyl, -NH of₂or-COCH₃；

R³Independently H, D, methyl, F, Cl, ethyl or acetyl.

A method of using a compound of formula I:

the invention also includes methods of treating the following diseases: glaucoma, seizures, idiopathic intracranial hypertension (pseudocerebroma), altitude sickness, cystinuria, periodic paralysis and dural expansion, congestive heart failure, drug-induced edema, diuresis, intermittent claudication due to vascular occlusion of the extremities, and vascular dementia, improving blood flow through peripheral blood vessels and thus contributing to blood circulation in the extremities (i.e., intermittent claudication) and the brain (and thus used in vascular dementia), venous diseases, peyronie's disease, neurological damage, stroke, sickle cell disease, nausea and headache (altitude sickness) due to mountains, non-alcoholic steatohepatitis and alcoholic liver disease, fibrotic lesions due to radiation therapy of breast cancer, cytokine release syndrome, type 1 and 2 diabetes, asthma, bronchiectasis, kidney disease, kidney protection, vascular ischemia, Neuroprotection, vasodilation, Alzheimer's disease, dementia, stroke, endometriosis.

Preparation method

Examples of synthetic routes for preparing compounds of formula I are listed and summarized as scheme 1 in the examples below.

Scheme-1:

step-1: synthesis of Compound 2:

to a suspension of 608g (4.56 moles) of 2-amino-1, 3, 4-thiadiazole-5-thiol 1 in 456cc of water was added 301g (5.36 moles) of 85% potassium hydroxide to obtain a brown solution. The solution was clarified with Darco (g-60) (for filtration) and then diluted with 1300cc of ethanol. Benzyl chloride (575g,4.56 moles) was added rapidly with stirring, and a thick reaction mixture was formed immediately and stirred, cooled to 0 ℃, held for 30 minutes, and then diluted with 2L of cold water. Solid compound 2 was removed by filtration and then washed with water and diethyl ether.

Step-2: synthesis of Compound 3:

a suspension containing 4.0 moles of Compound 2 and 1500cc of acetic acid in 4.4 moles of acetic anhydride was heated to 60 ℃ for 10 minutes to give a clear solution. The solution was slowly cooled and 2L of water was added when crystals first appeared. The suspension was cooled to 0 ℃ and the solid compound 3 was collected by filtration.

Step-3: synthesis of Compound 4:

a suspension containing 0.50g of Compound 3 in 40cc of 50% aqueous acetic acid was chlorinated at 50 ℃ for half an hour. After this time, the solid was filtered off and then added to 20cc of liquid ammonia. After the ammonia was evaporated and the resulting dry residue was diluted with water, the aqueous solution was filtered. Acidification with hydrochloric acid gives the solid compound 4 with a melting point of 260 ℃.

Step-4: synthesis of Compound 5:

a solution of compound 4(15g,67.5 mmol) in a mixture of ethanol (100mL) and concentrated hydrochloric acid (30mL) was heated at reflux for 4.5 h, during which time the solid slowly precipitated. After the solution was cooled, the solvent was removed in vacuo and the solid residue was redissolved in H₂O (75 mL). The solution was basified to pH 7 with 5M sodium hydroxide and the precipitated product was collected by filtration and then recrystallized from water to give product 5(10.6g, 58.9mmol, 87%), mp 228-.

Step-5: synthesis of compound 7:

to a solution of 605mg of 5,8,11,14, 17-eicosapentaenoic acid 6 in 6ml of dry chloroform was added 0.25ml of oxalyl chloride under argon at room temperature. The mixture was reacted for 2 hours. Chloroform and the remaining oxalyl chloride were removed from the reaction mixture by distillation under reduced pressure to give 5,8,11,14, 17-eicosapentaenoic acid chloride 7, which was used directly in the next step.

Step-6: synthesis of compound 8:

a dry DMF solution (10ml) containing compound 5(2mmol) was suspended in anhydrous potassium carbonate (2.2mmol) at room temperature. To the reaction mixture was added dropwise a solution of 5,8,11,14, 17-eicosapentaenoic acid chloride 7 in 2ml of DMF solution, prepared as described above, containing 2mmol of the acid chloride 7, over 15 minutes, and the mixture was heated to 100 ℃ for 8 hours. Insoluble matter was removed from the reaction mixture by filtration, and then water was added to the filtrate. The mixture was extracted twice with ethyl acetate (2 × 10 ml). The organic layer of the extract was washed with water and dried over anhydrous sodium sulfate. Then, the solvent was distilled off under reduced pressure, and the obtained residue was purified by silica gel column chromatography to obtain pure compound 8.

