Libro Quimica Opcion Quimica Medica PDF

25
Option D Medicinal chemistry

ESSENTIAL IDEAS
■ Medicines and drugs have a variety of different effects on the functioning of the body.
■ Natural products with useful medicinal properties can be chemically altered to produce
more potent or safer medicines.
■ Potent medical drugs prepared by chemical modification of natural products can be
addictive and become substances of abuse.
■ Excess stomach acid is a common problem that can be alleviated by compounds that
increase the stomach pH by neutralizing or reducing its secretion.
■ Antiviral medications have recently been developed for some viral infections while
others are still being researched.
■ The synthesis, isolation and administration of medications can have an effect on the
environment.
■ Chiral auxiliaries allow the production of individual enantiomers of chiral molecules.
■ Nuclear radiation, whilst dangerous owing to its ability to damage cells and cause
mutations, can also be used to both diagnose and cure diseases.
■ A variety of analytical techniques is used for detection, identification, isolation and
analysis of medicines and drugs.
25.1 Pharmaceutical products and drug action –

medicines and drugs have a variety of different effects on the functioning of the body
■■ Drugs
A drug (Figure 25.1) may be defined as any substance (natural or synthetic) that, by its chemical
nature, has an influence on the physical or mental functions of the body. Its effects may include
one or more of the following: altering incoming sensory perceptions, for example
hallucinogens such as LSD (‘acid’) and mescaline; altering mood or emotions,
for example Valium and Mogadon; altering the physiological state of the body,
including consciousness, for example alcohol and LSD; altering activity levels, for
example amphetamines (‘speed’), or muscular coordination, for example alcohol.
A medicine or pharmaceutical is defined as a drug that leads to an
improvement in health. These include mild analgesics, or painkillers, such as
aspirin, ibuprofen and paracetamol (acetaminophen); powerful analgesics such
as morphine and codeine; drugs used for cancer treatment, such as cisplatin and
Taxol; antivirals, such as zidovudine (Retrovir) used to treat people with HIV;
antibiotics such as penicillin; and cimetidine (Tagamet) and ranitidine (Zantac) to
■■ Figure 25.1 Propecia: a medicinal
treat gastric ulcers.
drug used to treat male pattern
Not all drugs are pharmaceuticals: for example, caffeine, present in coffee and
baldness (by reducing testosterone
tea, and nicotine, present in cigarette smoke. Some former pharmaceuticals are no
levels)
longer prescribed in many countries because of their highly addictive nature. These
include cocaine and heroin, both formerly used as painkillers in the 1930s. Many drugs are
described as OTC (over-the-counter) medications and do not require a prescription. Examples
include the painkillers aspirin, ibuprofen and paracetamol (acetaminophen).
Many drugs fall into the following classes: depressants, such as ethanol (alcohol) at low
concentrations which leads to relaxation; stimulants, which result in wakefulness and a sense
of well-being, for example amphetamines; narcotics and analgesics, for example morphine;
hallucinogens which produce altered perceptions, for example LSD; and psychotherapeutics
which are used for the control of mental problems. Some drugs, such as caffeine, nicotine and
marijuana, fit into more than one category.
Natural products are chemical compounds that are isolated from living organisms,
for example plants and trees, using chemical techniques such as solvent extraction and
Chemistry for the IB Diploma, Second Edition © Christopher Talbot, Richard Harwood and Christopher Coates 2015
2 25 Medicinal chemistry
H chromatography. Some natural products are limited to a single species of plant or

tree. For example, the anti-malarial drug quinine (Figure 25.2) is a natural product
H that is found only in the bark of the cinchona tree. Taxol (see section 25.7) is
HO another natural product from the Pacific yew tree.
N
CH3O H Chemotherapy, in its most general sense, refers to the treatment of disease
by chemicals. The German microbiologist Paul Ehrlich (1854–1915) is regarded
quinine
as the ‘father of chemotherapy’. His early interests in the staining of tissues and
N cells with azo dyes caused him to consider the idea that certain chemicals might
■■ Figure 25.2 Structure of quinine
have a particular affinity for certain types of cells. In particular, he was keen to
find chemicals, which he dubbed ‘magic bullets’, that would bind to bacterial cells
and be toxic to them, but leave the cells of the host organism unaffected. One of
his most famous ‘magic bullets’ was Salvarsan (Figure 25.3), used to treat syphilis and sleeping
sickness until it was replaced by antibiotics in the 1940s.
■■ Figure 25.3
OH
Structure of Salvarsan
H2N As
As NH2
HO
International availability of drugs

Over-the-counter (OTC) drugs are medicines sold directly to a customer without a prescription
from a healthcare professional (GP or doctor), while prescription drugs may be sold only to
customers with a valid prescription. In many countries, OTC drugs are selected by a regulatory
agency to ensure that the ingredients are safe and effective when used without a doctor’s
supervision. OTC drugs are usually regulated by active pharmaceutical ingredients (APIs), not
final products. By regulating APIs instead of specific drug formulations, governments allow
manufacturers freedom to formulate ingredients, or combinations of ingredients, into proprietary
mixtures.
The term over-the-counter may be misleading, since, in many countries, these drugs are
often located on the shelves of stores like any other packaged product. In contrast, prescription
drugs are almost always passed over a counter from the pharmacist to the customer. Some drugs
may be legally classified as over-the-counter (that is, no prescription is required), but may only be
dispensed by a pharmacist after an assessment of the patient’s needs or the provision of advice to
the patient. In many countries, a number of OTC drugs are available in establishments without
a pharmacy, such as general stores, supermarkets and petrol (gas) stations. Regulations detailing
the establishments where drugs may be sold, who is authorized to dispense them, and whether a
prescription is required vary considerably from country to country.
For example, Arcoxia, which is a strong anti-inflammatory, is non-FDA (Food and
Drug Administration) approved in the USA but marketed by Merck outside the USA. It
is prescription only in the UK but available OTC in Thailand. It can be ordered online in
New Zealand.
Nature of Science Classification of pharmaceuticals
Although there are thousands of different drugs, all drugs marketed in the USA fall under one
or more of the first tier of the American Hospital Formulary Service (AHFS) Pharmacologic-
Therapeutic Classification System. The classification was developed and is maintained by the
American Society of Health-System Pharmacists (ASHP), a national association of pharmacists.
One important tier of drugs under this classification are the anti-infective agents which includes
the penicillins and antivirals.
In the USA, the legal classification of drugs was initiated under the Controlled Substances
Act. Drugs fall within different schedules based on their potential for abuse. Some of the drugs
are available only by prescription and some are available OTC.
25.1 Pharmaceutical products and drug action 3
■ Schedule 1 drugs have high potential for abuse, are not recognized for medical use and pose a
safety risk. These drugs include heroin, lysergic acid diethylamide (LSD), MDMA (ecstasy)
and marijuana.
■ Schedule 2 drugs have a high potential for abuse, have medical effects and pose a high risk
for dependency (addiction). Drugs categorized as Schedule 2 include opium, morphine,
cocaine, methadone and methamphetamine.
■ Schedule 3 drugs have a lower potential for abuse, have medical uses and pose a moderate
risk for dependency. Amphetamine, barbiturate, Valium, anabolic steroids and codeine are
Schedule 3 drugs.
■ Schedule 4 drugs have limited potential for abuse, have high medical uses and pose a limited
risk for dependency. This category includes chloral hydrate and phenobarbital.
■ Schedule 5 drugs pose minor problems and are generally preparations of drugs containing
limited amounts of Schedule 1 through 4 drugs. Cough medicines with codeine are an
example of Schedule 5 drugs.
■■ Pharmacology
Pharmacology is the scientific study of the interactions of drugs with the various different types
of cells found in the human body. Pharmacologists seek to understand the various biochemical
changes produced by drugs. Many of the effects of drugs are a result of changes in intercellular
communications.
There are three modes of communication between cells:
■ neurotransmission, where a nerve cell (neuron) passes a chemical signal on to another nerve
cell or to a muscle or gland cell;
■ hormonal, where hormones (‘chemical messengers’) are released from endocrine glands and
carried by the blood to a distant ‘target’ organ;
■ autacoid, where ‘local hormones’ are released and act on nearby cells.
Neurotransmission
A nerve impulse involves the movement of sodium and potassium ions across the cell
membrane of the axon (nerve fibre). However, there is no direct connection between axons or
between axons and muscle or gland cells. At the junctions or ‘gaps’ between these cells, the
electrochemical impulse of the axon is converted to a chemical signal. A synapse is a junction
between two neurons (see Figure 25.4).
■■ Figure 25.4 neurotransmitter neurotransmitter

electrochemical signal
The structure of a release binding
synapse nerve
induced fit
receptor
synaptic gap
post-synaptic
membrane
target cell message
The impulse causes the release of a neurotransmitter, a chemical that diffuses across the synapse
and then binds to the binding site of a specific receptor (compare this with the lock-and-key
hypothesis of enzyme action in Chapter 23). These receptors are usually sugar-containing
proteins (glycoproteins) located on the surface of the post-synaptic membrane.
Many drugs, for example nicotine and caffeine, also fit into the various receptors. Those that
produce a response are called agonists, and those that bind tightly to the receptor and block it
without producing a response are called antagonists (Figure 25.5). Neurotransmitters function by
causing changes in the permeability of the target cell membrane to sodium, potassium, calcium
and chloride ions. Once a new impulse has been generated the neurotransmitter is broken down
by enzymes or ‘recycled’ back to the neuron from where it was released.
Many drugs function by reducing or increasing the release of neurotransmitters, by binding to
their receptors, or by changing the permeability of neuronal cell membranes, mimicking or copying
the action of the neurotransmitter, or by altering the re-uptake or ‘recycling’ by the neuron.
■■ Figure 25.5 agonist antagonist

An illustration of
receptor
an agonist and an
antagonist binding to
a receptor site on a
protein molecule
The agonist binds to the receptor and induces The antagonist binds to the receptor but it
changes in it that lead to the appropriate response does not induce the correct change in it,
so it does not produce a response
Autacoids
Two well-studied local hormones, or autacoids, are histamine and serotonin. Histamine is
released from cells in the gastric mucosa, or stomach lining, in response to eating and is
a powerful stimulant of gastric juice production. It is also released by certain white blood
cells in the lungs, called mast cells, in response to an allergic reaction, for example to pollen
grains. Breathlessness, a runny nose and the watery eyes that accompany hay fever are two
consequences of its action inside the body. Serotonin (5-hydroxytryptamine) is also produced
in the gastric mucosa, but it is also produced by certain neurons in the central nervous system
(brain and spinal cord) where it is involved with the control of sleep and vomiting. A deficiency
within the brain may lead to migraine and depression.
Other local hormones are the prostaglandins produced in tiny quantities by many cells,
which are involved in controlling gastric acidity, labour, blood platelet aggregation during blood
clotting and bronchoconstriction (a reduction in the diameter of tiny air tubules, or bronchioles,
inside lung tissue). They are also involved indirectly in inducing pain, fever and inflammation
(redness and swelling).
Signal transduction
All these chemical messengers, whether they be neurotransmitters, hormones or autacoids, carry
what is termed a primary signal to a cell. A process called signal transduction then occurs,
where the primary signal induces some kind of response by the cell.
For example, many of the neurotransmitters bind to receptors in the cell membrane and this
results in the opening of ‘tunnels’ across the membrane that allow sodium ions to pass into the
cell. Some hormones, for example insulin, bind to receptors that activate enzymes in the cell
membrane. Other primary signals may cause the production of a so-called secondary messenger,
for example cyclic AMP (cAMP), which inhibits or activates enzymes inside the cell. Finally,
steroid hormones, for example oestrogen, pass through the cell membrane and enter the nucleus.
Here they bind to a protein receptor, which then binds to DNA, ‘switching on’ a variety of genes.
Receptors and their interactions
A receptor is a protein on the cell membrane or within the cytoplasm or cell nucleus of the
target cell that binds reversibly to a specific molecule to initiate a biochemical or cellular
response. Receptors interact and bind to a specific substrate to induce a change. The interaction
is based upon the drug and receptor having complementary shapes that allow a variety of bonds
and intermolecular forces to operate. The substrate can be a molecule or a hormone (steroid- or
peptide-based). The drug enters the active site of the receptor and binds to it, often causing a
change in shape of the receptor (Figure 25.6). If the receptor is an enzyme many drugs act as
inhibitors, reducing the activities of enzymes via competitive or non-competitive inhibition.
■■ Figure 25.6 binding

The equilibrium of a regions
drug being bound and binding
unbound to its target groups
drug intermolecular
molecule binding site
molecule forces
binding
site induced drug molecule
fit
unbound drug bound drug
target molecule
The forces responsible for receptor interactions include covalent bonding, ionic interactions,
ion–dipole interactions, hydrogen bonding and London (dispersion) forces (Figure 25.7).
■■ Figure 25.7
Various electrostatic III
H3C
interactions between Val 114
a drug molecule and H3C
London Asp 113
its protein receptor −
(dispersion) CH2 COO
(target). The drug
forces
is noradrenaline, O H H
δ+ ionic bonding VII
a hormone and Ser 204 +
H δ–
O NH2
neurotransmitter CH2
V hydrogen O R
bond δ– δ+
hydrophobic pocket
δ+ H
O
Ser 207 H hydrogen bond
O H NH2
δ–
London (dispersion) O
forces Asn 293
Phe 290
VI
Covalent bonding is not a common force of interaction between receptors and drugs because
covalent bonds are usually strong bonds. Once formed, they are usually difficult to break, and
irreversible bonding occurs. A number of poisons, such as cyanide ions, function in this way.
Ionic interactions are strong attractive forces, involving the electrostatic forces of attraction
between opposite charges. These interactions usually involve charged amino acid residues, such
as negatively charged aspartic acid or positively charged lysine.
An ion–dipole interaction is the electrostatic attraction between a charge and an electron-
deficient or electron-rich centre. It is weaker than an ionic interaction since a partial rather than
a full charge is involved.
Hydrogen bonding is the relatively strong intermolecular force operating between a hydrogen
atom bonded to a small and highly electronegative element (fluorine, oxygen or nitrogen) and
the lone pair of that element. In proteins and receptors, most of the hydrogen bonds are due to
the presence on molecules of hydroxyl groups, –OH, carboxylic acid groups, –COOH, peptide
bonds (–CONH–) or the primary amine group (–NH2).
The final receptor interactions are London (dispersion) forces. In non-polar molecules,
the temporary dipoles are generated from random fluctuations in the distribution of electron
clouds of molecules. These temporary dipoles then induce another dipole in the neighbouring
molecules, which spreads through the sample of molecules. London (dispersion) forces are only
significant at short molecular distances and when the molecules involved in receptor binding
are relatively large. Polar molecules, in contrast, have permanent dipoles because of an uneven
distribution of electrons due to a difference in electronegativity. The permanent dipoles of polar
molecules attract each via electrostatic forces of attraction.
■■ The placebo effect

A placebo is an inert chemical used as a control when testing a drug clinically. The placebo
effect is the pharmacological effect on a person, or group of people, who have been given a
placebo rather than an active drug.
It is not understood why chemically inert substances can be effective in treating illness, but
it is thought that a person’s beliefs and hopes about a treatment can have a biochemical effect on
the body, presumably via the endocrine and immune systems. This means that a person’s mental
attitude may be very important in determining whether he or she recovers from injury or illness.
It is thought that the placebo effect triggers natural healing processes in the body.
■■ Developing new drugs

Medicinal drugs have to be tested in clinical trials (Figure 25.8) to determine if they are safe.
Clinical trials involve recording the results of treating a group of patients with the drug and
comparing them to a group of similar patients receiving a different treatment or a placebo.
Before clinical testing begins, researchers analyse the drug’s physical and chemical properties
in the laboratory and study its pharmacological and toxicological properties on animals and cells
grown in culture.
■■ Figure 25.8 10 000 possible projects initiated
Summary of the steps
in the development of 0
laboratory and animal studies
a new drug
1st phase of clinical studies (initial trials on humans)
Approximate time/years
2nd phase of clinical studies

testing for efficacy and
side-effects
5 3rd phase of clinical studies
(extensive trialling)
new drug application review by drug

