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Phenothiazine, abbreviated PTZ, is an
organic compound In chemistry, organic compounds are generally any chemical compounds that contain carbon-hydrogen or carbon-carbon bonds. Due to carbon's ability to catenate (form chains with other carbon atoms), millions of organic compounds are known. The ...
that has the formula S(C6H4)2NH and is related to the
thiazine Thiazine is an organic compound containing a ring of four carbon, one nitrogen and one sulfur atom. There are three isomers of thiazine, 1,2-thiazine, 1,3-thiazine, and 1,4-thiazine, which differ by the arrangement of the nitrogen and sulfur ato ...
-class of
heterocyclic compound A heterocyclic compound or ring structure is a cyclic compound that has atoms of at least two different elements as members of its ring(s). Heterocyclic chemistry is the branch of organic chemistry dealing with the synthesis, properties, and ...
s. Derivatives of phenothiazine are highly bioactive and have widespread use and rich history. The derivatives chlorpromazine and promethazine revolutionized the fields of
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psych ...
and
allergy Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...
treatment, respectively. An earlier derivative,
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglobin ...
, was one of the first
antimalarial drugs Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often natural product, naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target ...
, and derivatives are under investigation as possible anti-infective drugs. Phenothiazine is a prototypical pharmaceutical lead structure in medicinal chemistry.


Uses

Phenothiazine itself is only of theoretical interest, but its derivatives revolutionized psychiatry, other fields of medicine, and pest management. Other derivatives have been studied for possible use in advanced batteries and fuel cells.


Phenothiazine-derived drugs

In 1876,
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglobin ...
, a derivative of phenothiazine, was synthesized by Heinrich Caro at BASF. The structure was deduced in 1885 by Heinrich August Bernthsen. Bernthsen synthesized phenothiazine in 1883. In the mid 1880s, Paul Ehrlich began to use methylene blue in his cell staining experiments that led to pioneering discoveries about different cell types. He was awarded a Nobel Prize based in part on that work. He became particularly interested in its use to stain bacteria and parasites such as ''
Plasmodiidae The Plasmodiidae are a family (biology), family of apicomplexan parasites, including the type genus ''Plasmodium'', which is responsible for malaria. This family was erected in 1903 by Mesnil and is one of the four families in the Order (biology) ...
'' – the genus that includes the
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
pathogen – and found that it could be stained with methylene blue. He thought methylene blue could possibly be used in the treatment of malaria, tested it clinically, and by the 1890s methylene blue was being used for that purpose. For the next several decades, research on derivatives lapsed until phenothiazine itself came to market as an insecticide and deworming drug. In the 1940s, chemists working with Paul Charpentier at Rhone-Poulenc Laboratories in Paris (a precursor company to Sanofi), began making derivatives. This work led to promethazine which had no activity against infective organisms, but did have good
antihistamine Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provides re ...
activity, with a strong sedative effect. It went to market as a drug for allergies and for
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
. As of 2012 it was still on the market. At the end of the 1940s the same lab produced chlorpromazine which had an even stronger sedative and soothing effect, and
Jean Delay Jean Delay (14 November 1907, Bayonne – 29 May 1987, Paris) was a French psychiatrist, neurologist, writer, and a member of the Académie française (Chair 17). His assistant Pierre Deniker conducted a test of chlorpromazine on the male mental ...
and
Pierre Deniker Pierre Deniker (16 February 1917, in Paris – 17 August 1998) was involved, jointly with Jean Delay and J. M. Harl, in the introduction of chlorpromazine (Thorazine), the first antipsychotic used in the treatment of schizophrenia, in the 1950s. ...
attempted to use it on their psychiatric patients, publishing their results in the early 1950s. The strong effects they found opened the door of the modern field of psychiatry and led to a proliferation of work on phenothiazine derivatives. The systematic research conducted by chemists to explore phenothiazine derivatives and their activity was a pioneering example of medicinal chemistry; phenothiazine is often discussed as a prototypical example of a pharmaceutical lead structure. A number of phenothiazines other than methylene blue have been shown to have antimicrobial effects. In particular, thioridazine has been shown to make extensively drug-resistant tuberculosis (XDR-TB) drug-susceptible again and make
methicillin-resistant Staphylococcus aureus Methicillin-resistant ''Staphylococcus aureus'' (MRSA) is a group of Gram-positive bacteria that are genetically distinct from other strains of ''Staphylococcus aureus''. MRSA is responsible for several difficult-to-treat infections in humans. ...
(MRSA) susceptible to beta-lactam antibiotics. The major reason why thioridazine has not been utilized as an antimicrobial agent (it is a first-generation or "typical" antipsychotic medication) is due to its adverse effects on the central nervous system and cardiovascular system (particularly QT interval prolongation). The term "phenothiazines" describes the largest of the five main classes of antipsychotic drugs. These drugs have antipsychotic and, often, antiemetic properties, although they may also cause severe
side effects In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
such as extrapyramidal symptoms (including akathisia and tardive dyskinesia), hyperprolactinaemia, and the rare but potentially fatal neuroleptic malignant syndrome, as well as substantial weight gain. Use of phenothiazines has been associated with antiphospholipid syndrome, but no causal relationship has been established. Phenothiazine antipsychotics are classified into three groups that differ with respect to the substituent on nitrogen: the
aliphatic compound In organic chemistry, hydrocarbons ( compounds composed solely of carbon and hydrogen) are divided into two classes: aromatic compounds and aliphatic compounds (; G. ''aleiphar'', fat, oil). Aliphatic compounds can be saturated, like hexane, or ...
s (bearing acyclic groups), the "piperidines" (bearing piperidine-derived groups), and the piperazine (bearing piperazine-derived substituents).


