Procaine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Procaine acts mainly by inhibiting sodium influx through voltage gated sodium channels in the neuronal cell membrane of peripheral nerves. When the influx of sodium is interrupted, an action potential cannot arise and signal conduction is thus inhibited. The receptor site is thought to be located at the cytoplasmic (inner) portion of the sodium channel. Procaine has also been shown to bind or antagonize the function of N-methyl-D-aspartate (NMDA) receptors as well as nicotinic acetylcholine receptors and the serotonin receptor-ion channel complex. Pyridoxine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Vitamin B6 is the collective term for a group of three related compounds, pyridoxine (PN), pyridoxal (PL) and pyridoxamine (PM), and their phosphorylated derivatives, pyridoxine 5'-phosphate (PNP), pyridoxal 5'-phosphate (PLP) and pyridoxamine 5'-phosphate (PMP). Although all six of these compounds should technically be referred to as vitamin B6, the term vitamin B6 is commonly used interchangeably with just one of them, pyridoxine. Vitamin B6, principally in the form of the coenzyme pyridoxal 5'-phosphate, is involved in a wide range of biochemical reactions, including the metabolism of amino acids and glycogen, the synthesis of nucleic acids, hemogloblin, sphingomyelin and other sphingolipids, and the synthesis of the neurotransmitters serotonin, dopamine, norepinephrine and gamma-aminobutyric acid (GABA). Riboflavin¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Binds to riboflavin hydrogenase, riboflavin kinase, and riboflavin synthase. Riboflavin is the precursor of flavin mononucleotide (FMN, riboflavin monophosphate) and flavin adenine dinucleotide (FAD). The antioxidant activity of riboflavin is principally derived from its role as a precursor of FAD and the role of this cofactor in the production of the antioxidant reduced glutathione. Reduced glutathione is the cofactor of the selenium-containing glutathione peroxidases among other things. The glutathione peroxidases are major antioxidant enzymes. Reduced glutathione is generated by the FAD-containing enzyme glutathione reductase. Thiamine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ It is thought that the mechanism of action of thiamine on endothelial cells is related to a reduction in intracellular protein glycation by redirecting the glycolytic flux.
Pharmacology
Procaine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Procaine is an anesthetic agent indicated for production of local or regional anesthesia, particularly for oral surgery. Procaine (like cocaine) has the advantage of constricting blood vessels which reduces bleeding, unlike other local anesthetics like lidocaine. Procaine is an ester anesthetic. It is metabolized in the plasma by the enzyme pseudocholinesterase through hydrolysis into para-aminobenzoic acid (PABA), which is then excreted by the kidneys into the urine. Pyridoxine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Vitamin B6 (pyridoxine) is a water-soluble vitamin used in the prophylaxis and treatment of vitamin B6 deficiency and peripheral neuropathy in those receiving isoniazid (isonicotinic acid hydrazide, INH). Vitamin B6 has been found to lower systolic and diastolic blood pressure in a small group of subjects with essential hypertension. Hypertension is another risk factor for atherosclerosis and coronary heart disease. Another study showed pyridoxine hydrochloride to inhibit ADP- or epinephrine-induced platelet aggregation and to lower total cholesterol levels and increase HDL-cholesterol levels, again in a small group of subjects. Vitamin B6, in the form of pyridoxal 5'-phosphate, was found to protect vascular endothelial cells in culture from injury by activated platelets. Endothelial injury and dysfunction are critical initiating events in the pathogenesis of atherosclerosis. Human studies have demonstrated that vitamin B6 deficiency affects cellular and humoral responses of the immune system. Vitamin B6 deficiency results in altered lymphocyte differentiation and maturation, reduced delayed-type hypersensitivity (DTH) responses, impaired antibody production, decreased lymphocyte proliferation and decreased interleukin (IL)-2 production, among other immunologic activities. Riboflavin¿¡ ´ëÇÑ Pharmacology Á¤º¸ Riboflavin or vitamin B2 is an easily absorbed, water-soluble micronutrient with a key role in maintaining human health. Like the other B vitamins, it supports energy production by aiding in the metabolising of fats, carbohydrates, and proteins. Vitamin B2 is also required for red blood cell formation and respiration, antibody production, and for regulating human growth and reproduction. It is essential for healthy skin, nails, hair growth and general good health, including regulating thyroid activity. Riboflavin also helps in the prevention or treatment of many types of eye disorders, including some cases of cataracts. Thiamine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Thiamine is a vitamin with antioxidant, erythropoietic, cognition-and mood-modulatory, antiatherosclerotic, putative ergogenic, and detoxification activities. Thiamine has been found to protect against lead-induced lipid peroxidation in rat liver and kidney. Thiamine deficiency results in selective neuronal death in animal models. The neuronal death is associated with increased free radical production, suggesting that oxidative stress may play an important early role in brain damage associated with thiamine deficiency. Thiamine plays a key role in intracellular glucose metabolism and it is thought that thiamine inhibits the effect of glucose and insulin on arterial smooth muscle cell proliferation. Inhibition of endothelial cell proliferation may also promote atherosclerosis. Endothelial cells in culture have been found to have a decreased proliferative rate and delayed migration in response to hyperglycemic conditions. Thiamine has been shown to inhibit this effect of glucose on endothelial cells.