logged with drug admin.
administration
10 final drug administration approval for one new drug
In vivo (‘in the living’) tests involve the use of live animals, whereas in vitro (‘in glass’) tests do
not. In vitro tests may involve testing potential drugs on cells grown in culture. In vitro testing is
generally quicker and cheaper than in vivo testing. However, many drugs that are active in vitro
turn out to be inactive in vivo. This is because a drug may not be able to reach its target in the
human body.
If the laboratory and animal study results are promising, then the drug company will apply to
conduct initial studies where the drug is administered to a small number of healthy volunteers
to assess its safety, dosage and side effects. A side effect of a drug is any effect that is in addition
to its intended effect, especially an effect that is harmful or unpleasant. If there are no major
problems, such as unacceptable toxicity or severe side effects, then clinical trials will begin and
the drug is tested in patients who have the condition it is intended to treat.
The principles of a clinical trial are simple: groups of patients are recruited and a drug is
administered to see if there is an improvement in their health or survival rate. However, drugs do
not usually miraculously reverse fatal illnesses and although they reduce the risk of death, they
do not eliminate it. In addition, many viral diseases, such as influenza (flu), are spontaneously
dealt with by the body’s immune system, and some, such as asthma (caused by environmental
and genetic factors), follow an unpredictable path. Some drugs, however, are easy to evaluate
since they alter a clinical measurement, for example captopril reduces blood pressure.
A further difficulty in assessing the effectiveness of a drug is that some measurements of a
disease, such as pain, are subjective, relying on the judgement of both doctor and patient. Such
measurements can also be influenced by the doctor’s or patient’s expectations – the placebo effect.
To minimize these problems, controlled clinical trials are conducted where one group
receives the drug under investigation and a group of similar patients receives either a different
dose of the drug, another drug, a placebo or no treatment at all. The test and control groups
are studied at the same time, but in some clinical trials ‘historical controls’ are conducted where
patients given the drug are compared with similar patients treated with the control drug at a
different time and place.
It is important that the treatment and control groups should be as similar as possible
in characteristics such as age, weight, sex and general health. An important method used
to achieve this is called randomization, where patients are assigned randomly to either the
treatment or the control group. Randomization helps to reduce the possibility of ‘selection bias’
where healthier patients are selected to receive the new drug.
In conjunction with randomization, a design feature known as ‘blinding’ helps ensure that
bias does not distort the results of the clinical trials. Single-blind studies involve not informing
the patients whether they are receiving the new drug or a placebo. The more common double-
blind studies are where the patients, the doctors and the drug company analysts do not know
which patients received the drug. The study is ‘unblinded’ at the completion of the study, when
assignment codes are deciphered to reveal the treatment and control patients.
The first stage of clinical trials, known as phase 1, is carried out on healthy human
volunteers to provide a preliminary evaluation of the drug’s safety and its dose levels. During the
study, the volunteers do not take medication, caffeine, alcohol or cigarettes. This is to avoid any
complications that might arise due to drug–drug interactions. In some cases, phase 1 studies are
carried out not on healthy volunteers but on volunteer patients. This occurs when the drug is
potentially toxic and is used to treat AIDS or cancer.
For ethical and economic reasons, pharmaceutical trials and studies must be kept to a
minimum, which normally includes the determination of therapeutic doses, therapeutic window
and specific drug interactions.
ToK Link
Drugs trials use double-blind tests. When is it ethically acceptable to deceive people?
The first placebo-controlled trial was probably conducted in 1931, when sanocrysin was compared with
distilled water for the treatment of tuberculosis (a bacterial infection of the lungs). Ever since then, placebo-
controlled trials have been controversial, especially when patients randomly assigned to receive a placebo
have forgone effective medical treatments. Recently, the debate has become polarized. One view, termed
‘placebo orthodoxy’ by its opponents, is that methodology considerations make placebo-controlled trials
necessary. The other view, which might be called ‘active-control orthodoxy’, is that placebo orthodoxy
sacrifices ethics and the rights and welfare of patients to the gain of scientific knowledge.
Supporters of placebo-controlled studies argue that it is ethical to conduct such trials even in the case
of medical conditions for which there are drugs known to be effective, because of the limitations of the
methodology in the trials in which active treatment is used as the control group. Sometimes drugs that are
known to be effective are no better than placebo in particular trials because of variable responses to drugs
in particular populations, unpredictable and small effects, and high rates of spontaneous improvement in
patients. Hence, without a placebo group to ensure validity, the finding that there is no difference between
the investigational and standard treatments can be misleading or uninterpretable. New treatments that are
no better than existing treatments may still be clinically valuable if they have fewer side effects or are more
effective for particular subgroups of patients. However, no drug should be approved for use in patients
unless it is clearly superior to placebo or no treatment. Supporters of such studies acknowledge that they are
unethical in some circumstances, especially when withholding an effective treatment might be life-threatening.
Because of these problems, some people have attacked placebo orthodoxy as unethical. Supporters of
active controls propose that whenever an effective drug for a condition exists, it must be used in the control
group. Furthermore, they argue that placebo controls are inappropriate because the medical question is not
whether a new drug is better than nothing but whether it is better than standard treatments.
Thalidomide
Thalidomide was a drug introduced in 1957 in West Germany by the pharmaceutical company
Chemie Grünenthal. It was used as a hypnotic and sedative and was found to give relief from
morning sickness in pregnant women.
It was subjected to some types of toxicity tests before it was marketed, but critics have stated
these were superficial and incomplete. In particular, the drug was not tested for birth defects,
because this was not required by the law at that time.
In early 1961 a sudden increase in the incidence of phocomelia (Figure 25.9), a failure in the
development of the long bones of the arms and legs, was noticed. The drug was withdrawn by
the end of 1961, but by then an estimated 10 000 deformed babies had been born.
However, soon after thalidomide was launched in West Germany reports were noted of
a condition called peripheral neuropathy, which is a result of damage to the nervous system.
It is characterized by a prickly feeling followed by numbness and coldness, followed by severe
muscular cramps and a lack of coordination. This note of peripheral neuropathy was sufficient
for the US FDA to refuse approval for the drug in the USA.
Thalidomide is an example of a teratogenic drug, indicating that it produces malformed
■■ Figure 25.9 The fetuses. The drug has no effect in rats and mice even at very high doses. However, effects
long bones in this in rabbits are found at very high concentrations. Aspirin is a potent teratogen in rats,
little boy’s arms failed mice and hamsters and not recommended for use during pregnancy. Synthetic products
to develop as a result such as thalidomide and aspirin are chemical compounds that are made by chemists in a
of his mother taking laboratory.
thalidomide during
pregnancy
■■ Administering drugs
Oral administration
This method of drug delivery is the most popular as it is simple and cheap. A drug taken by
mouth enters the digestive system before being absorbed into the bloodstream. However, the
stomach contains strongly acidic gastric juices which will hydrolyse many drugs. These acid-
labile drugs can be protected to some extent by covering them with an acid-resistant polymer
called an enteric coating.
To minimize the problem of drug decomposition, many drugs are taken at mealtimes. When
food is present in the stomach the pH is higher, so acid attack on the drug and its coating is
reduced. Few drugs, except ethanol (‘alcohol’), are absorbed in the stomach since the stomach
wall is lined with an insoluble mucous layer that prevents absorption.
Most drugs are absorbed in the small intestine, which has a large surface area due to the
presence of millions of tiny finger-like projections called villi. Hydrogen carbonate ions are
also secreted from the wall of the intestine to neutralize the acidic stomach contents. Enteric
coatings are designed to dissolve in the neutral or slightly alkaline environment of the small
intestine. Many drugs, for example aspirin, are designed to ionize and become more soluble as
they pass from the stomach to the small intestine.
Drugs absorbed from the small intestine into the bloodstream pass via the hepatic portal
vein to the liver. This organ produces a variety of enzymes designed to protect the body from
poisons. Many drugs are slowly decomposed by the liver, but this can be remedied by ensuring a
high oral dose is given, thereby ensuring a therapeutically or medically active amount remains in
the blood after passing through the liver. However, some drugs are designed to be swallowed in
an inactive form called a prodrug which is activated by a liver enzyme into an active form. Such
an approach is used particularly for toxic anti-cancer drugs.
Injection
Some drugs cannot be given by mouth, for example insulin used to treat diabetes, which is a
protein and would be broken down by the acid and enzymes present in gastric juice. Others may
be broken down rapidly by the liver. Such drugs are given parenterally, or by injection. There
are three methods of injection: intravenously, by injection into a vein; intramuscularly, into
a muscle; and subcutaneously, under the skin (Figure 25.10). For example, insulin is injected
subcutaneously.
skin
fatty tissue
intramuscular intravenous
vein
(usually injected subcutaneous (this has the most
into arm, leg or (injected directly rapid effect as the drug enters
muscle
buttock muscles) under the skin) the bloodstream directly)
■■ Figure 25.10 Summary of common methods of drug delivery by injection
Suppositories
To minimize metabolism in the liver, some drugs are inserted into the vagina or rectum, since
veins in these organs do not carry absorbed food and hence do not pass directly through the
liver – most of the blood and dissolved drug is transported to other body tissues.
Drugs administered via the vagina and rectum are given in the form of pessaries or
suppositories. They are made from waxy polymers that slowly melt at body temperature, releasing
the drug and allowing it to be absorbed across the mucous membranes into the bloodstream.
Fat-soluble drugs can be slowly released through the skin by means of a ‘patch’ where
the drug is suspended in a polymer matrix behind a protective coat. Such an approach is
used for female contraceptives (Chapter 23), hormone replacement therapy (HRT) and anti-
smoking aids. Some topical
medications (ointments, pain- canister
relieving gels) are absorbed
plastic holder
through the skin.
propellant with drug
Inhalation suspension
An increasingly important
method of administering drugs metering valve
is via inhalation. A familiar
example is the drug called mouthpiece
Ventolin which is given to
asthma patients to dilate their aerosol
bronchioles. A pressurized
delivery device (Figure 25.11)
ensures that a fine mist of
droplets of the correct size
reaches the lungs.
■■ Figure 25.11 Cross section of metered dose inhaler (MDI)
Types of membranes
There are a number of membranes that drugs may pass when present in the human body. They
differ in their degree of resistance to the movement of drugs.
■ Cell membranes: this barrier is permeable to many drug molecules but not to others,
depending on their lipid solubility. Small pores permit small molecules such as alcohol
(ethanol) and water to pass through.
■ Walls of capillaries: pores between the epithelial cells are larger than most drug molecules,
allowing them to pass freely, without lipid solubility being a factor.
■ Blood–brain barrier: this barrier provides a protective environment for the brain. The rate of
transport across this barrier is limited by the lipid solubility of the psychoactive molecule.
■ Placental barrier: this barrier separates the mother from her baby but is very permeable to
lipid-soluble drugs.
Solubility of drugs
Drugs that are water soluble are often composed of molecules that are ionized and hence have
an electrical charge. They are able to cross through pores in capillaries, but not cell membranes.
Lipid-soluble drugs are uncharged and not ionized.
The dissociation constant, Ka or pKa indicates the pH where 50 per cent of the drug (X) is ionized
(water soluble) and 50 per cent non-ionized (lipid soluble); pKeq = pH + log10[X]ionized/[X]non-ionized.
This affects a drug’s solubility, permeability, binding and other characteristics (Figure 25.12).
■■ Figure 25.12 lipid soluble (lipophilic)

water soluble
Water-soluble and uncharged
drug must be charged to be drug must be uncharged to
drug excreted in urine cross a cell membrane
lipid-soluble drugs
(water = H+ + –OH)
H+ O–
O acidic O– acid
acidic acidic
drug H drug – drug
OH base
+ H+ H+
an acidic drug DONATES an
H+ (proton) when dissolved in water
H H – H
OH base
basic basic basic
drug N drug N H+ drug N
H+
acid
H H H
a basic drug ACCEPTS an
H+ (proton) when dissolved in water
Drug distribution
Depending upon its route of administration and target area, every drug has to be absorbed, by
diffusion, through a variety of bodily tissues. Tissue is composed of cells that are surrounded
by membranes, consisting of three layers, two layers of water-soluble complex lipid molecules
(phospholipids) and a fluid layer of lipids, sandwiched within these layers. Suspended within the
layers are large proteins, with some, such as receptors, spanning all three layers.
The permeability of a cell membrane for a specific drug depends on a ratio of its water to
lipid solubility. Within the body, drugs may exist as a mixture of two interchangeable forms,
either water-soluble (ionized-charged) or lipid-soluble (non-ionized). The concentration of
two forms depends on characteristics of the drug molecule (pKa, pH at which 50 per cent of
the drug is ionized) and the pH of fluid in which it is dissolved. In water-soluble form, these
drug molecules cannot pass through lipid membranes, but to reach their target area, they must
permeate a variety of types of membranes.
Drug administration methods
Slow absorption methods for drugs include the following methods of drug administration: orally,
through mucous membranes, topical/transdermal (through the skin) and rectally (suppository).
Faster absorption is achieved through the various types of injections and inhalation (via the
lungs). The fastest method of absorption is directly into the brain. The general principle of drug
delivery to the brain is the faster the absorption, the quicker the onset and
100
the higher the addictiveness, but the shorter the duration.
Blood level/ %
intravenous
In order to reach the target organ, most drugs have to enter the
50 bloodstream, which may be an issue if a drug is lipophilic (non-polar) and has
limited solubility in water or has a slow absorption rate from the stomach or
oral
small intestine when it is administered orally. When a drug is administered
0
intravenously (via injection) its bioavailability is 100 per cent, but other routes
Time/arbitrary units
of administration, such as oral, decrease its bioavailability (Figure 25.13) due to
■■ Figure 25.13 Drug concentration in the incomplete absorption and chemical degradation. The bioavailability refers to
bloodstream as a function of time the fraction or percentage of drug that is available in the bloodstream.
ToK Link
Naming of drugs
The same drug can be identified by different names. Are names simply labels or do they influence our other
ways of knowing?
One of the greatest human skills is the ability to name things. We name and classify the members of the
natural world into categories. We saw a tall plant and we defined that plant a ‘tree’. Then we looked at
some of the appendages sticking out from the tree and we defined them as branches. And the flat green
parts that sprout out of the branches we called leaves. A tree is a living organism that includes branches and
leaves. Branches sprout leaves and leaves grow on branches and trees.
Trees, branches and leaves already existed before humans named them. We are not creating but just
labelling biological objects that already exist. Did the things that we named exist before we named them?
Or more precisely, in what sense did they exist before they were named, and how did their existence change
after being named? If we think about trees it is easy to assume that our naming it a tree does not change
anything. It is not an act of creation.
However, consider a newly synthesized anti-cancer drug. Many of these drugs have reassuring complex and
unfamiliar chemical names, for example, sunitinib (technical name) or Sutent (commercial name). Patients
might be less willing to take this drug if it was renamed as ‘last chance lung-cancer treatment’. Emotion has
a powerful effect on drug names.
The names we give to drugs and many other objects are inevitably not just labels – they are interpretations.
And we act on the basis of those interpretations, and those interpretations define reality for us. We act as
if the distinctions we make in the world are real and once these distinctions become fixed in our minds it is
very hard to view the world in any other way.
■■ Drug kinetics
Drugs do not remain in the body. They may be broken down or converted to an unreactive
product. The drug and its metabolites are excreted via the lungs (as with inhaled anaesthetics),
through the skin (rarely and to a small extent) or in the urine and faeces.
As time passes the concentration of drug in the body fluids,
Plasma concentration/µg dm–3
45 such as the blood, will fall. Many drugs are lost (eliminated) in a
40 simple first-order reaction, in which the rate of the loss of the drug is
35 proportional to its concentration:
30
25
20
Rate = k [drug]
15
10 where square brackets denote concentration in moles per cubic
5 decimetre and k the rate constant. This results in an exponential
0 decay of the drug concentrations with time. Figure 25.14 plots the
0 2 4 6 8 10 12 14 16 18 20 22 24
concentrations of a drug in the blood at various times after a single
Time/hours intravenous injection. A characteristic feature of first-order reactions
■■ Figure 25.14 Exponential decay of a drug with a
is their constant half-life; the curve in Figure 25.14 has a half-life of
half-life of five hours
five hours.
high Dosage
The dose–response curve shows the relationship between the drug dose and
the magnitude of the drug effect (Figure 25.15). It should be noted that drugs
Effect of drug
after this point,

increasing doses can have more than one effect and drugs vary in effectiveness: they have
do not produce different sites of actions and different affinities for receptors. The effectiveness
a stronger effect
of a drug is considered relative to its safety (therapeutic index).
Lethal dosage
low
Tests are performed on all pharmaceuticals (medicinal drugs) to establish their
low Dose of drug toxicity. Such data is normally reported in the form of LD50 values (lethal
high
■■ Figure 25.15 Dose–response curve dose, 50%) which indicate the quantity of the drug or other substance that, if
administered to a group of animals, will kill 50 per cent of them.
LD50 values are normally expressed in milligrams (mg) of drug per kilogram (kg) of the test
animal’s body weight. The method of administration, for example injection into the blood or via
the mouth (oral), should also be recorded, as should the subject animal.
A large LD50 value means that the substance is relatively non-toxic and that a large quantity
of the substance is required to cause a toxic response. Conversely, a small LD50 value means
that the substance is relatively toxic and that only a small quantity of the substance is needed
to cause a toxic response. The important point to note is that all substances are potentially
poisonous: it is only the dose that determines whether a substance is poisonous. The concepts of
toxicology imply that no drug is 100 per cent safe.
Table 25.1 shows some examples of LD50 values. In the case of caffeine the LD50 value is
achieved by taking about 50 caffeine pills or drinking between 100 to 200 normal cups of
coffee in one hour. The LD50 value for humans is estimated from the value for rats, allowing for
difference in body weight and sensitivity to caffeine.
■■ Table 25.1 LD50

Chemical LD50/mg kg−1 Subject, route
values for selected
Sucrose 29 700 Rat, oral
substances
Ethanol 7060 Rat, oral
Sodium chloride 3000 Rat, oral
Caffeine 192 Rat, oral
Sarin (a nerve gas) 25 Human, subcutaneous (via skin)
Sodium cyanide 6.4 Rat, oral
Toxic dosage and effective dosage

In toxicology, the toxic dose, TD50, is the dose at which toxicity occurs in 50 per cent of humans
in a test sample of a drug or chemical. The type of toxicity needs to be specified for this value
to have any practical meaning. Since toxicity need not be lethal, the TD50 value is generally
loss than the lethal dose, LD50. The LD50 value can be regarded as an upper boundary on the
TD50 value. An effective dosage, ED50, in pharmacology is the amount of drug that produces a
therapeutic effect in 50 per cent of the human subjects taking it.
Therapeutic index
The ED50 of a drug is the dose required to produce the desired effect, for example reduce blood
pressure, in 50 per cent of test animals or patients. The ratio of LD50 to ED50 is known as the
therapeutic index. A therapeutic index of 10 indicates an LD50 : ED50 ratio of 10 to 1. This means a
tenfold increase in the dose corresponding to the ED50 would result in a 50 per cent death rate.
The dose–response curves for a drug’s therapeutic and lethal effects can be compared
(Figure 25.16) to determine whether the therapeutic ratio is safe. The curves should not overlap
on the x-axis, which means that the shallower the slopes of the curves, the higher the risk
attached to use of the drug.
Figure 25.16 shows the therapeutic and lethal dose–response curves for a drug that cures a
particular animal illness. A 50 mg dose of the drug will cure 95 per cent of the test animals, but
will kill 5 per cent of the animals. Obviously, this drug would not be tested on human patients
because of its high therapeutic window (10) (see below on this page). A safer drug would have to
be developed that has a considerably lower therapeutic window, for example in the region of 1.
95 therapeutic
dose curve
% of subjects responding
lethal dose
curve
50
5
0
0 5 10 50 100 Dose/mg
ED50 LD50
■■ Figure 25.16 Comparison of therapeutic and lethal dose curves for a pharmaceutical
Therapeutic windows are relevant to animal testing of drugs, but they do not take into account
any non-lethal side effects. Hence, the therapeutic dose levels that are used on patients should
have a minimum risk of side effects or long-term toxicity.
Therapeutic window
Drugs are usually taken at regular time intervals, and the doses are designed to keep the blood
levels of the drug within a maximum and minimum level such that they are not too high to
be toxic but not so low as to be ineffective. The therapeutic window is the range of dosages
between the minimum amount of the drug that produces the desired effect and a medically
unacceptable adverse effect.
In general, the concentration of free drug in the blood is a good
A
indication of the availability of a drug at its target. Figure 25.17 shows
two different types of dosing. The dosing approach labelled A quickly
Blood plasma drug
reaches the therapeutic level but continues to rise to a steady state

