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Advances in the stereoselective synthesis of antifungal agents and ...

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Chapter 1 14ClClORNClN5 a-dCl5aR=Cl5cR=ClCl5bR=Cl5dR=SFigure 1.11: Miconazole 5a, Econazole 5b, Isoconazole 5c , Tioconazole 5d .No <strong>in</strong>formations are available <strong>in</strong> <strong>the</strong> literature regard<strong>in</strong>g <strong>the</strong><strong>stereoselective</strong> syn<strong>the</strong>sis <strong>of</strong> 5a <strong>and</strong> its analogues 5c-d. Miconazole 5a hasbeen shown to have a broad spectrum <strong>of</strong> <strong>antifungal</strong> activities 44 .Dermatophytes, pathogenic yeasts, dimorphic fungi, Aspergillusspecies <strong>and</strong> several mycetoma-caus<strong>in</strong>g <strong>agents</strong> have been shown to besusceptible to cl<strong>in</strong>ically obta<strong>in</strong>able concentrations <strong>of</strong> this compound 45 .Cl<strong>in</strong>ically, Miconazole 5a can be adm<strong>in</strong>istered ei<strong>the</strong>r <strong>in</strong>traveneously ortopically. It requires solubilization <strong>in</strong> polyethoxylated castor oil for<strong>in</strong>travenous adm<strong>in</strong>istration, but this vehicle has been suggested to beresponsible for many side effects with<strong>in</strong> this <strong>the</strong>rapy 46 . The role <strong>of</strong> thisimidazole derivative <strong>in</strong> <strong>the</strong> <strong>the</strong>rapy <strong>of</strong> fungal diseases rema<strong>in</strong>s uncerta<strong>in</strong>,it has never been properly def<strong>in</strong>ed. Some authors 47 have reported <strong>the</strong>oral use <strong>of</strong> miconazole <strong>in</strong> <strong>the</strong> prophylaxis <strong>in</strong> neutropenic cancer. Topicalapplications to treat dermatophytes appears to be moderately successful.Fortunately, no side effects resulted from topical treatments 48 .Econazole 1-[2-(2,4-dichlorophenyl)-2-(4-chloro benzyloxy) ethyl]imidazole 5b, an analogue <strong>of</strong> 5a was also syn<strong>the</strong>sized by JanssenPharmaceuticals 49 . In <strong>the</strong> literature <strong>the</strong>re are no <strong>in</strong>formations regard<strong>in</strong>gits <strong>stereoselective</strong> syn<strong>the</strong>sis, but it has been also reported that one <strong>of</strong> <strong>the</strong>

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