Ergot Alkaloids and Related Compounds

I Introduction to the Pharmacology of Ergot Alkaloids and Related Compounds as a Basis of Their Therapeutic Application.- II Chemical Background.- A. Occurrence, Biosynthesis, and Production.- 1. Presence of Ergot Alkaloids in the Plant Kingdom.- 2. Biogenesis.- 3. Production.- B. Structure and Synthesis of the Natural Alkaloids.- 1. General Structural Aspects.- 2. Structure of Ergot Alkaloids.- 3. Synthesis of Ergot Alkaloids.- C. Chemical Modifications in the Lysergic Acid Half of Ergot Alkaloids.- 1. Substitutions in Position 1.- 2. Substitutions in Position 2.- 3. Chemical Transformations in Positions 4 and 5.- 4. Replacement of the N-Methyl Group in Position 6 by Other Substituents.- 5. Reactions Involving Position 7.- 6. Modifications of the Carboxylic Acid Function of d-Lysergic Acid.- 7. Reactions at Position 8.- 8. Derivatives of 6-Methyl-8-ergolene-8-carboxylic Acid.- 9. Chemical Transformations on the Double Bond in Position 9, 10.- 10. Substitution Reactions in the Benzene Ring.- D. Chemical Modification in the Peptide Part of Ergot Alkaloids.- 1. The Aci-Rearrangement.- 2. Synthesis of Analoga of Natural Ergot Peptide Alkaloids.- 3. Substitution of l-Proline by Other Amino Acids in Ergot Peptide Alkaloids.- 4. Synthetic Ergot Peptide Alkaloids Modified in Position 5?.- E. Some Analytical Tools for the Determination of Ergot Alkaloids.- 1. Separation of Ergot Alkaloids.- 2. Assay of Ergot Alkaloids.- F. Subject Index.- G. References.- III Basic Pharmacological Properties.- A. Introduction.- Competitive Drug Antagonism.- Corollaries of Competitive Antagonism.- Affinity and Intrinsic Activity (Efficacy).- Receptor Classification.- Noncompetitive Antagonism.- B. Actions of Ergot Alkaloids at 5-HT Receptors.- 1. Actions of Ergot Alkaloids at Extraneuronal 5-HT Receptors.- 2. Effects of Ergot Alkaloids on 5-HT Metabolism.- 3. Effects of Ergot Alkaloids on Neuronal 5-HT Receptors.- 4. Effects of Ergot Alkaloids on 5-HT-Sensitive Enzyme Systems.- C. Actions of Ergot Alkaloids at Dopamine Receptors.- 1. Actions of Ergot Alkaloids at Extraneuronal Dopamine Receptors.- 2. Interaction of Ergot Alkaloids With Indirect Dopamine Effects.- 3. Actions of Ergot Alkaloids at Neuronal Dopamine Receptors.- 4. Effects of Ergot Alkaloids on Dopamine-Sensitive Enzyme Systems.- 5. Effects of Ergot Alkaloids on Dopamine Receptors Mediating Hormone Secretion.- D. Actions of Ergot Alkaloids at Adrenoceptors.- 1. Effects of Ergot Alkaloids Mediated by Peripheral ?-Adrenoceptors.- 2. Depletion of Noradrenaline From Tissues by Ergot Alkaloids.- 3. Effects of Ergot Alkaloids on Noradrenaline Release and Theories on the Mechanism of Noradrenaline “Overflow”.- 4. Effects of Ergot Alkaloids on the Responses of Organs to Stimulation of Their Sympathetic Innervation.- 5. Actions of Ergot Alkaloids at ?-Adrenoceptors.- E. The Shape of Ergotamine and Dihydroergotamine in Relation to Their Interaction With ?-Adrenoceptors.- F. Actions of Ergot Alkaloids at Acetylcholine Receptors.- G. Actions of Ergot Alkaloids at Histamine Receptors.- H. Interaction of Ergot Alkaloids With Prostaglandins.- 1. Interference of Ergot Alkaloids With Endogenous Prostaglandin Synthesis.- 2. Interference of Ergot Alkaloids With Prostaglandin Effects.