concentration
toxic level which is toxic. The dosing approach labelled B involves half the
B
therapeutic window
therapeutic level
amount of the drug provided with the same time frequency. The time
taken to reach the therapeutic level is longer, but the steady-state levels
of the drug remain between the therapeutic and toxic levels – the
Dose times therapeutic window (Figure 25.17).
■■ Figure 25.17 Approaches to the dosing of a drug Drug dosing involving regular administration of a drug works
well in most cases, especially if the size of each dose is less than
200 mg and doses are taken once or twice a day.
The experimental foundations for therapeutic index and therapeutic
window through animal and human studies
Drugs have therapeutic effects, toxic side effects and, in some cases, lethal effects. Side effects
and lethal effects are typically dose-dependent and can be quantified by defining the dose that
produces a toxic effect in 50 per cent of the population (TD50) and (at least in animals) lethal
effects in 50 per cent of the population (LD50). All of these measurements are based upon
experiments with large numbers of controlled experiments in animals and humans.
The dose relationships for toxic and lethal effects may have different slopes compared to the
therapeutic dose–response relationship because they produce effects by different receptors or
mechanisms (Figure 25.18). It is of value to know the relative difference between the average toxic
dose and the average therapeutic dose. The most common way to define this relationship is using
the therapeutic index, which is defined as the ratio between the TD50 and ED50. Figure 25.18 also
shows the therapeutic window which is a well-defined range of a drug’s concentration in the blood
at which a desired effect occurs, below which there is little effect, and above which toxicity occurs;
the therapeutic window differs among patients and is determined from experimental studies.
therapeutic window
■■ Figure 25.18
Patients affected or responding/%
The therapeutic index 100

and therapeutic therapeutic toxic adverse
window effect side effect
effect
therapeutic
50
index
0
ED50 TD50
Dose administered/mg kg–1
Pharmacokinetics
The study of how a drug reaches its target cell, tissue or organ in the body is known as
pharmacokinetics. This information is important in the pharmaceutical industry when a new
drug is being developed. There is no benefit for medicinal chemists trying to optimize the
structure of a new compound to bind and interact with a specific protein receptor, if little or
none of the drug reaches the target site.
There are four issues to consider:
■ Drug absorption is the route by which the drug reaches the bloodstream from the point at
which the drug entered the body.
■ Drug distribution refers to the transport of the drug in the bloodstream and then the slower
transport to the organs, tissues and cells.
■ Drug metabolism refers to the chemical breaking down of a drug due to the action of
enzymes, often in the liver.
■ Drug excretion refers to the removal of the drug from the body, usually via the urine. The
main route for excretion is via the kidneys and bladder.
The aim is to design a drug with an optimum lifetime in the body, long enough to reach its target
and be effective, but short enough to ensure its concentration does not build up in the body.
Tolerance
Tolerance towards a particular drug occurs when a larger dose of the drug is required in order
to achieve the effect originally obtained by a smaller dose. A classic example is alcohol: a steady
consumption of alcohol in alcoholic drinks leads to tolerance.
There are two different time frames of tolerance: acute tolerance and chronic tolerance. Acute
tolerance occurs following a single exposure to the drug; chronic tolerance occurs gradually as the drug
is taken repeatedly. Both types of tolerance can occur with alcohol, though the latter is more common.
There are two mechanisms by which tolerance to alcohol can develop: metabolic tolerance
involving an increase in liver activity, and functional tolerance produced by changes in the
central nervous system (brain and spinal cord). Tolerance of the functional type is also observed
with nicotine. Smokers develop an increased number of nicotine receptors in the brain. While
alcoholics may have a higher tolerance for alcohol than social drinkers or abstainers (those who
do not drink), the size of a lethal dose is not very different between these two groups.
Cross-tolerance can also develop between alcohol and many other sedative or hypnotic
drugs. This means that tolerance to alcohol also produces tolerance to other drugs, so that
they do not have the required effect. Once the body develops dependence on alcohol, a sudden
stopping of drinking is likely to produce withdrawal symptoms. These can be life-threatening
and include severe anxiety, tremors, hallucinations and convulsions.
Side effects
The term side effect is used to describe any effect other than the intended effect of drug
treatment. Side effects may be negative, neutral or positive for the patient. The drug Viagra
was originally screened as a potential drug to treat heart disease. Prolonged penile erections were
noted in patients as an unexpected side effect.
Morphine is a narcotic (pain-relieving and sleep-inducing drug) that is extracted from the
opium poppy (Papaver somniferum) (Figure 25.19) grown mainly in parts of Afghanistan. It is a very
powerful (and addictive) painkiller that is prescribed only to alleviate severe pain, frequently in
■■ Figure 25.19
patients who are terminally ill. It also causes a sense of euphoria or great happiness and well-being.
Seed pods of the
However, unwanted serious side effects of the drug include a feeling of drowsiness, slow weak
opium poppy
breathing, mental confusion, seizures, nausea and constipation. (Laxatives such as Dulcolax or
Senokot, which stimulate contractions of the bowel, are often used to relieve the constipation
caused by morphine.)
Morphine’s most dangerous side effect is its desensitization of the medulla oblongata in the
brain which is concerned with the regulation of breathing. This causes the ventilation of the lungs
to slow down. Moderate doses of morphine may become fatal if taken in conjunction with alcohol.
Bioavailability
Bioavailability refers to how quickly and how much of a particular drug reaches the blood supply
following absorption, distribution, metabolism and excretion. Oral bioavailability is the fraction
of the dose taken by mouth that reaches the blood stream. This is an important property when it
comes to designing new drugs and should be considered with the pharmacokinetics of the drug
(how effectively the drug interacts with its target molecule).
Bioavailability can depend on a variety of factors including the crystal form of the drug,
whether the drug is given (administered) as a tablet or capsule, or a variation in the components
of a tablet or capsule. It is important during phase 1 studies for researchers to check that
bioavailability remains the same should there be any change to the manufacturing process or
how the drug is stored. Powder-filled capsules are often used in phase 1, whereas tablets are used
in phases 2 and 3. Therefore it is necessary that these formulations show bioequivalence in
healthy volunteers involved in the drug testing.
Comparison of how functional groups, polarity and medicinal
administration can affect bioavailability
The bioavailability is the fraction of an administered dose of drug that reaches the bloodstream.
A number of properties affect bioavailability, including the chemical structure of the drug,
which determines physical properties such as solubility, pKa and hydrophobicity (degree of lipid
solubility) and method of administration.
In developing a drug, medicinal chemists often chemically modify the structures of lead
compounds. A lead compound is a molecule that shows pharmaceutical activity in a screening
process for active molecules.
2
1 This relationship between the molecular structure of a drug and its effect on
HO 3
animals or plants is termed the structure–activity relationship. It may be investigated by
4
synthesizing a series of structurally related molecules, followed by measuring the change
in the therapeutic effect and bioavailability in animals.
O
NCH3 Morphine (Figure 25.20) acts as an agonist and binds to the analgesic (pain) receptors
5
in the brain and turns them on, causing an analgesic effect. Since the molecule has
6
8 a complex structure, small changes in the molecular structure may result in large
HO 7 differences in the activity and bioavailability of the drug. Since modification of structure
■■ Figure 25.20 Morphine leads to changes in physical properties, such as solubility, acidity and polarity, it results in
structure with atom labels changes in properties of absorption, distribution, metabolism and excretion of the drug.
A free phenol group (position 3) is essential for analgesic activity. Substituting the phenol
group (–OH) in the benzene ring with a methoxy group (as in codeine) reduces the activity
of the analogue 15 per cent relative to morphine. The activity is further reduced if an ethoxy
group is used. This is due to the fact that the ether group significantly decreases the binding
to the receptor. In fact when codeine is directly injected into the brain, no analgesic activity
is observed. The activity of the drug is derived from the metabolic demethylation process
(conversion of methoxy group (–O–CH3) to hydroxyl group) brought about by the liver. Only if
codeine passes through the liver can its activity be observed in the body.
In contrast, methylating the alcohol group at position 6 increases analgesic activity. It is
believed that the ether group in position 6 reduces the polarity of the analogue (the ether
functional group is less polar than the alcohol group), leading to a more efficient crossing
of the blood–brain barrier. Hence the compound may accumulate in the brain in higher
concentrations, enhancing the analgesic effect. The charge on the nitrogen atom and the
size of the alkyl group attached to it are crucial to the analgesic activity of the compound.
Bioavailability is also determined by the method of administration. Morphine administered
nasally to humans as a simple solution is only absorbed to a limited degree, with a bioavailability
of the order of 10 per cent compared with intravenous administration.
Nature of Science Drug testing and risk/benefit analysis
It is extremely difficult to develop an ideal medicinal drug, but an ideal drug should have
the following characteristics: no toxicity, high effectiveness and selectivity (lack of side
effects), ease of administration, high chemical stability, low cost, high purity and no tendency
for the patient to develop addiction or tolerance. No such drug exists but the list serves as
an objective in pharmaceutical research and development. In deciding whether the drug
is safe enough to be on the market, regulators would evaluate the risk-to-benefit ratio. It
would be ideal to have low risk, but if an effective treatment is found for cancer or human
immunodeficiency virus (HIV), it may still be acceptable to release the drug even if there is a
high risk of harmful side effects.
Before a drug is released to the market it must go through a wide variety of tests, starting
with in vitro tests – laboratory tests involving tissues, cells or enzymes. These tests aim to study
the biochemical functions of the target molecule as a result of binding to a potential drug. In
vivo tests give more knowledge about the action of the drug in animals. Drug candidates with
the desired activity undergo further tests to assess the risk of the drug upon administration.
Preclinical trials involve toxicity, drug metabolism and other biological tests in animals.
Potential drugs are often chemically modified based on the results of the tests. Preclinical
trials help researchers to estimate the toxic dose of a potential drug, preparing for later clinical
trials on normal healthy volunteers and patients. Clinical trials take place in various phases
(Table 25.2) and often involve blind and double-blind trials.
■■ Table 25.2 Clinical

Phase Subjects Test results
(human) trials
1 Small number of healthy consenting volunteers Toxicity and safety dosage (TD50) and side effects
2 Small number of patients Effectiveness and effective dosage (ED50) and
short-term side effects
3 Large number of patients Comparison of effectiveness with other
drugs available in the market, further data on
effectiveness and side effects
■■ Drug action
Isomerism
Compounds that have the same molecular formula but different structural formulae are
described as isomers. Isomerism is most common in organic chemistry, but structural, geometric
and optical isomerism are all shown by transition metal complex ions (see Chapter 13), some of
which are used as pharmaceuticals.
H3N H3N
NH3 cis-[PtCl2(NH3)2] Cl trans-[PtCl2(NH3)2]
Cl Pt Cl Pt
cisplatin
Cl NH3
■■ Figure 25.21 Geometrical isomerism in diamminedichloroplatinum(ii)
Geometrical isomerism occurs when transition metal complex ions have the same numbers and
types of ligands, but their arrangement around the central metal ion varies. This is often loosely
called cis–trans isomerism, referring to the relative positions of two of the selected ligands. This
type of isomerism is only possible where the number of ligands is greater than or equal to four.
Diamminedichloroplatinum(ii), [Pt(NH3)2Cl2], a square planar complex, exhibits geometrical
isomerism (Figure 25.21). There are two different ways of arranging the four ligands: ammonia
molecules adjacent to one another – a so-called ‘cis’ arrangement – and a ‘trans’ arrangement
where the two ammonia molecules are opposite one another.
The cis isomer of [Pt(NH3)2Cl2] is used medicinally as an anti-cancer drug and is known as
cisplatin (see Chapter 13). The trans isomer does not show any anti-cancer properties.
Cisplatin is a highly effective drug commonly used to treat cancer of the ovaries and testes,
as well as tumours in the lungs, head, neck, bladder and cervix. Cisplatin is injected directly
into the blood where it easily diffuses through the cell membranes of the tumour cells, since it
is electrically neutral. Inside the cell, cisplatin exchanges a chloride ion for a molecule of water
to form [Pt(NH3)2(Cl)(H2O)]+ which is the active principle (the molecule that has the anti-
NH3 tumour properties).
This positively charged molecule then passes through the nuclear membrane where it
O Pt NH3 binds to DNA. Once the complex [Pt(NH3)2(Cl)(H2O)]+ has bound to DNA it exchanges
H + another chloride ion to form [Pt(NH3)2(DNA)(H2O)]2+, which will then bond at a
N
N second site on the double helix of the DNA. Bonding occurs between the platinum ion
at the centre of cisplatin and the nitrogen or oxygen atoms of the four bases of DNA
H2N N N (Figure 25.22). The second bond formed can be within the same base, between two
H adjacent bases on the same strand of DNA or between two bases on opposite strands
of DNA. As a consequence, the helical turns of DNA are shortened and bent, thereby
■■ Figure 25.22 Cisplatin preventing DNA replication during cell division.
bonded to guanine
The importance of chirality in the action of drugs
Enantiomers that act as drugs have different biological properties because they interact and bind
with receptor molecules. These receptors are frequently cell membrane proteins whose surface
contains a groove or cavity that is capable of interacting and binding only with the enantiomer
that has a complementary structure (similar to the lock-and-key hypothesis of enzyme action).
Thalidomide is a chiral molecule that was prescribed as a racemic mixture. It contains
one chiral centre based at the carbon atom of the six-membered ring attached to the nitrogen
(alpha-amino position) on the five-membered glutarimide ring. There are therefore two possible
enantiomers (Figure 25.23).
■■ Figure 25.23
O O H O O H
Structures of the
N N
two enantiomers of
N O N O
thalidomide
O chiral centre O
After thalidomide was withdrawn from the pharmaceutical market it was reported that the
isomer on the right of Figure 25.23 was teratogenic. It has been suggested that if thalidomide was
marketed only as the isomer shown on the left the thalidomide tragedy could have been avoided.
However, this long accepted hypothesis has become controversial since recent studies have
shown that the two enantiomers undergo rapid conversion in human blood plasma.
Penicillin
The various penicillins are a group of antibiotics that belong to a large class of antibiotics
termed beta-lactam antibiotics. All the antibiotics in this class contain the beta-lactam ring
(Figure 25.24). It is this strained four-membered ring that is responsible for the antibacterial
activity of penicillins and other beta-lactam antibiotics. The bond angles of the carbon and
nitrogen atoms of the amide group in this ring are 90°, instead of 109° and 120° for sp3 and sp2
hybridized atoms, respectively.
Penicillins inhibit the final step in the synthesis of bacterial cell walls. The final step
involves the enzyme-controlled cross-linking of peptidoglycan strands. Penicillin resembles the
dipeptide moiety (alanine–alanine) incorporated by the transpeptidase enzyme to perform the
cross-linking reaction (Figure 25.24). The penicillin mimics the enzyme’s normal substrate and
hence enters the active site. The enzyme becomes covalently attached to the penicillin molecule
and is then not capable of catalysing any further reactions.
■■ Figure 25.24
H
Structures of penicillin O O
H COOH COOH
and alanine–alanine, N N
H H
the substrate for O H O CH3 H
transpeptidase N S N CH3
CH3
R H CH3 H
penicillin natural substrate
The high chemical reactivity of the amide group within the four-membered ring structure is a
result of ring strain. The bond angles in the four-membered ring will be close to 90°, considerably
less than the favoured bond angle of 109° for sp3 hybridized carbon atoms. The beta-lactam ring
opens so that the penicillin molecule becomes covalently bonded to the transpeptidase.
Heroin and morphine
Semi-synthetic drugs are drugs synthesized from a naturally occurring chemical rather than
from simple starting substances. An early example of a semi-synthetic drug was diamorphine
(heroin), which was synthesized from morphine. The conversion is performed by reacting
morphine with excess ethanoic anhydride which converts an alcohol functional group
(Figure 25.25) into an ester functional group. This is an example of an acylation, specifically
ethanoylation (acetylation).
■■ Figure 25.25 O
Synthesis of heroin
HO CH3 C O
morphine heroin
O O
ethanoic anhydride
N CH3 N CH3
O
HH HH
HO CH3 C O
The consequence of the acylation is that a polar alcohol group (−OH) has been converted to a
less polar ethanoyl group. This functional group conversion results in an increased potency by a
factor of between 5 and 10 for heroin relative to morphine. Morphine, heroin and other opiates
act on the brain but they have to pass through the blood–brain barrier (Figure 25.26). This is
a membrane-based structure that protects the delicate brain cells (neurons and glial cells) from
toxic chemicals in the blood, but still allows the absorption of nutrients and dissolved oxygen.
■■ Figure 25.26 glial cell capillary wall