Metabolism
Pyridoxine¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Methylenetetrahydrofolate reductase Riboflavin¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Monoamine oxidase type A (MAO-A)Methylenetetrahydrofolate reductase
Procaine¿¡ ´ëÇÑ Absorption Á¤º¸ Not Available Pyridoxine¿¡ ´ëÇÑ Absorption Á¤º¸ The B vitamins are readily absorbed from the gastrointestinal tract, except in malabsorption syndromes. Pyridoxine is absorbed mainly in the jejunum. Riboflavin¿¡ ´ëÇÑ Absorption Á¤º¸ Vitamin B2 is readily absorbed from the upper gastrointestinal tract. Thiamine¿¡ ´ëÇÑ Absorption Á¤º¸ Absorbed mainly from duodenum, by both active and passive processes
Pharmacokinetics
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Procaine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hydrolysis by plasma esterases to PABA Riboflavin¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hepatic. Thiamine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hepatic
Toxicity
Procaine¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available Pyridoxine¿¡ ´ëÇÑ Toxicity Á¤º¸ Oral Rat LD50 = 4 gm/kg. Toxic effects include convulsions, dyspnea, hypermotility, diarrhea, ataxia and muscle weakness. Riboflavin¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available Thiamine¿¡ ´ëÇÑ Toxicity Á¤º¸ Thiamine toxicity is uncommon; as excesses are readily excreted, although long-term supplementation of amounts larger than 3 gram have been known to cause toxicity. Oral mouse LD50 = 8224 mg/kg, oral rat LD50 = 3710 mg/kg.
Drug Interactions
Procaine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Aluminium Formation of non-absorbable complexesBismuth Formation of non-absorbable complexesCalcium Formation of non-absorbable complexesDihydroxyaluminium Formation of non-absorbable complexesEstramustine Increases the levels of estramustineMagnesium oxide Formation of non-absorbable complexesMagnesium Formation of non-absorbable complexesSucralfate Formation of non-absorbable complexesIron Formation of non-absorbable complexes Pyridoxine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Not Available Riboflavin¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Not Available Thiamine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Not Available
Procaine¿¡ ´ëÇÑ Description Á¤º¸ A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [PubChem] Pyridoxine¿¡ ´ëÇÑ Description Á¤º¸ The 4-methanol form of vitamin B 6 which is converted to pyridoxal phosphate which is a coenzyme for synthesis of amino acids, neurotransmitters (serotonin, norepinephrine), sphingolipids, aminolevulinic acid. Although pyridoxine and Vitamin B 6 are still frequently used as synonyms, especially by medical researchers, this practice is erroneous and sometimes misleading (EE Snell; Ann NY Acad Sci, vol 585 pg 1, 1990). [PubChem] Riboflavin¿¡ ´ëÇÑ Description Á¤º¸ Nutritional factor found in milk, eggs, malted barley, liver, kidney, heart, and leafy vegetables. The richest natural source is yeast. It occurs in the free form only in the retina of the eye, in whey, and in urine; its principal forms in tissues and cells are as flavin mononucleotide and flavin-adenine dinucleotide. [PubChem] Thiamine¿¡ ´ëÇÑ Description Á¤º¸ 3-((4-Amino-2-methyl-5-pyrimidinyl)methyl)-5-(2- hydroxyethyl)-4-methylthiazolium chloride. [PubChem]