The term "sample" refers to a sample of bodily fluid, to an isolated sample of cells or to a sample from a tissue or organ. Body fluid samples may be obtained by well known techniques and preferably comprise blood, plasma, serum or urine samples, more preferably blood, plasma or serum samples.

Equivalents of

The present disclosure provides, among other things, compositions and methods for treating diseases exhibiting carbonic anhydrase activity and complications thereof. While specific embodiments of the present disclosure have been discussed, the foregoing description is intended to be illustrative and not restrictive. Many variations of the systems and methods herein will become apparent to those skilled in the art upon review of this specification. The full scope of the claimed system and method should be determined by reference to the claims, along with their full scope of equivalents, and the specification, along with such variations.

Incorporation by reference

All publications and patents mentioned herein, including the items listed above, are hereby incorporated by reference in their entirety as if each individual publication or patent was specifically and individually indicated to be incorporated by reference. In case of conflict, the present application, including any definitions made herein, will control the scope of what is claimed.

Claims (17)

1. A compound of formula I, or a pharmaceutically acceptable salt, hydrate, polymorph, solvate, prodrug, enantiomer or stereoisomer thereof:

wherein,

R¹the representation D, H is presented independently of each other,

R²each independently represent

a is independently 2, 3 or 7;

each b is independently 3, 5 or 6;

e is independently 1, 2 or 6;

c and d are each independently H, D, -OH, -OD, C₁To C₆Alkyl, -NH of₂or-COCH₃；

R³Independently H, D, methyl, F, Cl, ethyl or acetyl.

2. A pharmaceutical composition comprising a compound of claim 1 and a pharmaceutically acceptable carrier.

3. The pharmaceutical composition of claim 2, formulated to treat the underlying etiology by administering an effective amount to a patient in need thereof by oral administration, delayed or sustained release, transmucosal, syrup, topical, parenteral administration, injection, subcutaneous, oral solution, rectal administration, buccal administration, or transdermal administration.

4. A method for treating a disease having carbonic anhydrase activity as the underlying etiology, the method comprising administering to a patient in need thereof an effective amount of the pharmaceutical composition of claim 3.

5. Formulating compounds and compositions according to claim 4, where the diseases with carbonic anhydrase activity as the underlying cause are selected from glaucoma, seizures, idiopathic increased intracranial pressure (pseudocerebroma), altitude sickness, cystinuria, periodic paralysis and dural dilatation, congestive heart failure, drug-induced edema, diuresis, intermittent claudication due to vascular occlusion of the extremities, and vascular dementia, osteoporosis, improving blood flow through peripheral vessels and thus contributing to blood circulation in the arms and legs (i.e. intermittent claudication) and in the brain (and thus used in vascular dementia), venous diseases, neurological injuries, stroke, sickle cell disease, nausea and headaches (altitude sickness) on high mountains, non-alcoholic steatohepatitis and alcoholic liver disease, fibrotic changes due to radiation therapy of breast cancer, cytokine release syndrome, chronic lymphocytic leukemia, Treatment of type 1 and type 2 diabetes, asthma, bronchiectasis, nephropathy, renal protection, vascular ischemia, neuroprotection, vasodilation, Alzheimer's disease, dementia, stroke, endometriosis.

6. A molecular conjugate of acetazolamide and R-lipoic acid.

7. A molecular conjugate of acetazolamide and eicosapentaenoic acid is provided.

8. A molecular conjugate of acetazolamide and docosahexaenoic acid is provided.

9. A molecular conjugate of acetazolamide and acetylcysteine.

10. A molecular combination of acetazolamide and salsalate.

11. A molecular conjugate of acetazolamide and fumaric acid.

12. A molecular conjugate of methazolamide and eicosapentaenoic acid is provided.

13. A molecular conjugate of methazolamide and docosahexaenoic acid is provided.

14. A molecular conjugate of methazolamide and acetylcysteine.

15. A molecular combination of methazolamide and salsalate.

16. A molecular conjugate of methazolamide and fumaric acid is provided.

17. A molecular conjugate of methazolamide and R-lipoic acid.