The blood–brain
barrier: many large
drug molecules cannot
pass through the thick
capillary wall and glial
cells
blood
drug molecule
■■ Drug design
Traditionally, researchers first identified a disease target, usually an enzyme or structural protein,
and then searched for a chemical that would bind and interact with the drug target molecule
and inhibit its action. Many of these compounds were discovered by ‘screening’ natural products,
often from plant extracts, and testing them with cells grown in culture. The cells are frequently
cancer cells of various types or, more recently, white cells infected with HIV. The cells were then
observed for any changes in growth, specifically inhibition.
However, once a compound had been identified to be active against a particular target, for
example cancerous cells, it rarely had all the necessary properties required to become a drug.
For example, it might be poorly soluble in water. Therefore, chemical analogues of the active
compound were synthesized in order to optimize desirable properties and, equally, minimize
any harmful effects. These chemical analogues constitute a chemical library: they will share
common structural features but will have one or more different functional groups, for example
Taxol (paclitaxel) and Taxotere (docetaxel). The various chemical analogues were then re-tested
until a suitable molecule, known as the drug candidate, with the best balance of chemical,
pharmacological and physical properties was obtained.
The problem with this approach is that chemists using traditional methods of synthesis can
typically synthesize only one different compound a day. Synthesizing a range of compounds to
test against a disease target could have taken several years. Optimizing an active compound and
discovering a drug candidate could take several more years.
The term pharmacophore refers to the particular group of atoms or functional groups
required for a drug to bind to a target. The knowledge of a drug’s pharmacophore is critical to
drug optimization.
Computer modelling
The modern approach to drug design is target orientated, aiming to improve the binding
between the drug and the target molecule. It also aims to increase the drug’s selectivity for the
target molecule. If these aims are achieved then activity should be increased, while side effects
should be decreased.
At a molecular level this means that the drug molecule must be of the correct size and shape
to fit into the active site of the target molecule. The necessary functional groups must be present
and in the required orientation so that binding can occur.
Many drug targets have been identified and their genes can be
easily cloned and inserted into a bacterium using genetic engineering
techniques. Large quantities of a particular receptor or enzyme can
then be grown. The structures of the drug target and its active site can
then be established using X-ray diffraction (see Chapter 4) and NMR
(see Chapter 21).
In theory it is then possible to design a drug based on the structure
of the target binding site using computer-based molecular modelling
software (Figure 25.27). This is known as de novo drug design, but to
date no clinical drugs have been designed by this method. Generally,
molecular modelling is used to optimize analogues derived from a drug
candidate or identify which analogues are most likely to bind to the
■■ Figure 25.27 A computer-generated model active site of the drug target.
of Taxol (using Chem 3-D from Cambridgesoft Molecular modelling software allows medicinal chemists to create
Software) an accurate model of a molecule in three dimensions. However, the
molecule may be distorted and not have the correct bond lengths and,
in particular, bond angles. There will be many shapes that the molecule
can adopt known as conformations (see Chapter 20).
The software will then perform a process called energy minimization
Toatal potential energy
(Figure 25.28) where the program modifies the bond lengths and angles
in the computer model of the molecule and calculates the steric energy
of the new conformation. If the energy increases significantly, it means
potential energy
minimum that the new structure is unstable. The process is repeated many times,
until new modifications carried out have little effect on the total energy
of the molecule. This corresponds to a stable structure or an energy
minimum.
Improving the solubility of drugs
Atomic coordinates
Drugs need to be soluble in both polar and non-polar environments.
The solubility of a drug in these environments determines its absorption,
■■ Figure 25.28 The technique of energy distribution and excretion. Modifying the polarity of a drug or its acid/
minimization base properties will vary its solubility and may improve its medicinal
properties.
Drugs that contain a carboxylic acid functional group can be
made more polar by converting them to a salt. This is the case for
soluble aspirin (Figure 25.29) which is the calcium or sodium salt of
aspirin (Figure 25.30). Once the aspirin anion reaches the strongly
acidic environment of the stomach it reverts back to the un-ionized or
molecular form (free acid).
■■ Figure 25.29 Disprin, a – O CH3

popular brand of soluble O O 2+
Ca –
aspirin from the UK O O
H3C O
■■ Figure 25.30 Structure of the calcium form of

soluble aspirin
Many drugs that contain an amine group are similarly administered as their
hydrochloride salt as this increases their solubility in polar environments and
F3C hence their transport around the body. The antidepressant drug Prozac
CH2 (Figure 25.31) is administered as the hydrochloride.
O CH2 NH2
+
Cl
–
Chiral auxiliaries
CH3 There are many examples of drugs where the biological activities of
the two isomers are very different. Until recently many synthetic drugs
■■ Figure 25.31 Structure of Prozac were produced as racemic mixtures consisting of equimolar mixtures
(fluoxetine hydrochloride) of both enantiomers. Such mixtures are difficult to resolve (separate)
and frequently the two enantiomers crystallize into a racemic crystal.
However, various techniques have been developed that allow the production of single
enantiomers. One such approach is the use of a reagent or reactant that contains a chiral
auxiliary, a group located near the reaction site that controls the stereochemistry and
is easily removed afterwards. This approach is an example of true asymmetric synthesis
because chirality is created in the course of the reaction. This approach is used in the total
synthesis and semi-synthesis of Taxol (see Section 25.7).
Figure 25.32 shows the stereoselective conversion of propanoic acid (an achiral
compound) to a specific enantiomer of 2-hydroxypropanoic acid (a chiral compound). A
chemical synthesis that did not employ a chiral auxiliary would result in the formation of a
racemic mixture.
O O O
chiral centres
H3C C normal steps H3C C H3C C

C OH C OH + C OH
H propanoic acid H HO
H (no chiral centre) OH mixture of both H
enantiomers formed
chiral auxiliary added
O O O
chiral auxiliary
H3C C H3C C removed H3C C
C C only desired C OH
H H enantiomer formed H
H OH OH
■■ Figure 25.32 The use of a chiral auxiliary in the synthesis of 2-hydroxypropanoic acid
A chiral auxiliary is employed in the synthesis of the drug l-DOPA, used to control
Parkinson’s disease. This is a degenerative disease of the brain that impairs motor skills and
speech. It is characterized by muscle rigidity, shaking and a slowing of physical movement.
3,4-Dihydroxyphenylalanine (DOPA) exists in two enantiomers (Figure 25.33), but only l-DOPA
is active. The d-form is inactive.
■■ Figure 25.33 The

O O
two enantiomers of
DOPA. The * marks the C C
HO * * OH
chiral centre OH HO
HO H2N H H NH2 OH
L D
The key step in the synthesis of l-DOPA is the use of a homogeneous rhodium catalyst to
hydrogenate a carbon–carbon double bond. It is this step that creates the chiral centre. By
using a catalyst which itself contains only one stereoisomer of a chiral phosphorus ligand, the
catalyst is able to direct the addition of hydrogen to the carbon–carbon double bond so that only
one enantiomer is formed. Hydrolysis of this product forms a mixture containing 97.5 per cent
l-DOPA and 2.5 per cent d-DOPA.
Rational drug design – enzyme inhibitors as medicines
In rational drug design, biologically active compounds are specifically designed to interact with a
particular drug target. Rational drug design often involves the use of molecular design software,
which researchers use to create three-dimensional models of drugs and their biological targets.
Receptors and enzymes are very similar. Both are globular proteins with precise structures
that have evolved (by natural selection) to accommodate specific arrangements of atoms on
another molecule such as a neurotransmitter or a substance.
Just as antagonists are used to block receptors, so medicinal drugs can function by inhibiting
the action of enzymes. A good example is captopril – which is widely used to treat high blood
pressure (hypertension). If not treated, this can lead to serious consequences such as stroke or
heart attack.
A small protein, angiotensin II, formed from eight amino acids is known to be a key factor in
raising blood pressure. The body synthesizes angiotensin II for an inactive 10-amino-acid protein
called angiotensin I. The enzyme which brings about the loss of the two amino acids in this
conversion is called angiotensin converting enzyme (ACE).

ACE
Angiotensin I ⎯⎯→ Angiotensin II + dipeptide
An imbalance in the production of angiotensin II results in high blood pressure, so

one method of treatment is to inhibit the enzyme which catalyses its formation. The
medicine needs to be an ACE inhibitor and captopril works in this way.
The lead for the development of captopril was the discovery that the venom
of the Brazilian arrowhead viper (Figure 25.34) brought about its toxic effect by
causing a decrease in the blood pressure. The venom is a complex mixture, but
separation, analysis and further study of the components led to the identification of
several small proteins which were powerful ACE inhibitors. Unfortunately, proteins
are difficult to administer as medicines by mouth because they are readily broken
down by pepsin and hydrochloric acid present in the stomach.
■■ Figure 25.34 Brazilian
The snake venom proteins could not therefore be used medically as ACE inhibitors,
arrowhead viper
but their structures gave medicinal chemists information about the shape and structure
of the enzyme’s active site. They learned more by studying the way the enzyme changes
angiotensin I into angiotensin II. From this they realized that ACE must be similar to
another, well-studied zinc-containing enzyme, carboxypeptidase. The combination of these results
led to a model in which the ACE enzyme binds to its substrate (angiotensin I) in three places by
three different types of interaction:
1 a metal–ligand coordinate bond between a zinc ion on the enzyme and an atom with a
partial negative charge on the substrate
2 a hydrogen bond between an N–H group (from an amino acid) on the enzyme and a
negatively charged atom on the substrate (angiotensin I)
3 an ionic interaction between a positively charged –NH3+ group on the enzyme and a
negatively charged –COO – group at one end of the substrate.
These interactions (labelled 1, 2 and 3) between ACE and the three amino acid residues at the
–COOH end of angiotensin I are shown in Figure 25.35. Note that the enzyme’s active site has a
precise shape that also fits other groups on the amino acid side-chains.
■■ Figure 25.35
The structure ACE active site
proposed for the ACE–
N CH3
angiotensin I complex
NH H C CH3
CH2 CH2 CH2
angiotensin I molecule N CH C N CH C N CH C O– 3 +NH3

δ–
H O H O H O
1 2 δ+
H
Zn2+
N
ACE catalyses
hydrolysis at this bond
It is essential for the biological action of ACE, and all enzymes, that the products are
bound less strongly than the substrate. This ensures that the products will leave the enzyme
and allow more substrate molecules to bind, thus continuing the catalysis. In this case,
angiotensin I (the substance) is bound by three interactions, but angiotensin II (one of the
products) is only bound by the metal–ligand bond (interaction 1 in Figure 25.35), and the
dipeptide (the other product) is only held by the hydrogen bond and the ionic interaction
(interactions 2 and 3 in Figure 25.35).
A successful ACE inhibitor needs to bind but not react, so it remains attached by all three
interactions. The use of interactive computer graphics to study the shape and charge density in
the active site played an important role in the design of possible compounds.
R C N
All the active proteins which were isolated from the snake venom had proline as the amino
O COOH acid at the –COOH end of the chain. This was chosen as a good lead for the development of
■■ Figure 25.36 an ACE inhibitor. Medicinal chemists set about synthesizing hundreds of compounds with the
Proline with an acyl general structure as shown in Figure 25.36, but with different R groups, each with a different
group side-chain.
They were all capable of interacting at positions 2 and 3 with the ACE enzyme. The
breakthrough came when it was discovered that derivatives which contained an –SH group in
the right position to interact with the Zn2+ were particularly effective.
Figure 25.37 shows how captopril is thought to bind to ACE. Captopril is not a protein and
is not broken down by digestive enzymes when it is taken orally (by mouth). The peptide link
which is broken in angiotensin I is not present in captopril. At the corresponding position on
the captopril–enzyme complex, there are S–C and C–C bonds which cannot be hydrolysed. The
development of captopril is an excellent example of the rational design of a new molecule. The
drug went through clinical trials and was marketed in 1980 and is now in widespread use.
■■ Figure 25.37
Captopril in the ACE ACE active site
active site
CH2
CH3 CH2
H2C
captopril
molecule CH2 CH C N CH C O– +NH
3
– S δ−
O O
δ+
H
Zn2+
N
ToK Link
Risks and benefits of drugs
All drugs carry risks as well as benefits. Who should ultimately be responsible for assessing these? Public
bodies can protect the individual but also limit their freedom. How do we know what is best for society and
the individual?
Regulatory bodies are responsible for accessing the scientific and clinical data, and approving whether a
drug can proceed to clinical trials or the marketplace.
In the USA, pharmaceutical companies submit an IND (Investigational Exemption to a New Drug Application)
to the FDA (Food and Drug Administration) when they want to start clinical trials on a drug.
The IND should contain information regarding the chemistry, manufacture and quality control of the drug.
It should also include information regarding the drug pharmacology, distribution and toxicology in animals,
and any clinical information that may be known about the drug. The IND is a confidential document and is
not released to the public.
A new drug application has to be submitted to the FDA if a drug is to be marketed in the USA. This contains
all the scientific and clinical information regarding the drug’s manufacture and testing. Fast tracking is
permissible for drugs that are effective against life-threatening diseases such as ebola where existing drugs
are either lacking or not effective.
Labelling must be approved by the regulatory authority and should give full details on the drug, its side
effects and its administration.
Good laboratory, manufacturing and clinical practice (GLP, GMP and GCP, respectively) are regulations
designed to ensure high professional, scientific and clinical standards in laboratory, manufacturing and clinical
settings, respectively. Detailed documentation must be kept to prove that the company is adhering to these
standards. Regulatory bodies such as the FDA must approve any marketing claims made about new drugs.
However, local regulations vary greatly between countries so the same drug may be available over the
counter in some countries but require a doctor’s prescription or even be unavailable in other countries. Such
national differences restrict international trade and raise a number of ethical issues, such as the balance
between the freedom of individuals and the right of public and regulatory bodies to protect the physical
and mental health of their citizens.
25.2 Aspirin and penicillin – natural products with useful

medicinal properties can be chemically altered to produce more potent or safer
medicines
■■ Analgesics
Analgesics (Figure 25.38) are drugs used to relieve pain without causing loss of consciousness.
Strong analgesics include the opium derivatives morphine and codeine and are used to provide
relief from pain. Morphine is a much stronger analgesic than codeine. Mild analgesics are
able to provide relief from mild pain and, on occasions, severe pain. They are also frequently
antipyretic: they reduce fever to normal body temperature. Mild analgesics include aspirin,
paracetamol (acetaminophen), ibuprofen and naproxen. Local anaesthetics are also analgesic in
function.
By the 1970s medical researchers had discovered that aspirin reduces pain by acting on
inflamed tissues and the associated nerves. This mechanism of action is in contrast to the
action of morphine, a very powerful painkiller that acts directly on the brain. However, aspirin
■■ Figure 25.38 has other side effects that could not be easily accounted for, such as its ability to inhibit platelet
Counterpain: a function. Platelets are small fragments of cells concerned with the clotting of blood.
commercial mild In 1971 John Vane (now Sir John Vane and a winner of the 1982 Nobel Prize in chemistry)
analgesic containing suggested that aspirin functions by inhibiting production of prostaglandins. These are ‘local
methylsalicylate and hormones’ or autacoids that control a number of processes, such as blood pressure and platelet
the essential oils function. Unlike hormones they are present in all cells and are released when the cells are
menthol and eugenol damaged or stimulated by hormones.
25.2 Aspirin and penicillin 25
Prostaglandins are responsible for the classic symptoms of inflammation, namely redness
(caused by dilation of blood vessels) and heat (leading to fever). Vane and his colleagues
demonstrated in 1973 that aspirin inhibits the production of several prostaglandins from
arachidonic acid (Figure 25.39), a fatty acid component of cell membranes. The enzyme
responsible for this conversion is prostaglandin H synthase, which has an amine group that
undergoes a chemical reaction with aspirin (Figure 25.40).
COOH CH3 COOH CH3 O

–
COO
(CH2)3 (CH2)4 (CH2)3 (CH2)4 C aspirin
O CH3
CH CH CH CHOH
CH CH CH CH + enzyme – NH2
CH2 CH2 CH2 CH

O
CH CH CH CH –
enzyme NH C CH3 + COO
CH CH O C CH OH
OH
CH2 CH2
arachidonic acid PGE2

■■ Figure 25.39 The formation of prostaglandin ■■ Figure 25.40 The reaction between aspirin
(PGE2) from arachidonic acid and prostaglandin H synthase
Vane’s hypothesis also explained some of the side effects of aspirin, such as its tendency to cause
stomach irritation and ulcers. He suggested that aspirin causes these problems because it blocks
the synthesis of prostaglandins. The stomach lining releases these to regulate the overproduction
of hydrochloric acid and to synthesize the protective mucous barrier that prevents self-digestion.
In addition, aspirin prevents the body from excreting salt and water properly by preventing the
kidney from synthesizing a prostaglandin concerned with dilating blood vessels.
Other side effects of aspirin use may include fluid accumulation and interference with the
clotting of blood. The latter has been exploited in the use of aspirin as an anti-coagulant to
prevent and reduce strokes (preventing blood clotting inside the blood vessels of the brain) and
heart attacks. An unwanted side effect of aspirin is aspirin sensitivity syndrome, a rare genetic
condition resulting in constriction of the trachea (windpipe), which can cause death.
Paracetamol does not prevent prostaglandin H synthase from synthesizing prostaglandins
within body tissues, but is effective at inhibiting the enzyme in the brain, which perhaps
explains its antipyretic activity. Some of the effects of aspirin and paracetamol are believed to
depend on the direct interaction of these molecules with cell membranes.
■■ Aspirin
Aspirin is a very widely used mild analgesic (painkiller). It is derived from salicylic acid
(2-hydroxybenzoic acid). It has a range of useful medicinal actions. In 1758, an English
vicar, the Reverend Edward Stone, discovered that a crude (impure) extract from the bark
of the willow tree (Figure 25.41) was effective in reducing the fever associated with various
conditions, for example malaria (which was present in England during those times). The
active ingredient was later identified as salicin (Figure 25.42), a glycoside. It was first isolated
in significant amounts in 1828 by a French pharmacist, Leroux, and takes the form of bitter-
tasting yellow crystals.
■■ Figure 25.41 ■■ Figure 25.42

A weeping willow tree: Structure of salicin HO
its bark contains salicin O
HO O OH
HO OH
O
In 1860 the German chemist Hermann Kolbe synthesized salicylic acid (Figure 25.43) by reacting
sodium phenoxide (C6H5O –Na+) and carbon dioxide. In 1876 two German doctors reported the
C successful treatment of the symptoms of acute rheumatic fever, an auto-immune disease where
OH the body’s own immune system attacks bacteria in the joints between bones. In 1888 salicylic
acid was used to alleviate the symptoms of arthritis.
OH Acetylsalicylate, or aspirin (Figure 25.44), was introduced in 1898 by the German chemist
■■ Figure 25.43 Felix Hoffmann who found that his arthritic father could not tolerate the large daily doses of
Structure of salicylic bitter sodium salicylate (a soluble salt of salicylic acid). Aspirin was much more palatable than
acid (2-hydroxybenzoic sodium salicylate and was equally effective, but at lower doses. Aspirin was initially sold as a
acid) powder, but then later sold in tablet form bound together by starch. It not only proved effective
at treating fevers and pain, but also reduced swelling and inflammation.
A potentially fatal condition linked to aspirin usage is Reye’s syndrome which, although
H
primarily a children’s disease, can occur at any age. It affects all organs of the body, but those
O O most at risk are the brain, which swells due to an increase in fluid pressure, and the liver,
C due to a massive accumulation of fat.
The cause of Reye’s syndrome is not known but a risk factor is the use of aspirin and
O CH3 related drugs during a viral illness. Recovery from Reye’s syndrome depends critically on the
C
amount of swelling that has occurred within the brain. A complete recovery is possible, but
O permanent brain damage, coma or death from a heart attack are also possibilities.
Aspirin shows a synergistic effect with alcohol. This is an effect between two or more
■■ Figure 25.44
drugs that produces an effect greater than the sum of their individual effects. Drinking alcohol
Structure of aspirin
and daily use of aspirin may result in torn stomach lining and internal bleeding (gastrointestinal
(acetylsalicylic acid)
hemorrhaging).
Synthesis of aspirin
Aspirin (2-acetoxybenzoic acid) can be synthesized in the laboratory by reacting salicylic acid
(2-hydroxybenzoic acid) with ethanoic anhydride in the presence of concentrated sulfuric acid,
with hydrogen ions acting as the catalyst (Figure 25.45). The reaction mixture is heated under
reflux and cooled in ice to induce crystallization. The crude (impure) aspirin is removed by
suction filtration and washed with ice-cold water. The crystals are dried and recrystallized and
the melting point determined to establish purity. A sharp melting point suggests the aspirin is
pure; impurities will often lower the melting point.
■■ Figure 25.45 O OH O OH
Reaction between C C
H+
salicylic acid and O H + H3C O CH3 O CH3 + CH3COOH
ethanoic anhydride to C C C
form aspirin O O O
salicylic acid ethanoic anhydride aspirin ethanoic acid
(2-hydroxybenzoic acid) bp 140°C (acetylsalicylic acid)
mp 159°C mp 128–137°C
Aspirin still has its side effects because the carboxylic acid functional group remains intact. This
may result in hemorrhaging of the stomach walls even with normal dosages. The acidic irritation
can be reduced through the use of buffering agents, like antacids, in the form of magnesium
hydroxide, magnesium carbonate and aluminium glycinate when mixed with aspirin (known
commercially as Bufferin).
An alternative synthetic route to aspirin in the laboratory involves ethanoyl chloride and a
base catalyst (for example pyridine) (Figure 25.46).
■■ Figure 25.46 O OH O OH
Reaction between C C
base
salicylic acid and O H + Cl CH3 e.g. pyridine
O CH3 + HCl
ethanoyl chloride to C C
form aspirin O O
1 A student produced a sample of aspirin by the esterification of 9.40 g of 2-hydroxybenzoic acid with
excess ethanoic anhydride. After purification by recrystallization, 7.77 g of aspirin was obtained. Calculate
the percentage yield obtained.
Analysis of salicylic acid and aspirin