- J. Stimulation of Smooth Muscle by Ergot Alkaloids Mediated by Miscellaneous Mechanisms.- 1. Enhancement of Responses to Biogenic Amines by Ergot Alkaloids in Vascular Smooth Muscles.- 2. Enhancement of Responses to Biogenic Agents by Ergot Alkaloids in Nonvascular Smooth Muscles.- K. Biochemical Identification of Specific Binding Sites for Ergot Alkaloids.- 1. Interaction of Ergot Compounds With Specific Sites in the Central Nervous System.- 2. Peripheral Binding Sites for Ergot Compounds.- L. References.- IV Effects on the Uterus.- A. Introduction.- B. Actions on Uterine Motor Activity.- 1. Peptide Alkaloids.- 2. Dihydrogenated Peptide Alkaloids.- 3. Lysergic Acid-Amides.- C. References.- V Actions on the Heart and Circulation.- A. Actions on Systemic Blood Pressure.- 1. Nature of the Effect.- 2. Effects on Blood Pressure Control Mechanisms.- 3. Effects on the Carotid Sinus and Impulse Transmission in Sino-Aortic Nerves.- 4. Effects on Responses to Catecholamines and 5-Hydroxytryptamine.- 5. Mechanisms Involved in the Hypotensive Action.- 6. Mechanisms Involved in the Pressor Action.- B. Hemodynamic Effects.- C. Effects on Regional Hemodynamics.- 1. Effects on Limb Blood Vessels.- 2. Effects on Cranial Blood Vessels.- 3. Effects on Renal Blood Vessels.- 4. Effects on Mesenteric Blood Vessels.- 5. Effects on Coronary Blood Vessels.- 6. Effects on Uterine Blood Vessels.- D. Actions on the Heart.- 1. Effects in Mammals.- 2. Effects in Amphibia.- 3. Effects in Molluscs.- E. Pharmacologic Basis for the Clinical Use of Ergot Alkaloids.- 1. Orthostatic Hypotension.- 2. Venous Thrombosis.- 3. Shock.- 4. Migraine.- F. References.- VI Effects on the Central Nervous System.- A. Introduction.- B. Early Evidence of Central Effects.- 1. Convulsive Ergotism in Man.- 2. Early Description of Central Effects in Animals.- 3. The Question of “Toxic” versus “Therapeutic” Dose.- C. Whole-Animal Studies.- 1. Behavioral Excitation.- 2. Behavioral Depression.- 3. Interaction With Centrally Depressant Drugs.- 4. Anticonvulsant Effects.- 5. Electroencephalogram.- 6. Cerebral Blood Flow.- 7. Body Temperature.- 8. Emesis.- D. Synaptic Transmission: Catecholaminergic Mechanisms.- 1. Criteria of Catecholaminergic Stimulation and Antagonism at the Synaptic Level.- 2. Agroclavine-Type Ergot Derivatives.- 3. Ergometrine.- 4. D-LSD, 2-Br-LSD, and Methysergide.- 5. PRT 17-402.- 6. Ergocornine.- 7. Bromocriptine.- 8. Other Ergopeptine Derivatives.- 9. Efficacy of Ergot Derivatives as Antiparkinsonian Agents.- E. Synaptic Transmission: Serotoninergic Mechanisms.- 1. Criteria of Serotoninergic Stimulation and Antagonism at the Synaptic Level.- 2. D-LSD.- 3. 2-Br-LSD.- 4. Methysergide.- 5. Other Lysergic Acid Derivatives.- 6. Ergopeptine Derivatives.- F. Brain Metabolism.- 1. Brain Cyclic Adenosine Monophosphate.- 2. Adenosine Triphosphate Metabolism in the Brain.- 3. Transformation of Biosubstrates by Demethylation, Acetylation and Glucuronoconjugation.- G. References.- VII Clinical Pharmacology of Ergot Alkaloids in Senile Cerebral Insufficiency.- A. Introduction.- B. Terminology, Etiology, and Pathology of the Aging Process of the Brain.- 1. Terminology.- 2. Definition.- 3. Etiology and Pathology.- C. Research Techniques Used in Clinical Pharmacologic Studies of Ergot Alkaloids in Senile Cerebral Insufficiency.