Nondrug applications

The synthetic dye
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglobin ...
, containing the structure, was described in 1876. Many water-soluble phenothiazine derivatives, such as
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglobin ...
,
methylene green Methylene green is a Heterocyclic ring, heterocyclic aromaticity, aromatic chemical compound similar to methylene blue. It is used as a dye. It functions as a visible light-activated photocatalyst in organic synthesis. References External li ...
,
thionine Thionine, also known as Lauth's violet, is the salt of a heterocyclic compound A heterocyclic compound or ring structure is a cyclic compound that has atoms of at least two different elements as members of its ring(s). Heterocyclic chemi ...
, and others, can be electropolymerized into
conductive polymers Conductive polymers or, more precisely, intrinsically conducting polymers (ICPs) are organic polymers that Electrical conductance, conduct electricity. Such compounds may have metallic conductivity or can be semiconductors. The biggest advantage ...
used as
electrocatalyst An electrocatalyst is a catalyst that participates in electrochemical reactions. Electrocatalysts are a specific form of catalysts that function at electrode surfaces or, most commonly, may be the electrode surface itself. An electrocatalyst ...
s for NADH oxidation in enzymatic biosensors and biofuel cells. Phenothiazine is used as an anaerobic inhibitor for
acrylic acid Acrylic acid (IUPAC: propenoic acid) is an organic compound with the formula CH2=CHCOOH. It is the simplest unsaturated carboxylic acid, consisting of a vinyl group connected directly to a carboxylic acid terminus. This colorless liquid has a ...
polymerization, often used as an in-process inhibitor during the purification of acrylic acid.


Trade names

Like many commercially significant compounds, phenothiazine has numerous trade names, including AFI-Tiazin, Agrazine, Antiverm, Biverm, Dibenzothiazine, Orimon, Lethelmin, Souframine, Nemazene, Vermitin, Padophene, Fenoverm, Fentiazine, Contaverm, Fenothiazine, Phenovarm, Ieeno, ENT 38, Helmetina, Helmetine, Penthazine, XL-50, Wurm-thional, Phenegic, Phenovis, Phenoxur, and Reconox.