Chemical analysis
Salicylic acid can be extracted from willow bark by refluxing fresh chopped bark with sulfuric
acid and potassium manganate(vii). Thin-layer chromatography can be used to show that the
pharmacologically active chemical in willow bark is salicylic acid.
A knowledge of some relatively simple test-tube experiments can often be used effectively in
the identification of unknown organic substances. For example, you will be familiar with the use of
bromine solutions for detecting double bonds between carbon atoms in alkenes (see Chapter 10).
Three chemical tests are helpful in confirming the structure of salicylic acid:
1 An aqueous solution of the compound is weakly acidic.
2 Salicylic acid reacts with alcohols (like ethanol) to produce compounds called esters. Esters
have strong odours, often of fruit or flowers.
3 A neutral solution of iron(iii) chloride turns an intense purple colour when salicylic acid is
added. This is a complex formation.
Tests 1 and 2 are characteristic of carboxylic acids (compounds containing the –COOH
functional group); test 3 indicates the presence of a phenol group (an –OH group attached
directly to a benzene ring). Aspirin would give positive results for tests 1 and 2, but not for test 3,
since it has an acetyl group rather than a phenol group. Iron(iii) chloride can be used as a test of
aspirin purity prepared by a laboratory synthesis.
Although chemical tests provide evidence for the presence of carboxylic acid and phenol
groups in salicylic acid, instrumental techniques such as mass spectrometry (MS), infrared (IR)
spectroscopy and nuclear magnetic resonance (NMR) are today’s most efficient analytical tools
used in drug research and analysis (see Chapter 21).
Evidence from infrared spectroscopy

One of the very first tasks which would be done with any undefined new organic substance is to
record its infrared (IR) spectrum. An IR spectrum measures the extent to which electromagnetic
radiation in part of the infrared region is transmitted through a sample of a substance.
The wavenumber ranges absorbed provide important clues about the functional groups
present. The functional groups absorb at similar frequencies in many different compounds so an
IR absorption pattern provides a kind of fingerprint of the molecule.
The IR spectrum of salicylic acid (Figure 25.47) shows clear evidence of the presence of the
C–O and –OH groups. The narrow peak centred at 1700 cm−1 is due to the carbonyl group
present in the carboxylic acid functional group. The IR spectrum suggests an –OH group (free
or more likely internally hydrogen bonded) at about 3600 cm−1 and an –OH group (hydrogen
bonded) at about 3250 cm−1. The C–H (arene) absorption is at about 3100 cm−1.
■■ Figure 25.47 The IR 100

spectrum of salicylic
acid 80
Transmittance/%
60
40
20
0
4000 3000 2000 1800 1600 1400 1200 1000 800 600
−1
Wave number/cm
Evidence from nuclear magnetic resonance spectroscopy

A second instrumental technique which would be applied to an unidentified compound is
nuclear magnetic resonance (NMR) spectroscopy. The high-resolution and low-resolution proton
(1H) NMR spectra for salicylic acid are shown in Figure 25.48.
■■ Figure 25.48
The high-resolution
Absorption
and low-resolution
1H NMR spectra of
salicylic acid
12 10 8 6 4 2 0
Chemical shift
Absorption
TMS
12 10 8 6 4 2 0
Chemical shift
The NMR spectra show that salicylic acid contains:

■ one hydrogen in a –COOH environment
■ one hydrogen in a phenolic –OH environment
■ four hydrogens attached to a benzene ring.
A combination of IR and NMR spectroscopy shows that salicylic acid

100 92
has an –OH group and a –COOH group both attached to a benzene
120 ring. However, there are three possible isomeric hydroxybenzoic acids:
2-hydroxybenzoic acid, 3-hydroxybenzoic acid and 4-hydroxybenzoic
Intensity/%
acid. A decision about which isomer salicylic acid is can be made by

138
64 analysis of the mass spectrum of salicylic acid.
39 63 Figure 25.49 shows the mass spectrum of salicylic acid. Chemists can
use information contained in spectra like this to find the structures of
compounds.
20 40 60 80 100 120 140 The mass spectrum shows signals which correspond to positively
■■ Figure 25.49 The mass spectrum of salicylic charged fragmentation ions formed from the parent compound
acid fragmentation. The molecular ion signal at m/z = 138 confirms that the
substance has an empirical formula of C7H6O3.
The way in which a molecular ion breaks down is characteristic of that compound.
In this case, comparison with a database of known mass spectra identifies salicylic acid
as 2-hydroxybenzoic acid. Considering the way that the 3-hydroxybenzoic acid and the
4-hydroxybenzoic acid isomers would break down also leads to the conclusion that these isomers
could not form some of the fragments observed in the mass spectrum of salicylic acid.
2 Identify the bonds responsible for the broad peak around 3000 cm−1, and the sharp peaks at 1750 cm−1
and 1690 cm−1 in Figure 25.50 showing the IR spectrum of aspirin.
100
Transmittance/%
80
60
40
30
3500 3000 2500 2000 1500 1000 500
Wave number/cm–1
■ Figure 25.50 IR spectrum of aspirin
3 Identify the hydrogen atoms responsible for the signals at chemical shifts 2.2. and 13.1 in Figure 25.51
showing the NMR spectrum of aspirin.
3H
Absorption
1H 1H
1H 1H TMS
1H
13 12 11 10 9 8 7 6 5 4 3 2 1 0
Chemical shift
■ Figure 25.51 1HNMR spectrum of aspirin
The hydrogen atoms responsible for the cluster of signals in the chemical shift range 7.5 ± 0.5 are indicated as
w, x, y and z on the structure of aspirin shown in Figure 25.52.
O
w
HO x
O
y
H3C O z
■ Figure 25.52 The aromatic hydrogen atoms responsible for the cluster of downfield signals in the
NMR spectrum
4 Identify the ions responsible for the peaks at mass 180, 163, 120 and 43 in Figure 25.53 which shows the
mass spectrum of aspirin.
100
120
80
Intensity/%
43 138
60
92
40
20
163 180
0
0 20 40 60 80 100 120 140 160 180 200
Mass
■ Figure 25.53 Mass spectrum of aspirin
Nature of Science Discovery of aspirin

Aspirin is the most widely used medicinal drug in the world and a good example of a medicine
that bridges the gap between natural and synthetic medicines. Over 2000 years ago in Greece,
Hippocrates recorded that the Ancient Greeks used powdered willow bark to reduce fever. This
knowledge was rediscovered by the Revered Edward Stone in 1763 who lived in a village in
Oxfordshire, UK. He used an extract of willow bark to cure fevers in more than 50 residents. He
was influenced by the ‘doctrine of signatories’. Willow grew in damp places and because fevers
were associated with damp places, willow might produce a medicine to treat them. The active
ingredient in the willow bark is salicin which can be metabolized to salicylic acid.
Soluble aspirin
Aspirin has limited solubility in water due to the presence of a hydrophobic benzene ring.
Aspirin is a weak monoprotic acid (Ka = 2.8 × 10−4 mol dm−3 at 25 °C), so very little of the
molecular aspirin dissociates to form acetylsalicylate anions.
For the equilibrium dissociation reaction (Figure 25.54), the equilibrium position lies on the
left, strongly favouring molecular aspirin.
■■ Figure 25.54 O O
Dissociation of aspirin C C
in water OH O–
+ H+
O O
C CH3 C CH3
O O
Because of the low solubility of aspirin in water, its bioavailability in the blood is limited. The
solubility and bioavailability of pharmaceutical drugs can be increased by converting them into
ionic salts. In the case of aspirin, the carboxyl group can be neutralized with sodium hydroxide
solution, producing the water-soluble sodium salt of acetylsalicylic acid, also known as soluble
aspirin (Figure 25.55). Salts of calcium and lysine are also used to prepare ‘soluble aspirin’.
■■ Figure 25.55
O OH O O– Na+
Formation of the C C
soluble sodium salt of O CH3 + NaOH O CH3 + H2O
aspirin C C
O O
In aqueous solution the sodium salt of aspirin completely dissociates into sodium cations and
acetylsalicylate anions, which form ion–dipole forces and hydrogen bonds with surrounding
water molecules. However, the sodium salt is rapidly converted back into less soluble aspirin
by the reaction with hydrochloric acid in the stomach (Figure 25.56), so the bioavailability of
soluble aspirin is only slightly higher than that of aspirin.
■■ Figure 25.56
O O–Na+ O O H
Reaction between the C C
sodium salt of aspirin O CH3 + H+Cl– O CH3 + Na+Cl–
and hydrochloric acid C C
O O
Analysis of aspirin
The acid-neutralizing capacity of a tablet is the amount of hydrochloric acid that it can
neutralize. It is the quantity that is referred to in some advertisements when it is stated that the
tablet ‘neutralizes x times its mass in stomach acid.’
This capacity can be determined by a back titration (see Chapter 1). A known amount of
antacid is dissolved in an excess of hydrochloric acid, and then the excess acid is back titrated
with standardized sodium hydroxide solution.
When the end-point is reached with a suitable indicator, the amount of acid that was added
to the antacid sample is equal to the amount of base present, sodium hydroxide plus the antacid.
Therefore, the amount of hydrochloric acid that was neutralized by the antacid is equal to
the total amount of hydrochloric acid added minus the amount that was neutralized by the
sodium hydroxide:
amount of acid neutralized = (amount of HCl added)

− (amount of NaOH required for back titration)
= (MHCl × VHCl) − (MNaOH × VNaOH)
where M = molarity (mol dm−3) and V = volume in cubic decimetres (dm3).

Nature of Science Natural products
Some drugs, such as penicillin and cisplatin, have been discovered by accident. Taxol was
discovered as the result of a systematic search, but there was a long period of time between its
discovery and its medical use. In 1958 the American National Cancer Institute launched a
program to discover new pharmaceuticals by investigating natural sources such as plants and
marine organisms.
In 1962 the botanist Arthur Barclay collected bark samples from Pacific yew trees in
Washington state. In 1967 Munroe Wall and Manuskh Wani found that a chemical in the
samples killed leukemia cells. They isolated the white crystals of the molecule responsible and
named it Taxol after the Pacific yew tree (Taxus brevifolia) and determined its complex structure
in 1971. There was little progress because the optimum yield from the bark is 0.014 per cent and
the drug had not been tested against solid tumours.
However, in 1978 Susan Horwitz found that Taxol stabilized microtubules which are involved
in the movement of chromosomes during cell division. The drug inhibits mitosis and the cells
were unable to divide and grow. Taxol was tested against human tumour cells (breast, large
intestine and lung) transplanted to mice and found to cause regression (reduction in size).
Uses of aspirin
Aspirin is the most widely used medication in the world. Worldwide there are over 200 analgesic
formulations that contain aspirin. There are so many because the medicine may come in
different forms, for example solids, soluble substances and syrups. Other compounds may be
present to help relieve other symptoms which occur along with the one being treated. There may
be other substances present to help the action of the principal compound. For all these different
formulations, there are many companies each producing their own brand-name equivalent.
Aspirin has a wide variety of beneficial effects. It is a mild analgesic (pain reliever) and
antipyretic (reduces fever). In addition it has anti-clotting properties that could help prevent
heart attacks and limit the brain damage from a stroke. Hence at low doses aspirin is described
as cardio-protective. It is a prophylactic for reducing the risk of heart disease. A prophylactic
is a medicine used to treat or prevent the occurrence of a disease or condition. However, the
potential benefits, especially in patients with no signs of heart disease, must be balanced against
the possible harm from side effects, such as bleeding and gastrointestinal symptoms.
Aspirin is thought of as a ‘safe’ medicine, but like all medicines it if only safe if taken in the
recommended dose. The lethal dose is 30 g for an adult of average size. A typical tablet contains
0.3 g, so 100 aspirin tablets could be a lethal dose. Unpleasant symptoms would be experienced
with far fewer tablets than this. The recommended dose of aspirin is no more than 12 tablets a
day, and it is not recommended for children under 12 years old.
Paracetamol
OH Paracetamol (UK) or acetaminophen (USA) (Figure 25.57), like aspirin, relieves pain and reduces
fever, but unlike aspirin does not reduce stiffness, redness and the swelling symptoms of arthritis. It
has very few side effects when taken as directed for a short period, but it should not be taken with
paracetamol
(acetaminophen)
alcohol, nor by patients with kidney or liver disease. It is the preferred treatment for patients with
aspirin allergy, ulcers or clotting disorders. However, there is some evidence that people who take high
doses of paracetamol and drink large amounts of alcohol will have an increased risk of liver damage.
NHCOCH3 The differences between aspirin and paracetamol (Figure 25.58) are summarized in Table 25.3.
■■ Figure 25.57
Structure of Effect Aspirin Paracetamol
paracetamol (N-(4-
Causes gastrointestinal tract blood loss? Yes No
hydroxyphenyl)
ethanamide) Increases the tendency to bleed? Yes No
Thins the blood and prevents clots from Yes (effective against heart No
forming? attacks and strokes)
Can cause an allergic reaction? Yes No, because it is not a salicylate
Potential for causing nausea and vomiting? More Less
Possesses anti-inflammatory action? Yes and hence used in Weakly anti-inflammatory

treating rheumatoid arthritis
Potential to act as a suicide drug? Yes Yes
Antipyretic Yes Yes
■■ Table 25.3 A summary table of the differences between aspirin and paracetamol
■■ Figure 25.58 Paracetamol and aspirin ■■ Figure 25.59 Alka-Seltzer tablet reacting
with water
Alka-Seltzer (Figure 25.59) is a name owned by the German Bayer Corporation for a line
of medications sold over the counter. Alka-Seltzer is a combination of aspirin, sodium
hydrogencarbonate (NaHCO3) and citric acid, designed to treat pain and simultaneously
neutralize excess stomach acid (the Alka being derived from the word alkali). It is provided in
the form of large effervescent tablets, which are dissolved in a glass of water. As the tablets
dissolve, the base (hydrogencarbonate) and the acid (citric acid) react vigorously, producing
carbon dioxide gas (hence the Seltzer).
ToK Link
Pain and perception
Different painkillers act in different ways. How do we perceive pain, and how are our perceptions influenced
by the other ways of knowing?
Sensory perception is one of the eight ways of knowing identified by the IB’s Theory of Knowledge
Program. It is an important source of knowledge and our sense organs provide a means of communication
between us and the physical world. Pain is an unpleasant but important type of perception. It often plays an
important role in survival and protecting our bodies from being hurt. Consider the withdrawal reflex when
you touch a hot object. Information about pain is brought to the brain from free nerve endings in the skin.
Opioid-based painkillers such as morphine bind to brain receptors that modulate pain. Opioids are used to
control moderate to severe pain, but are highly addictive. Non-opoid-based painkillers are mild analgesics,
such as aspirin, which act locally to reduce pain at the site of the injury.
Research has shown that our brains can regulate, control, determine and even produce pain. This has been
demonstrated most clearly in patients with phantom limbs. Many people have the ability to feel pain,
pressure, temperature, and many other types of sensations including pain in a limb that does not exist
(either amputated or born without).
These observations suggest that ‘reality’ is ’simulated’ inside the brain and that the brain creates the
impression that the limb exists and functions. The majority of scientists and philosophers would agree that
pain is generated within the brain. However, how do the electrochemical signals generated within the
neurons of brain tissue generate the sensation of pain? How do brain states generate mental states? Are
brain states the same as mental states?
There are factors that can affect the way perception influences our thinking. The most common is logic or
reason. Human reason can filter out or accept new perceptions. Human values and culture can also filter or
accommodate new perceptions regardless of the logicality of new information. These values may come from
religion or faith, education or superstitions.
■■ Antibacterials
Alexander Fleming was a bacteriologist who had worked in a hospital in France during World
War I. On his return to England he took up a post in St Mary’s Hospital in London where he
studied an antibacterial agent present in tears and nasal mucus. Unfortunately, neither of these
secretions was particularly active. However, egg white was identified as a better source of an
antibacterial agent he called lysozyme.
His discovery of penicillin occurred when he left a pile of used culture plates containing
a growth of a Staphylococcus bacterium on the end of a bench when he went on holiday. In
his absence a rare strain of a fungus called Penicillium notatum entered through a window and
landed on one of the plates. During a warm spell later in the month the fungus multiplied and
inhibited the growth of the surrounding Staphylococcus bacteria. In nature Penicillium produces
penicillin when its food resources are limited, to kill surrounding bacteria.
Fleming cultured the fungus and found it would inhibit the growth of a range of bacterial
strains. Once the fungus had been identified Fleming named the extract penicillin. Fleming
arranged for two of his graduate students to grow large quantities of the mould so that it could
be characterized and later given to patients with a variety of bacterial infections with mixed
success. Early research indicated that penicillin was not a protein and was not stable in the
presence of acid. During the next decade the group at St Mary’s continued to culture P. notatum.
Howard Florey was appointed as a professor in the Pathology Department of Oxford
University in 1935 where he continued his studies of the antibacterial properties of lysozyme
begun in 1927. In 1937, one of his students, Ernst Chain, showed that it attacked the cell walls of
susceptible bacteria, causing their disintegration.
acyl In 1938 Chain, Abraham and Healey repeated Fleming’s earlier work
side-chain on the isolation of penicillin, but significantly improved the purity of
thiazolidine ring their extract. They then began to produce large quantities of penicillin
O H H H
and conduct medical trials.
S The Nobel Prize in Physiology or Medicine was jointly awarded
R C N C C CH3
C to Fleming, Florey and Chain in 1945. The structure of a penicillin
C N CH3 (penicillin G from Penicillium chrysogenum) was established using X-ray
C crystallography by Dorothy Hodgkin at Oxford. Penicillin molecules
O
H consist of a four-membered beta-lactam ring fused to a five-membered
beta-lactam ring COOH sulfur-containing thiazolidine ring (Figure 25.60).
■■ Figure 25.60 General structure of the penicillins
ToK Link
Serendipitous discoveries
‘Chance favours only the prepared mind’ (Louis Pasteur). Fleming’s
discovery of penicillin is often described as serendipitous but the
significance of his observations would have been missed by non-
experts. What influence does an open-minded attitude have on
our perceptions?
Serendipity refers to the accidental discovery of something important
while looking for something else. The word derives from an old bases in the
Persian fairy tale (The Three Princes of Serendip) and was introduced DNA molecule
by Horace Wallace in 1754. The history of science has many examples
of serendipitous discoveries and inventions. Pharmacology and
chemistry are probably the fields where serendipity is most common.
Although luck is obviously a factor one should bear in mind Louis
Pasteur’s maxim: ‘in the field of observation, chance favours only the
prepared mind’.
cisplatin
Fleming’s discovery of penicillin provides an example of scientific molecule
serendipity. He failed to disinfect cultures of bacteria when
leaving for his holiday, only to later find them contaminated with
penicillium moulds. However, it should be noted that he had
previously done extensive research into antibacterial substances.
Antibiotics are compounds produced by bacteria and fungi that
are capable of killing, or inhibiting, competing microbial species. ■■ Figure 25.61 A diagram showing how cisplatin might
This phenomenon has long been known; it may explain why disrupt DNA replication. It forms intra-strand DNA cross-
the ancient Egyptians had the practice of applying a poultice of links between adjacent bases on the same strand of DNA
mouldy bread to infected wounds. and inter-strand DNA cross-links between DNA strands.
The initial discovery of the anti-cancer drug cisplatin was also Science involves more than common sense, logic and pure
serendipitous. The American chemist Barnett Rosenberg (1926– observation. Although reason and sharp powers of observation
2009) was looking into the effects of an electric field on the can lead to knowledge, they have limitations. Often break-
growth of bacteria. He noticed that bacteria ceased to divide when throughs in science begin with questioning and rejecting authority
placed in an electric field and eventually pinned down the cause – including scientific authority. The first attitude of science,
of this phenomenon to the platinum electrode he was using. A therefore, is to be open-minded and sceptical and question
chemical reaction between the electrode and nutrients in the authority, including scientific authority. Scientists are always open
solution caused production of small amounts of cisplatin. Cisplatin to accepting whatever theory the data (evidence) reveals, however
was later shown to inhibit the replication of DNA (Figure 25.61). strange or unexpected it may prove to be.
Types of antibiotics
A broad-spectrum antibiotic is active against a wide range of bacterial diseases or bacterial
strains. A narrow-spectrum antibiotic is active against only a small range of bacterial diseases or
bacterial strains.
Examples of broad-spectrum antibiotics include ampicillin and amoxicillin (both are
examples of penicillins), streptomycin, gentamicin, erythromycin (Figure 25.62), tetracycline and
■■ Figure 25.62
chloramphenicol. Examples of narrow-spectrum antibiotics include penicillin G, polymyxin and
Erythromycin tablets
bacitracin.
How penicillins work