- 1. Methods for Measuring Cerebral Bloodflow and Metabolism.- 2. Methods for the Clinical Assessment of Brain Function.- 3. Electroencephalography.- D. Results of Clinical Pharmacology Studies With Ergot Alkaloids.- 1. Cerebral Bloodflow and Metabolic Studies.- 2. Clinical Pharmacologic Studies With Ergot Alkaloids in Senile Cerebral Insufficiency.- E. Summary.- F. References.- VIII Some Compounds With Hallucinogenic Activity.- A. Introduction.- B. Discovery of LSD.- C. Effects of LSD in Man.- 1. Somatic Actions.- 2. Psychic Actions.- 3. Effects of LSD on the Human EEG.- 4. Clinical Laboratory Investigations.- 5. Tolerance to LSD Effect.- 6. Inhibitors of LSD Reaction.- 7. Side-Effects and Complications.- 8. Illicit Use and Addiction.- D. Clinical Applications of LSD.- 1. Adjuvant to Psychotherapy.- 2. Psychedelic Therapy.- 3. Use in Psychoses.- 4. Therapeutic Use in Children.- 5. Use in Terminal Cancer Patients.- E. LSD Analogues Tested in Man.- 1. LSD Isomers.- 2. Hydrogenated Derivatives.- 3. Unsubstituted and Monosubstituted Amide Derivatives.- 4. Disubstituted Amide Derivatives.- 5. Cyclic Amide Derivatives.- 6. Ring-Substituted Derivatives.- 7. Ololiuqui.- 8. Discussion.- F. Cross-Tolerance.- G. References.- IX Influence on the Endocrine System.- A. Animal Data.- 1. Actions on Pituitary Hormones.- 2. Actions on Peripheral Endocrine Systems.- B. Human Data.- 1. Actions on Pituitary Hormones.- C. References.- X Metabolic Effects.- A. Introduction.- B. In Vitro Systems.- 1. Liver.- 2. Adipose Tissue.- 3. Various Tissues.- C. Intact Animals and Men.- 1. Influence on Catecholamine-Stimulated Carbohydrate Mobilization.- 2. Influence on Catecholamine-Stimulated Lipolysis.- 3. Influence on Other Catecholamine-Stimulated Metabolic Processes.- 4. Influence on Stress-Stimulated Metabolic Parameters.- 5. Influence on the Effects of Adrenalectomy or Sympathectomy.- 6. Influence on Glucose or Galactose Tolerance.- 7. Influence on Serotonin Effects.- 8. Interaction With Pancreas, Hypophysis, and Thyroidea.- 9. Actions of Ergot Alkaloids Alone on Metabolic Parameters.- D. Various Actions of Ergot Alkaloids.- E. References.- XI Biopharmaceutical Aspects. Analytical Methods, Pharmacokinetics, Metabolism and Bioavailability.- A. Introduction.- B. Assay of Ergot Alkaloids.- 1. Introduction.- 2. Radiotracer Methods.- 3. Nonradioisotopic Physicochemical Methods.- 4. Radioimmunoassay.- C. Pharmacokinetics.- 1. Introduction.- 2. Experiments in Animals.- 3. Experiments in Man.- 4. Interactions in Man.- 5. Physicochemical Properties of Ergot Alkaloids Which May Affect Enteral Absorption.- 6. Synopsis.- D. Metabolism.- 1. Introduction.- 2. Experiments.- 3. Biotransformation Sites in the Molecule.- 4. Interaction of Ergot Derivatives With Cytochrome P 450.- 5. Conclusions and Prospects.- E. References.- XII Toxicologic Considerations.- A. Introduction.- B. Systemic Toxicity.- 1. Animals.- 2. Man.- C. Effects on Reproductive Processes.- 1. Implantation and Early Pregnancy.- 2. Embryonic and Fetal Development.- 3. Lactation and the Offspring.- D. Potential Genetic Effects.- 1. LSD.- 2. Other Ergot Alkaloids.- 3. Conclusions.- E. Interactions Leading to Enhanced Toxicity.- 1. Disease Processes.- 2. Concomitant Medication.- F. Summary.- G. References.- Authors Index.