Former uses

Phenothiazine was formerly used as an insecticide and as a drug to treat infections with parasitic worms (
anthelminthic Anthelmintics or antihelminthics are a group of antiparasitic drugs that expel parasitic worms (helminths) and other internal parasites from the body by either stunning or killing them and without causing significant damage to the host. They may a ...
) in
livestock Livestock are the domesticated animals raised in an agricultural setting to provide labor and produce diversified products for consumption such as meat, eggs, milk, fur, leather, and wool. The term is sometimes used to refer solely to animals ...
and people, but its use for those purposes has been superseded by other chemicals. Phenothiazine was introduced by
DuPont DuPont de Nemours, Inc., commonly shortened to DuPont, is an American multinational chemical company first formed in 1802 by French-American chemist and industrialist Éleuthère Irénée du Pont de Nemours. The company played a major role in ...
as an
insecticide Insecticides are substances used to kill insects. They include ovicides and larvicides used against insect eggs and larvae, respectively. Insecticides are used in agriculture, medicine, industry and by consumers. Insecticides are claimed to b ...
in 1935. About 3,500,000 pounds were sold in the US in 1944. However, because it was degraded by sunlight and air, it was difficult to determine how much to use in the field, and its use waned in the 1940s with the arrival of new pesticides like
DDT Dichlorodiphenyltrichloroethane, commonly known as DDT, is a colorless, tasteless, and almost odorless crystalline chemical compound, an organochloride. Originally developed as an insecticide, it became infamous for its environmental impacts. ...
that were more durable. As of July 2015 it is not registered for pesticide use in the US, Europe,ECH
phenothiazine at the European Chemicals Authority
Page accessed July 26, 2015. Note - Registered uses are only in manufacturing.
or Australia.Australian Pesticides and Veterinary Medicine Authorit
Phenothiazine Chemical Review
Page accessed July 26, 2015
It was introduced as anthelminthic in livestock in 1940 and is considered, with thiabendazole, to be the first modern anthelminthic. The first instances of resistance were noted in 1961. Among anthelmintics, Blizzard et al. 1990 found only paraherquamide to have similar activity to phenothiazine. It is possible that they share the same
mode of action A mode of action (MoA) describes a functional or anatomical change, resulting from the exposure of a living organism to a substance. In comparison, a mechanism of action (MOA) describes such changes at the molecular level. A mode of action is impor ...
. Uses for this purpose in the US are still described but it has "virtually disappeared from the market." In the 1940s it also was introduced as antihelminthic for humans; since it was often given to children, the drug was often sold in chocolate, leading to the popular name, "worm chocolate." Phenothiazine was superseded by other drugs in the 1950s.


Structure and synthesis

The central C4SN ring is folded in phenothiazines. The compound was originally prepared by Bernthsen in 1883 via the reaction of diphenylamine with sulfur, but more recent syntheses rely on the cyclization of 2-substituted diphenyl sulfides. Few pharmaceutically significant phenothiazines are prepared from phenothiazine, although some of them are.T. Kahl, K.-W. Schröder, F. R. Lawrence, W. J. Marshall, Hartmut Höke, Rudolf Jäckh, "Aniline" in ''Ullmann's Encyclopedia of Industrial Chemistry'', 2005, Wiley-VCH: Weinheim. Phenothiazines are electron donors, forming charge-transfer salts with many acceptors.


References


External links


MSDS
* Hendricks, Christensen, J.B., and Kristiansen, Jette E. Sonderborg, Denmark.
Antibakterielle Eigenschaften der Phenothiazine: Eine Behandlungsoption für die Zukunft?
''Chemotherapie Journal.'' 13.5. (2004): 203–205. ''Wissenschaftliche Verlagsgesesellschaft mbH.'' 21 August 2005. (PDF).
PubChem Substance Summary: Phenothiazine
National Center for Biotechnology Information.

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