The bacterial cell wall, or envelope, contains a protective peptidoglycan ‘mesh’ made up of many
long chains of alternating sugars (N-acetylmuramic acid (NAM) and N-acetylglucosamine (NAG)),
cross-linked by short peptides (Figure 25.63). Penicillin resembles the dipeptide moiety (alanine–
alanine) and functions by preventing proper cross-linking of the peptidoglycan layer when the
bacteria are creating new cell walls, during periods of growth or cell division. Penicillin has no effect
on peptidoglycan strands that are already cross-linked. Penicillins do not enter the bacterial cell to
be active as long as they can access the periplasmic space between the cell membrane and the cell
wall. The peptidoglycan cell wall is not a barrier either since it is so porous. However, additional
outer barriers beyond the cell wall can prevent penicillins reaching the periplasmic space.
■■ Figure 25.63
Simplified structure of
sugar backbone
the bacterial cell wall
NAG NAM NAG NAM NAG NAM NAG NAM NAG NAM
peptide
cross-link
The original P. notatum mould was found to produce a mixture of different penicillins that were
given the letters G, X, F and K. The most useful of these was penicillin G because of its high
effectiveness and the higher yield from the fermentation process.
Attempts were then made in the 1950s to modify the ‘natural’ penicillins chemically to vary
the nature of the R group in Figure 25.60. Three new semi-synthetic penicillins were produced:
S (R = CH3(CH2)3SCH2−), O (R = CH2=CHCH2SCH2−) and V (R = C6H5OCH2−). The only
one still in use is penicillin V, which is acid stable. This means that the drug can be given orally
rather than by injection. It also allows doctors to prescribe the drug for home use. However, the
spectrum of antibacterial activity is the same as for penicillin G.
Bacteria possess enzymes named penicillinases that can hydrolyse penicillin to the
inactive penicilloic acid. Penicillinase hydrolyses the four-membered beta-lactam ring present
in penicillins. Bacteria resistant to penicillin due to penicillinase production have become
widespread in hospitals.
A number of drugs are mixtures of penicillins with compounds that increase their potency.
One such combination is Augmentin, which is amoxicillin with clavulanic acid (Figure 25.64).
O OH Clavulanic acid is a beta-lactamase inhibitor; that is, it stops the action of enzymes that degrade
beta-lactam compounds, and thus protects the amoxicillin molecule from destruction.
N
O Vancomycin is often described as the antibiotic of ‘last resort’. It is a glycopeptide antibiotic
COOH used only after treatment with all other antibiotics has failed. Vancomycin was first isolated
in 1956 from a soil sample from the jungles of Borneo (Indonesia) by a missionary. It is
■■ Figure 25.64
administered by injection and, like penicillin, inhibits bacterial cell wall synthesis by interfering
Structure of clavulanic
with peptidoglycan synthesis.
acid
■■ Bacterial resistance to antibiotics

Penicillin quickly became a widely used antibiotic against a variety of bacteria. During World
War II it helped to conquer the biggest wartime killer: infected wounds. It was also used to treat
sexually transmitted diseases that were common in soldiers. However, just four years after the drug
companies began mass-producing penicillin in 1943, penicillin-resistant bacteria began to appear.
One reason why bacterial resistance to penicillin (and other antibiotics) has arisen is that
they are often overprescribed. If people take penicillin for a minor bacterial infection that their
immune system would be able to deal with, they are increasing the chances of a resistant strain
emerging. When the non-resistant bacteria are destroyed, the small numbers of resistant forms
will be able to multiply due to an absence of competition. A process of natural selection has
occurred in the bacterial population. Similar reasoning can also be applied to people who do
need to take antibiotics but who do not complete their course of treatment.
Bacterial resistance to penicillin comes in many forms. A mutation in bacterial DNA can
limit the permeability of the cell wall, preventing uptake of penicillin into the periplasmic space
between the cell wall and cell membrane. Or it may cause the bacteria to produce enzymes
called penicillinases, which break down the penicillin molecule, or alter cross-linking enzymes
involved in cell wall production so that penicillin can no longer inhibit them.
Bacteria can acquire antibiotic-resistant genes in a number of ways. The bacterial DNA
may mutate spontaneously. Such a process involves a change in the sequence of bases along
the length of DNA. In a form of sexual reproduction called conjugation or transformation, one
bacterium may acquire DNA from another bacterium. Antibiotic resistance spreads most quickly
when bacteria acquire small circular pieces of DNA called plasmids. A single bacterial plasmid
can confer resistance to several different antibiotics.
Antibiotics have been widely used in the livestock industry to treat sick animals and, more
significantly, to promote growth. Other drugs prescribed to livestock include hormones to
fatten and promote growth steroids, to build up bulk and weight, and tranquilizers to reduce
stress. Perhaps the most dangerous aspect of the use of antibiotics in livestock feeds is that they
promote the emergence of antibiotic-resistant strains in the animals.
Tuberculosis (TB) is a common and often deadly infectious disease caused by Mycobacterium
tuberculosis. Tuberculosis (Figure 25.65) is spread through the air by droplets when people who have
the disease cough, sneeze or spit. TB usually attacks the lungs (pulmonary TB)
but can also affect the central nervous system and the circulatory system. The
classic symptoms of TB are a chronic cough (with blood in the sputum), night
sweats and weight loss. People with HIV are especially prone to TB infection
because of their compromised immune systems. TB treatment is difficult and
requires long courses (6–12 months) of multiple antibiotics, often involving
rifampicin and isoniazid. Antibiotic resistance is a growing problem in the
treatment of TB.
The use of antibiotics carries a number of other risks. Penicillins can
cause allergic reactions in some people, and some antibiotics, such as
nitrofuran, are carcinogenic at high concentrations. Other antibiotics, such
as streptomycin (the first effective antibiotic against TB), can have serious
■■ Figure 25.65 TB service centre in Tanjong side effects due to toxicity, such as loss of hearing (leading to deafness) and
Pagar, Singapore, 1948 kidney damage.
Antibacterials
In 1924 the 16-year-old son of the president of the USA got a blister on the toe of his right foot
while playing tennis. He contracted septicaemia and was dead within one week. Septicaemia
is caused when certain virulent strains of bacteria get into the bloodstream. Twelve years later,
in 1936, the son of president Franklin Roosevelt developed a septic sore throat; he was injected
with a new antibacterial drug called Prontosil and made a complete recovery.
O O This was the first commercially available antibacterial and also helped to
S reduce the death rate due to bacterial infections among women giving birth.
H2N NH2
Prontosil (Figure 25.66) was found to be effective against some bacteria
N by a German chemist Gerhard Domagk (subsequently awarded the Nobel
N
Prize in Medicine in 1939) who tested a large number of dyestuffs on
bacteria. In 1932 he found that Prontosil worked well against streptococcal
NH2
infections in mice. He later treated a ‘strep’ infection in his own daughter
■■ Figure 25.66 The structure of Prontosil, who was facing a possible amputation of her arm. Prontosil and then later
4-[(2,4-diaminophenyl)azo]benzene penicillin in 1943 hugely reduced the mortality rate of soldiers in World
sulfonamide War II.
25.3 Opiates 37
Prontosil is rarely used because some bacteria are resistant to its action and it can cause
damage to the liver and other side effects. However, it was the first widely used and successful
example of chemotherapy: using chemicals to treat diseases. It was also the first antibacterial and
was widely used to save many lives from bacterial infection. Prontosil and penicillin transformed
the treatment of bacterial diseases.
25.3 Opiates – potent medical drugs prepared by chemical modification of

natural products can be addictive and become substances of abuse
■■ Opiates
Morphine is a natural opiate found in opium, which is extracted from the latex in the seed capsule
of the opium poppy. Opiates are natural alkaloids found in opium. Alkaloids are a diverse group
of nitrogen-containing bases extracted from plants. The two main opiates present in opium are
morphine and codeine. Heroin is readily synthesized from morphine via a simple single-step
synthesis. Heroin, morphine and codeine are all powerful analgesics that act on proteins known as
opioid receptors located on the surfaces of nerve cells in the brain, spinal cord and intestines. The
molecules of these opiates have a common structure, and hence shape, as shown in Figures 25.67,
25.68 and 25.69. Opiates are also known as narcotics since they have sleep-inducing properties.
CH2 OH CH2 OH CH2 OCCH3

CH2 CH2 CH2
CH3 N CH3 N CH3 N
O O O
O
morphine codeine heroin
OH OCH3 OCCH3
■■ Figure 25.67 Structure of ■■ Figure 25.68 Structure of
morphine codeine ■■ Figure 25.69 Structure of heroin
(The structures are also in the IB Chemistry data booklet.) The binding sites of the various opiate
receptors have specific shapes and therefore allow only certain molecules to bind at the sites. The
opiates fit into these receptors because they have the correct structure and molecular shape.
Codeine
Codeine (Figure 25.68) is an alkaloid found in opium, but most codeine used in medicine is
synthesized from morphine (via the attachment of a methyl group). It is an analgesic (although
significantly less potent than morphine) but it also has antitussive and antidiarrheal properties:
it suppresses the urge to cough and restores normal bowel movements.
Codeine is sometimes marketed in combination preparations with paracetamol
(acetaminophen) as co-codamol, or with aspirin as co-codaprin. These combinations provide
greater pain relief than either agent alone due to the operation of the synergistic effect.
Like all opiates, codeine is addictive unless used infrequently. However, the withdrawal symptoms
are relatively mild and as a consequence codeine is considerably less addictive than the other opiates.
Codeine is an example of a prodrug: a drug which is converted to a more active form inside
the body. A small proportion of the codeine is converted by liver enzymes to morphine and a
range of other compounds.
Diamorphine (heroin)
Diacetylmorphine (diamorphine) or heroin (Figure 25.69) is a semi-synthetic opiate, or opioid,
derived from morphine. In its pure form it is a white powder that readily dissolves in water.
Heroin can be swallowed or dissolved in water and injected into a vein – this method produces
the most intense effect. Alternatively, it can be sniffed, or the fumes from the heated powder
inhaled – this method is sometimes called ‘chasing the dragon’.
When heroin was first synthesized in 1874 it was marketed as a safe non-addictive substitute
for morphine. However, dependency or addiction quickly developed in some individuals and
heroin and other opiates were made illegal in many countries, for example in 1920 in the USA.
As well as acting as a strong analgesic, heroin produces a range of side effects such as depression
of the activity of the nervous system, including breathing and heart rate. Blood vessels are also
widened (vasodilation) which reduces bowel activity and hence causes constipation.
Diamorphine can be prepared from morphine by reaction with ethanoic anhydride in a
simple acetylation reaction (Figure 25.70). This is analogous to reaction between salicylic acid
and ethanoic anhydride to form aspirin (acetylsalicylic acid) and ethanoic acid.
During the acetylation of morphine both hydroxyl groups are substituted with ester groups
which significantly reduces the polarity of the molecule. This increases its lipophilicity (ability
to dissolve in lipids) and hence its ability to cross the blood–brain barrier.
In the brain diamorphine is rapidly metabolized into morphine, which binds to the opioid
receptor. This mechanism of action makes diamorphine about five times more potent an
analgesic than morphine when injected into the blood.
CH2 CH2
OH O CH3
C
H3C N CH2 H3C N CH2
O
O + 2H3C O CH3 O + 2CH3COOH
C C
O
O O
C
OH O CH3
■■ Figure 25.70 The formation of diamorphine
Comparison of the structures of morphine, codeine

and diamorphine (heroin)
The term pharmacophore defines the important functional groups for the binding to the
receptor and the activity of a drug molecule. Some pharmacophores are described by linking the
important functional groups by a common carbon skeleton.
The opioid receptor is believed to have three main areas that bind morphine, codeine,
diamorphine and related opioids. There is an ionic site which binds the tertiary amine nitrogen
(A), which can be become positively charged via protonation; a cavity (hole) which accepts the
piperidine ring (B); and a flat surface that binds the benzene ring (C) by London (dispersion)
forces (Figure 25.71).
■■ Figure 25.71 B
Opioid receptor and H3C
opioid molecule N anionic site
A H
D
OH
E cavity receptor
O
C
flat surface
OH
5 List all the

functional A number of structural features have to be present for the opioid painkiller to be active, including
groups present in the tertiary amine nitrogen with a small alkyl group (A), the presence of a piperidine ring (B), a
morphine, codeine quaternary carbon (D), a benzene ring (C) and a C2 ‘spacer’ (E), part of the piperidine ring, between
and diamorphine the tertiary nitrogen and the quaternary carbon. The molecules have a rigid structure which helps
(heroin).
them bind to the active site of the opioid receptor.
25.3 Opiates 39
Nature of Science Discovery and uses of opium

Plants make molecules known as secondary metabolites using a series of enzyme-controlled
reactions. The unripe seed pods of Papaver somniferum (see Figure 25.19) exude a creamy
coloured sap, which contains a mixture of perhaps 50 different alkaloids – molecules made by
the plant from amino acids. The sap dries to a yellow-brown paste known as opium. One of the
most abundant compounds present in opium is the powerful painkiller morphine.
Opiates are alkaloid molecules containing nitrogen atoms in the form of amine functional
groups. Since amines are bases, alkaloids form salts when reacted with acids just as alkalis do:
they were originally referred to as plant alkalis and later the term alkaloid was created. It is the
ability of alkaloids to readily form crystalline salts when treated with acids that makes them
relatively easy to isolate in pure form.
Over 5000 years ago, the Mesopotamians (in southern Iraq) had discovered some of the
euphoric properties of opium. Euphoria is a feeling of great happiness or well-being. By the time
of the Greek and Roman civilizations, people were also familiar with its painkilling effects.
It was probably Paracelsus, a famous 16th century alchemist, who first prepared the alcoholic
solution of opium known as laudanum, a widely used painkiller.
At the start of the 19th century, several chemists isolated pure morphine from opium.
Morphine exerts its effects in the body by binding to the mu-opioid receptor in the brain,
causing analgesia and sedation. It is because of its sedative properties that morphine is named
after Morpheus, the Greek god of dreams.
Diamorphine, better known today as heroin, was first marketed as a cough suppressant and,
ironically, as a cure for morphine addiction. Although heroin is inactive in the body, it crosses
the blood–brain barrier faster than morphine and is subsequently metabolized there to produce
morphine. This gives the user the intense ‘rush’ that makes heroin so addictive. Today, heroin
addiction affects millions of people around the world and claims thousands of lives every year.
■■ Problems associated with heroin use

Heroin causes users to feel drowsy, warm and contented. It also relieves stress and discomfort by
creating a relaxed detachment from pain. However, users quickly become physically dependent
and tolerant to the drug: larger and larger doses must be taken to achieve the same state of
euphoria (extreme happiness).
A sudden withdrawal from high doses of heroin produces a variety of withdrawal symptoms
similar to the flu. Although they rarely last more than a week, feelings of weakness and anxiety
can last for several months.
Many heroin addicts inject the drug (Figure 25.72) and the sharing of
unsterilized needles can spread diseases such as tetanus, AIDS and hepatitis. There
is also a risk of using impure drugs which have been mixed, or ‘cut’, with unknown
and potentially harmful substances. Apathy and the reduced appetite caused by
the drug can lead to a poor diet, and dependency on the drug can lead to financial
problems which people try to resolve by theft or prostitution.
Methadone is a synthetic opioid frequently used to treat heroin addicts.
Although chemically different from morphine and heroin, it acts on the same
receptors and produces many of the same effects. Methadone’s usefulness in
■■ Figure 25.72 Heroin which will be treating heroin addicts is due to its long duration of effect and its ability to block
cooked in a spoon the heroin withdrawal symptoms. At high concentrations it can block the euphoric
effects of heroin and morphine.
History of opium
Alexander the Great took opium to Persia (modern day Iran) and India, from where it reached
China. It was used medicinally as a painkiller. After the Chinese banned tobacco smoking in 1644,
many Chinese turned to opium as an alternative and the British East India Company made large
profits exporting to China. Chinese governments were unhappy with this and the Opium Wars of
the 18th century were a result. One consequence of the Opium Wars was that Hong Kong became
a British Crown Colony until 1997. Opium is a cash crop across a region stretching from the Middle
East to East Asia. Ninety per cent of the world’s opium and heroin originate in Afghanistan.
Morphine, heroin and cocaine and many other addictive substances of abuse are illegally
produced in a small number of countries and then distributed globally by criminal organizations.
According to the UN World Drug Report over 80 per cent of illegal opiates are produced in
Afghanistan. Myanmar, Thailand, Laos and Latin America also produce opium.
Only two per cent of these drugs are used by the local population; the remaining 98 per
cent are exported to Europe, Asia, Africa and North America. This amounts to an export value
of about 4 billion US dollars. Afghanistan is also the largest producer of cannabis (mostly as
hashish) in the world.
This is a reflection of differences in cultural and economic viewpoints. The problem of drug
abuse is an international issue and can only be solved by recognizing and dealing with the differences
through education, economic development, law enforcement and international cooperation.
ToK Link
Knowledge and culture
Cultures often clash over different perspectives and ideas. Is there any knowledge which is independent of
culture?
Cultures often clash over different historical, religious, racial and political ideas and perspectives. There is
often a perceived clash between science and different faiths or religions. However, it is worth noting the
Harvard biologist Stephen Jay Gould’s views on this matter. By nature, according to Gould, science and
religion do not and cannot conflict, because their respective concerns are entirely distinct:
‘Science tries to document the factual character of the natural world, and to develop theories that coordinate
and explain these facts. Religion, on the other hand, operates in the equally important, but utterly different,
realm of human purposes, meanings, and values – subjects that the factual domain of science might illuminate,
but can never resolve.’ http://skepticaljew.blogspot.sg/2010/05/stephen-jay-gould-on-science-and.html
Some knowledge and ways of knowing, such as emotion, may transcend culture. For example, the
psychologist Paul Ekman showed that isolated New Guinean Highlanders could recognize the facial
expression in the photographs of his American college students. Charles Darwin observed that children who
are born blind and deaf from birth display virtually the full range of facial expressions, including happiness,
sadness, anger, fear, disgust and surprise.
Apparently Eskimos have no word for anger and Tahitians do not recognize guilt, sadness or longing.
Cultures may differ in how their members talk and write about their emotions, but may not reflect how
people feel at the level of biological sense perceptions. The observation that a language does or does not
have a word for an emotion may have very little significance. Whether a language appears to have a word
for an emotion depends on the skill of the translator and the structure and history of the language.
It is likely that our basic emotions and our ability to recognize them and other basic sense perceptions of
time, distance and space in other humans may be universal and to some extent influenced by genes.
25.4 pH regulation of the stomach – excess stomach acid is

a common problem that can be alleviated by compounds that increase the stomach pH
by neutralizing or reducing its secretion
■■ Stomach acid
The process of digestion involves a series of enzyme-controlled catabolic reactions that transform
large insoluble molecules into smaller soluble molecules. Many of these hydrolysis reactions take
place in the stomach, where the food is mixed with a digestive fluid. This fluid, also known as
gastric juice, is composed of water, salts (mostly KCI and NaCl, which are dissociated into their
ions K+, Cl− and Na+), hydrochloric acid (HCl) and a protease (pepsin) secreted by the parietal
cells in the stomach lining. Pepsin and hydrochloric acid are responsible for the breakdown of
proteins into peptides and individual amino acids. Other cells produce hydrogen carbonate ions
(HCO3−) and gastric mucus to buffer the acid and prevent the gastric juice from digesting the
delicate stomach tissues and leading to an ulcer.
25.4 pH regulation of the stomach 41
The molar concentration of hydrochloric acid in the stomach varies from approximately
0.003 to 0.1 mol dm−3 (0.01–0.4%) which corresponds to a pH range of 2.5 to 1.0. The
hydrochloric acid in gastric juice provides an optimum pH for pepsin in the gastric juice. In
addition, hydrochloric acid acts a disinfectant, killing nearly all harmful microorganisms,
especially bacteria, that are ingested with the food.
Worked example
A 10.0 cm3 sample of gastric juice, obtained several hours after a meal, was titrated with 0.100 mol dm−3
NaOH to neutrality; 7.20 cm3 of NaOH was required. Assume that no buffers were present. Deduce the pH
of the gastric juice.
Amount of NaOH = 0.100 mol dm−3 × 7.20 × 10 −3 dm3 = 7.20 × 10 −4 mol

Amount of H+(aq) in 10.0 cm3 = 7.20 × 10 −4 mol
7.20 × 10 −4 mol
[H+(aq)] = = 0.072 mol dm−3
0.010 dm3
pH = −log10 (0.072) = 1.14
Nature of Science ■■ Early studies of stomach and gastric acid function

The presence of hydrochloric acid was discovered in 1838 by a US army surgeon William
Beaumont, who was observing a patient with a gastric fistula (an unhealed hole in the stomach)
left by a gunshot. By taking samples of gastric juice and using them to ‘digest’ pieces of protein
containing foods in cups, Beaumont discovered that digestion was a chemical rather than
a mechanical process. He also investigated the effects that temperature, exercise and even
emotions have on the digestive process.
Further experiments revealed the negative effects of excess stomach acid, for example ulcers,
which led to the development and uses of weak bases as antacids. The dose levels required for
neutralization were large and caused unpleasant side effects. The study of how hydrochloric acid
is generated by the cells lining the stomach led to the development (by rational drug design) of
new pharmaceuticals. These drugs, such as ranitidine and omeprazole, regulate the acidity of the
stomach by suppressing the secretion of hydrochloric acid. Ranitidine (Zantac) and cimetidine
(Tagamet) function by binding to histamine receptors; proton pump inhibitors such as omeprazole
(Prilosec) and esomeprazole (Nexium) function by inhibiting the proton pumps in parietal cells.
■■ Antacids
Peptic ulcer disease
Ulcers of the stomach (gastric ulcers) and the first part of the small intestine (duodenal ulcers),
known collectively as peptic ulcers, affect large numbers of people. Between 10 per cent and
20 per cent of adult men in Western countries will suffer from a peptic ulcer during their lives.
The disease is very painful and can be fatal.
Ulcers are small damaged areas of the mucous membranes of the stomach or small intestine
which expose the underlying muscle layers of the gut wall to hydrochloric acid and the enzyme
pepsin. These are both produced and released by the cells lining the stomach, and are involved
in the digestion of proteins into polypeptides. However, the acid is also concerned with killing
bacteria and other invading pathogens.
For many years the main medical treatment for peptic ulcers was the use of antacids
(Figure 25.73) to neutralize the gastric juice in the stomach. The earliest antacids were sodium
hydrogen carbonate (‘sodium bicarbonate’) and calcium carbonate (chalk), which although
■■ Figure 25.73 efficient and rapid, are not recommended for long-term use.
Mylanta: a commercial
NaHCO3(s) + HCl(aq) → NaCl(aq) + H2O(l) + CO2(g)
antacid containing
magnesium and CaCO3(s) + 2HCl(aq) → CaCl2(aq) + H2O(l) + CO2(g)
aluminium hydroxides
Excessive use of sodium hydrogen carbonate may lead to alkalosis (a rise in the pH of blood)
and fluid retention (‘bloating’). Repeated use of chalk as an antacid may lead to excessive
amounts of calcium ions being absorbed into the body.
Both antacids, but in particular sodium hydrogen carbonate (bicarbonate), suffer from
‘acid rebound’ where acid levels rise after neutralization as the stomach senses the change
and stimulates acid secretion via production of a hormone called gastrin. Calcium ions can
cause constipation so they are frequently combined with magnesium ions in commercial
preparations of antacids.
Aluminium hydroxide and magnesium hydroxide (milk of magnesia) are two other
compounds used as antacids. Aluminium-containing antacids are slow acting and buffer
the pH at acidic pH values (3–5). Aluminium ions have an astringent taste and may cause
constipation.
Al(OH)3(s) + 3HCl(aq) → AlCl3(aq) + 3H2O(l)

Mg(OH)2(s) + 2HCl(aq) → MgCl2(aq) + 2H2O(l)
Aluminium ions can also prevent uptake of phosphate ions, due to precipitation of aluminium
phosphate, and will bind to certain drugs because of their large charge density (a function of
aluminium’s small ionic radius and high charge). Magnesium hydroxide (milk of magnesia) is a
rapid and efficient antacid, but it does also act as a laxative. Aluminium and magnesium ions are
frequently combined together in commercial antacids. Calcium hydroxide is sometimes also used
as an antacid.
Some antacids are very weak bases and act very slowly but over a long
period of time. Magnesium trisilicate slowly reacts with hydrochloric acid
to form magnesium chloride and gelatinous silicon dioxide, which protects
the mucosa (lining) of the stomach.
Sucralfate (Carafate) is a hydrated complex of aluminium hydroxide
with a derivative of sucrose frequently prescribed to people with peptic
ulcer disease. It has no neutralizing capability, but forms a sticky viscous gel
that protects the damaged membrane from further attack by hydrochloric
acid and pepsin.
Dyspepsia is derived from the Greek word pepsis meaning digestion.
Dyspepsia is commonly known as indigestion and is frequently due to expulsion
of gastric juice from the stomach – acid reflux.
■■ Figure 25.74 Macgel (chewable antacid):
Dimethicone is an anti-foaming agent commonly present in antacid
contains aluminium hydroxide, magnesium
tablets (Figure 25.74) and other pharmaceuticals. It is also used as a
hydroxide and polydimethylsiloxane
defoaming agent in the food processing industry. It is a surface active
(dimethicone)
ingredient that reduces the surface tension of large bubbles, causing them
to coalesce and produce a foam.
It is a colourless viscous liquid with a low melting point. Its anti-foaming and anti-
flatulent properties are effective even when it is present at low concentrations. In addition
it is chemically inert and does not interfere with the process of neutralization and is
non-toxic to humans. Dimethicone is a polydimethylsiloxane whose structure is shown in
Figure 25.75.
CH3 Alginates (Figure 25.76) are derived from alginic acid, a slimy polysaccharide that prevents
brown seaweeds from excessive drying and dehydration when exposed to air during low tides.
O Si O Alginic acid is used in industry as a thickening agent and emulsion stabilizer and is found in
whipped toppings, sauces, dressings, gravy, ice cream, milk shakes, jellies and custards. Alginic
CH3 n acid also readily produces soft fibres which are used in light-weight wound dressings. They keep
■■ Figure 25.75 the wound moist and are able to absorb large amounts of fluid. Alginates can bind with toxic
Structure of a ‘heavy metals’ and remove them from the body, since alginates are not absorbed into the body
polydimethylsiloxane from the intestines.
■■ Figure 25.76
Na+ -OOC OH Na+ –OOC OH
Three sections of
O OH O OH O
sodium alginate
O O
polymer molecules O O
showing the two O OH O OH
different monomers, OH Na+ –OOC OH Na+ –OOC
‘G’ and ‘M’ G G G G
Na+ –OOC OH Na+ –OOC OH

O O HO O O
O O HO O
Na+ –OOC OH
M M M
OH Na+ –OOC OH
O O
Na+ –OOC OH HO
O O
O O
HO O OH
Na+ –OOC
M G M
6 Although it is a Alginates are frequently present in antacids. They produce a neutralizing layer on top of
large molecule, the contents of the stomach and prevent ‘heartburn’ when gastric juice moves up from the
sodium alginate stomach through the pyloric sphincter (a ring of circular muscle at the top of the stomach)
is quite soluble in into the oesophagus. Certain foods and drinks, and even lying down to sleep, can cause
water. Explain why
heartburn.
you would expect
this.
Worked example
The antacid tablet in a glass of water contains 810.0 mg of magnesium oxide per tablet. Determine the
volume of 0.1000 mol dm−3 stomach acid (HCl) that one tablet could neutralize.
Amount of magnesium oxide = (810.0/1000) g × (24.31 + 16.00) g mol-1 = 0.02025 mol

MgO(s) + 2HCl(aq) → MgCl2(aq) + H2O(l)
Amount of HCl = 2 × 0.02025 mol = 0.04050 mol
Volume = Amount/molarity; volume = 0.04050 mol/0.1000 dm3; volume = 0.4050 dm3 = 405 cm3
■■ The causes of peptic ulcers

Modern treatments of peptic ulcer disease have depended on an understanding of the various
mechanisms that control gastric secretions. Before food arrives in the stomach it stimulates the
NH secretory gastric cells in the stomach lining to produce acetylcholine and histamine (Figure 25.77).
When the food enters the stomach the organ becomes enlarged, which stimulates the gastric
H2N N cells to release a hormone called gastrin. Gastrin, together with acetylcholine and histamine,
stimulate the release of gastric juice (hydrochloric acid and pepsin) from parietal gastric cells.
■■ Figure 25.77 Another type of gastric cell secretes a glycoprotein called mucin, which coats the stomach to
Structure of histamine protect it against the actions of hydrochloric acid and pepsin. Mucin is continually produced but
only slowly digested. However, if the production of mucin is inhibited then part of the stomach
wall or mucosa could be digested, leading to a gastric ulcer.
The histamine acts directly on the acid-secreting parietal cells where it stimulates the
potassium–hydrogen ion ‘pump’. This is a membrane protein that uses the energy from
respiration to remove potassium ions from the gastric juice in the stomach and replace them
with hydrogen ions.
One of the most common and successful drugs for the treatment of stomach ulcers is
ranitidine (Zantac) (Figure 25.78). It is classified as an anti-secretory agent because it inhibits
the secretion of gastric juice. Its molecular structure has some similarities to histamine and
ranitidine acts as an antagonist of the histamine receptor. Therefore, this blocks the process by
which the potassium–hydrogen ion pump is stimulated.
The drugs and histamine are not binding directly to the proton pump. They bind to the
histamine receptor. If the histamine receptor is activated by histamine, the potassium–hydrogen
ion proton pump is deactivated. This means that the pump no longer operates and the secretion
of gastric juice in the stomach is significantly reduced, allowing the stomach to repair the
damage caused by the ulcer.
Proton pump inhibitors were the next step in drug development to
CH3 O- reduce acid secretion in the stomach and tests have shown that they
O NH
N S N + are very effective compared with Zantac and placebos. They work
by directly inhibiting the H+-K+-ATPase enzyme, a membrane-based
CH3 NH O
H3C protein that uses ATP to pump acid (protons) into the stomach.
Omeprazole (Prilosec) (Figure 25.79) is a well-known
■■ Figure 25.78 Structure of ranitidine (Zantac) example of this type of drug. It is a substituted benzimidazole
and binds to a specific amino acid of the enzyme, forming a
chiral sulfur centre lone pair of electrons covalent disulfide link and thereby inhibiting acid secretion.
Omeprazole is a racemic mixture of two enantiomers. It is
H optically active because the molecule is chiral due to the
N O
presence of three different substituents and a lone pair of
S
H3C N electrons on the chiral sulfur atom.
O N Omeprazole exists as two enantiomers. The R-form is
H2C CH3
inactive, though it converts into the active S-enantiomer in vivo
esomeprazole
H3C O CH3
(in the body). The pharmaceutical company AstraZeneca sells
the S isomer drug as Nexium (esomeprazole).
mirror plane In contrast to many drugs, both enantiomers of omeprazole
O O show very similar pharmacological properties. In their original
S S forms (known as prodrugs) they are biologically inactive and do
(ring) (ring)
not interact with the gastric proton pump directly.
CH2(ring) H2C(ring) Due to their low polarity, omeprazole and esomeprazole
esomeprazole readily cross the lipid bilayer of cell membranes and enter the
omeprazole enantiomers
cytoplasm of parietal cells containing hydrochloric acid.
They are actually activated once they exit the parietal cells into
■■ Figure 25.79 Structures of omeprazole the stomach. The proton pump is pumping out protons
as soon as they are generated, and so the increased acid
conditions are near the outer surface of cell and not within the cell itself.
Therefore, the drugs are activated once they depart the cell and then react with
the pumps on the outer surface of the parietal cell. If the drugs were activated
inside the cell, they would have adverse effects on other proteins within the cell.
In this acidic environment near the proton pump both enantiomers undergo a series
of acid-catalysed chemical changes and produce the same active metabolites, which
bind to the proton pump of the parietal cell (via a sulfur–sulfur bridge) and inhibit the
secretion of hydrochloric acid. Omeprazole also becomes ionized which makes it polar
and hence unable to cross back into the cell through the cell membrane This mechanism
of action increases the efficiency and bioavailability of both drugs and allows a reduced
frequency of administration. Omeprazole and proton pump inhibitors have few side
effects because of their selectivity and mechanism of action.
Helicobacter pylori
For many years the ultimate cause of ulcers was not known and it was widely
■■ Figure 25.80 Electron micrograph believed that hard work, high stress and a poor diet were the causes of ulcers.
of H. pylori possessing multiple However, in the 1980s evidence accumulated that ulcers are caused by a bacterium,
flagella (negative staining) Helicobacter pylori (Figure 25.80). H. pylori was first isolated by two Australian
scientists, Robin Warren and Barry Marshall, in 1982. They were awarded the Nobel Prize in
Physiology or Medicine in 2005 for their work on H. pylori and peptic ulcer disease.
H. pylori is found under the layers of mucus in the stomach lining, where the pH is only
4 compared to the value of 1 for the gastric juice. The bacterium produces large quantities of
an enzyme called urease which hydrolyses urea and leads to the production of ammonia. This
protects the H. pylori bacteria from the surrounding hydrochloric acid. A breath test has been
developed to detect the ammonia from H. pylori infections.
CO(NH2)2 (s) + H+(aq) + 2H2O(l) → HCO3−(aq) + 2NH4+(aq)

urea
The treatment of ulcers has therefore changed and currently the treatment involves antacids,
drugs such as ranitidine (Zantac), as well as antibiotics, such as amoxicillin and metronidazole.
Recent work has also shown that the presence of H. pylori increases the risk of gastric (stomach)
cancer sixfold, and accounts for about half of all gastric cancers. H. pylori is believed to be
transmitted orally.
Nature of Science Dyspepsia

The term ‘dyspepsia’ describes a clinical problem referring to a cluster of upper gastrointestinal
symptoms that has been defined in many ways. Symptoms need to be present for 4 weeks and
include upper abdominal pain or discomfort, heartburn, acid reflux, nausea and vomiting.
Dyspepsia is a symptom, not a diagnosis. Patients with dyspepsia can be divided into
subgroups on the basis of an endoscopic diagnosis, where a camera is introduced into the
oesophagus (esophagus).
Gastro-oesophageal reflux disease refers to patients with characteristic heartburn and acid
regurgitation. Approximately half of these patients will also have oesophagitis, an inflammation
of the lining of the oesophagus. Peptic ulcer disease can be subdivided into gastric and duodenal
ulcers. Helicobacter pylori and the use of non-steroidal anti-inflammatory drugs, such as aspirin,
are the major causes. Oesophageal and gastric cancer can also cause dyspepsia.
Dietary and lifestyle choices may contribute to dyspepsia. Certain foods and medications, for
example ibuprofen, may trigger relaxation of the stomach sphincter muscle, causing acid reflux
and heartburn. Studies have shown that cigarettes, spicy food, stress, fatty food, carbonated
drinks, alcohol, obesity, pregnancy and lifting can also cause dyspepsia. Eating smaller and more
frequent meals may relieve some of the symptoms.
ToK Link
Problem solving
Sometimes we utilize different approaches to solve the same problem. How do we decide between
competing evidence and approaches?
When a hypothesis explains scientific evidence or another hypothesis, the two cohere with each. This implies
both should be accepted or rejected. In contrast, if two hypotheses contradict each other, or if they offer
some competing explanations of some scientific evidence, then they are incoherent with each other. This
should lead to accepting one and rejecting the other.
In the early 1980s there were two competing hypotheses for the cause of peptic ulcers: excess acidity and the
newly discovered H. pylori. Excess acidity as the cause of ulcers was a well-established theory with supporting
evidence from the healing of ulcers using drugs such as cimetidine. The hypothesis that gastric bacteria exist
was incompatible with the accepted assumption that the stomach was too acidic for permanent bacterial
growth. Only a few researchers had observed the bacteria and there was only a small amount of evidence
connecting ulcers and bacteria. It was understandable that Marshall’s hypothesis about H. pylori being the
cause of ulcers was not accepted. The bacteria that Warren observed could be explained as the result of
contamination. Later in the 1990s, many researchers had studied H. pylori and the idea of the stomach as
being bacteria free had been discarded. Many studies from different researchers using different techniques
had shown that ulcers could be cured using antibiotics that eradicated the H. pylori bacteria. Researchers
also suggested that H. pylori increases stomach acidity and that the removal of H. pylori decreases acidity.
Maximizing coherence therefore required acceptance of the hypothesis that ulcers are caused by bacteria.
■■ Acid–base buffers
Gastric juice undergoes large changes in the concentration of hydrogen ions, H+(aq), by a
factor of 100, which corresponds to a change of 2 pH units. The pH of gastric juice will vary
due to the nature of the food being digested and whether the stomach is empty or full of
digesting food (chyme).
In contrast, the pH of other biological fluids (e.g. blood) remains relatively constant because
of the presence of buffers. The pH of blood is buffered at around 7.4.
Buffers (see Chapter 18) are aqueous acid–base systems that can neutralize small
amounts of strong acids and strong bases without their pH changing significantly. Each
acid–base buffer contains a conjugate acid–base pair which differ by a single proton (H+).
The conjugate acid is the protonated species and the conjugate base is able to accept a
proton from the conjugate acid.
For example, a mixture of propanoic acid and sodium propanoate behaves as an acidic
buffer whose pH will be less than 7. The propanoic acid molecule, CH3CH2COOH, can
donate a proton (from the –COOH group) and the propanoate anion, CH3CH2COO−, can
accept a proton. Hence, propanoic acid is the conjugate acid and the propanoate anion is
the conjugate base.
In buffer solutions, the conjugate acid and the conjugate base exist in equilibrium. The
conjugate acid is strong and the conjugate base is weak, so the equilibrium lies to the left.
For example:
CH3CH2COOH(aq) ⇋ CH3CH2COO−(aq) + H+(aq)
The sodium ion is a spectator ion (see Chapter 1) and hence not shown in the equilibrium
reaction.
The strength of an acid can be described by its dissociation constant, Ka or Kb, or its negative
logarithm (pKa = −log10Ka and pKb = −log10Kb).
[conjugate base] × [H+(aq)] −log10[conjugate base] × [H+(aq)]
Ka = =
[conjugate acid and pKa] [conjugate acid]
These two dissociation constants are related via the ionic product of water, Kw: Ka × Kb = Kw
and pKa + pKb = pKw.
Since pH = −log10[H+(aq)], the pKa expression can be mathematically transformed into the
Henderson–Hasselbalch equation (see Chapter 18 for its derivation):
pKa + log10[conjugate base]
pH =
[conjugate acid]
An equivalent expression is:
pKb + log10 [conjugate base]
pOH =
[conjugate acid]
The Henderson–Hasselbalch equation allows chemists to calculate the pH of a buffer
solution with known acid–base composition (in terms of concentrations), or the concentrations
of the conjugate acid and base in a solution with a known pH.
Worked examples
Calculate the pH of a standard solution containing 0.20 mol dm−3 HF(aq) and 0.40 mol dm−3 KF(aq). The Ka
for hydrofluoric acid is 6.8 × 10−4.
pH = pKa + log10 [salt]/[acid]

pH = −log10 (6.8 × 10 −4) + log10 (0.4)/(0.2) = 3.47
Calculate the mass in grams of ammonium chloride, NH4Cl, that must be added to 0.030 mol of ammonia,
NH3, to prepare 1.00 dm3 of buffer solution with a pH of 8.4. The Ka of ammonia is 6.8 × 10−4 and the
molar mass of NH4Cl is 53.50 g mol−1.
pOH = 14.0 − 8.4 = 5.6

pOH = pKb + log10 [salt]/[weak base]
5.6 = −log10 (1.8 × 10 −5) + log10 [NH4Cl]/[NH3]
0.86 = log10 [NH4Cl]/0.030
Amount of NH4Cl = 0.22 mol dm−3 × 1.00 dm3 = 0.22 mol

Mass of NH4Cl = 0.22 mol × 53.50 g mol−1 = 11.77 g = 12 g
Determine the ratio of potassium methanoate, HCOOK, to methanoic acid, HCOOH, to produce a buffer of
pH 4.00. The pKa of HCOOH is 3.75.
pH = pKa + log10 [HCOOK]/[HCOOH]

4.0 = 3.75 + log10 [HCOOK]/[HCOOH]
log10 [HCOOK]/[HCOOH] = 0.25
[HCOOK]/[HCOOH] = 1.78
The ratio of HCOOK to HCOOH = 1.78 to 1.
Determine the amount (in mol) of HCl that must be added to 0.80 mol of CH3COOK to prepare 1.00 dm3 of
buffer solution with a pH of 4.50. The Ka of ethanoic acid, CH3COOH, is 1.8 × 10−5.
Equation: HCl + CH3COONa → CH3COOH + NaCl

Initial amount (mol): y 0.80 0 0
Change in amount (mol): −y −y +y +y
Final amount (mol): 0 y y −y
pH = pKa + log10 [CH3COONa]/[CH3COOH]
4.50 = −log10 (1.8 × 10−5) + log10 (0.80−y/y)
log10 (0.80−y/y) = −0.245
y = 0.51; [HCl(aq)] = 0.51 mol dm−3, hence n HCl(aq) = 0.51 mol
0.025 mol of HCl is added to 1.00 dm3 of a buffer solution containing 0.35 mol dm−3 NH3 and 0.50 mol dm−3
NH4Cl. Calculate the pH of the solution after the addition of HCl. Assume that the volume of the solution
does not change. The pKb of ammonia is 4.75.
Equation: HCl + NH3 → NH4Cl

Initial amount (mol): 0.025 0.35 0.50
Change in amount (mol): −0.025 −0.025 +0.025
Final amount (mol): 0 0.325 0.525
pOH = pKb + log10 [NH4Cl]/[NH3]
pOH = −log10 (1.8 × 10−5) + log10 (0.525/0.325) = 4.95; pH =9.05
Determine the pH of a buffer solution prepared by dissolving 2.00 g of benzoic acid and 5.00 g of potassium
benzoate in 250 cm3 of water. Ka benzoic acid = 6.3 × 10−5.
Molar masses: Mr (C6H5COOH) = 122, Mr (C6H5COO−K+) = 160,

Amount of acid C6H5COOH = 2.00 g/122 g mol−1 = 0.0164 mol; molarity = 0.0656 mol dm−3
Amount of salt C6H5COO−K+ = 5.0/160 g mol−1 = 0.0313 mol; molarity = 0.125 mol dm−3
[H+(aq)] = Ka [acid(aq)]/[salt(aq)]
[H+(aq)] = 6.3 × 10−5 × 0.0656 / 0.125 = 3.31 × 10−5 mol dm−3
pH = −log10 [H+(aq)] = −log10 (3.31 × 10−5) = 4.48
Hydrogen carbonate and carbonate buffers (in the body)

Blood is a complex liquid that contains cells suspended in plasma, which contains various ions
and molecules dissolved in water. These dissolved solutes in blood contain buffer systems which
regulate the body pH to a constant value of 7.4.
The main buffer system in blood consists of carbonic acid, H2CO3(aq), hydrogen carbonate
ions, HCO3−(aq), and carbon dioxide, CO2(aq). Carbon dioxide is produced by the respiration
(oxidation) of glucose in all body tissues. The carbon dioxide released by respiration diffuses out
of the body cells into the blood and is transported in the plasma to the lungs, where it is exhaled
(breathed out).
The following equilibria are responsible for the buffering action of the carbonic acid–
hydrogen carbonate ion buffer. The equilibrium constants for reactions 1, 2 and 3 are K1, K2 and
K3, respectively:
1 H2CO3(aq) + H2O(l) ⇋ H3O+(aq) + HCO3−(aq); K1
2 CO2(aq) + H2O(l) ⇋ H2CO3(aq); K2
3 CO2(g) ⇋ CO2(aq); K3
4 CO2(g) + 2H2O(l) ⇋ H3O+(aq) + HCO3−(aq); K1 × K2 × K3 = K4
The overall reaction represented by equation 4 indicates that the concentration of oxonium
ions, H3O+(aq), and the pH of blood depend only on the concentration of hydrogen carbonate
ions dissolved in blood and on the partial pressure of gaseous carbon dioxide, CO2(g), in the air
spaces in the lungs.
Worked example
0.10 mol of solid sodium hydrogen carbonate and 0.20 mol of solid sodium carbonate are dissolved in the
same beaker of water, transferred to a volumetric ﬂask and made to 250.0 cm3. The Ka for the hydrogen
carbonate ion, HCO3−, is 4.7 × 10−11. Determine the pH of the resulting buffer.
pH = pKa + log10 ([A−]/[HA]) = −log10 (4.7 × 10−11) + log10 (0.2/0.1) = 10.6
Buffer pH range
The ability of acid–base buffers to resist pH changes when strong acids or bases are added is
limited. Its buffering ability depends on the concentrations and ratios of the conjugate acid and
base in the aqueous solution of the buffer.
At pH = pKa, an acidic acid–base buffer is able to neutralize the greatest amounts of acids
or bases before any significant pH change occurs (which is known as breaking the buffer;
see Chapter 18). The Henderson–Hasselbalch equation predicts that the ratio between the
concentrations of a conjugate acid–base pair increases or decreases by a factor of 10 when the pH
of the buffer solution changes by one unit. Therefore an acidic acid–base buffer can be used from
pH = pKa − 1 to pH = pKa + 1.
For example, a dihydrogen phosphate buffer (pKa = 2.12) works efficiently between
pH = 3.12 and pH = 1.12. However, outside this pH range the concentration of one of the
buffer components becomes low and the buffer loses its ability to maintain a constant pH in
the solution.
25.5 Antiviral medications – antiviral medications have been

developed for some viral infections while others are being researched
■■ Viruses and bacteria

Viruses
Viruses are acellular parasites that replicate inside living cells. They consist of a nucleic acid
(DNA, usually double stranded, or RNA, usually single stranded) surrounded by a protein capsid
25.5 Antiviral medications 49
and in some cases a membrane-like envelope. The capsid consists of multiple protein units
(capsomeres) arranged in a regular helical or polyhedral structure. X-ray diffraction is used to
study the crystalline structure of viruses.
Viruses can be divided into four types, depending on the make-up of their nucleic acid:
1 single-stranded DNA
2 double-stranded DNA
3 single-stranded RNA
4 double-stranded RNA.
The RNA viruses can be divided again into two groups, depending on how their RNA is
reproduced and used in the host cell. In ordinary RNA viruses, nucleic acid replication
occurs entirely in the cytoplasm, but in RNA retroviruses their RNA is used as a template for
making viral DNA, using a viral enzyme called reverse transcriptase. The RNA in human
immunodeficiency virus (HIV) is single stranded. Once in the host cell it acts as the template
for the formation of an RNA/DNA hybrid. The RNA strand is degraded and the surviving DNA
strand then acts as a template for double-stranded DNA.
Once a virus or its nucleic acid enters a cell the host cell’s enzymes and ribosomes are
‘hijacked’ to manufacture many new viral proteins and enzymes that self-assemble into
viruses. The viruses will then exit from the cell through the cell membrane, leaving
behind a dead or damaged cell. In some viral infections involving retroviruses, the viral
DNA becomes integrated into the host’s DNA and may not kill the host or cause any
obvious illness.
Familiar animal diseases caused by viruses include warts, herpes, viral meningitis, ebola,
measles, influenza (flu), rabies, hepatitis B, SARS, avian influenza (‘bird flu’) and AIDS
(caused by HIV). Plants and bacteria are also prone to viral infection. The structures of the
7 Find out about flu and herpes viruses are shown in Figure 25.81. The best defence against viruses has been
smallpox and the immunization which involves injecting deactivated virus (capsid) which will allow the immune
role of vaccination system to mount a response to a future infection. The viral proteins in the capsid are known as
in eradicating it.
antigens and are recognized by the antibodies of the immune system.
■■ Figure 25.81 flu virus herpes virus

RNA fragments
The structures of the envelope
flu and herpes viruses (lipid + protein)
capsid of protein
protein coat
(capsid)
envelope double strand

(lipid + protein) of DNA
H
antigens
N
The most familiar retrovirus is HIV (Figure 25.82), which is responsible for the condition
known as acquired immune deficiency syndrome (AIDS). It reproduces inside a group of
specialized white cells in the blood known as T4 lymphocytes or T4 helper cells, important
regulators of the immune system, which is concerned with resisting and fighting infectious
bacteria, fungi and viruses.
■■ Figure 25.82 external appearance section through the HIV particle

The external (x 400 000) protein, including
enzyme (reverse
appearance and interior
transcriptase)
structure of HIV two strands
of single-stranded
RNA
spherical envelope of lipid

bilayer with glycoproteins
(derived from the membrane protein coat
of the human cell from which (capsid)
the virus escaped)
Retroviruses like HIV are unusual because their genetic information is in the form of two
single-stranded RNA molecules. The key step in infection is the interaction between a
binding protein (a glycoprotein, gp120) on the HIV capsule and the CD4 receptor (also a
glycoprotein) on the surface of the lymphocyte (a type of white blood cell). Once inside
the T4 helper cell a viral enzyme called reverse transcriptase (hence the name retrovirus)
produces a DNA copy of the RNA. This is then inserted into the DNA of the T4 lymphocyte
(Figure 25.83).
1 binding protein on virus capsule 2 binding leads to fusion of 4 HIV becomes part of the white cell’s genome
capsule with cell membrane
a RNA strand
HIV particle
b DNA copy formed by action
of reverse transcriptase
c RNA strand removed by
action of ribonuclease
CD4 receptor
HIV antigens d transcription of
3 virus core remain on complementary DNA strand
enters the surface of by action of DNA polymerase
lymphocyte infected cell
e DNA double strand integrated
white cell into DNA of a chromosome
(T-lymphocyte) in nucleus of host to form a
provirus (latent virus)
■■ Figure 25.83 HIV infection of a white blood cell
Bacteria
Bacteria are single-celled organisms that lack membrane-bound organelles and a true nucleus.
There is no nuclear membrane and the only organelles present in the cytoplasm are ribosomes.
Bacteria reproduce asexually via binary fission (‘splitting in two’). They can also engage in
conjugation which involves the lateral transfer of circular pieces of DNA. These are known as
plasmids and are often responsible for antibiotic resistance. The cell can make multiple copies
and transfer copies during conjugation.
Bacteria (Figure 25.84) often have a protective outer membrane and an inner plasma
membrane that encloses the cytoplasm and the nucleoid – the area of cytoplasm that contains
a single circular DNA molecule. Between the inner and outer membranes (the latter is
not always present) is a thin but strong layer of sugar polymers cross-linked by amino acids
(peptidoglycans). Many bacteria have rotating flagella to propel themselves through their
surroundings and pili so they can adhere to the surfaces of animal cells or each other during
conjugation.
pili – enable attachment to surfaces and to other 1µm

bacteria for exchange of genetic material
plasma membrane* –
nucleoid* – genetic material: a barrier across which all
a single circular chromosome nutrients and waste
of about 4000 genes products must pass
cell wall* – protects cell

flagella – bring about lipid globules/ from rupture caused by
movement of the glycogen granules osmosis,and possible harm
bacterium from other organisms
plasmid
mesosome ribosomes* – sites

of protein synthesis
cytoplasm* – site of the * structures that
chemical reactions of life (metabolism) occur in all bacteria
■■ Figure 25.84 The structure of Escherichia coli – a ‘typical’ bacterium
Description of how viruses differ from bacteria

Table 25.4 shows some of the main differences between bacteria and viruses.
■■ Table 25.4 Differences and similarities between bacteria and viruses
Bacteria Viruses
Ribosomes Present Absent
Number of cells Unicellular; one cell (but can form No cells (acellular)
cooperating colonies)
Internal structure DNA floating freely in cytoplasm; has DNA or RNA enclosed inside a coat (capsid) of
cell wall and cell membrane protein or glycoproteins
Cell wall composition Peptidoglycan/lipopolysaccharide No cell wall; protein coat (capsid) present
instead
Treatment Antibiotics Vaccines prevent the spread of infection and
antiviral drugs help to slow replication but
cannot stop it completely
Enzymes Yes Yes in some, for example reverse transcriptase
in retroviruses
Nucleus No – the nuclear material (nucleoid) No
is not surrounded by a nuclear
membrane
Virulence Yes Yes
Infection Localized Systemic
Reproduction Binary fission – a form of asexual Invades a host cell and takes over the cell
reproduction causing it to make copies of the viral genome
(DNA or RNA); destroys or damages the host
cell, releasing new viruses
Size Larger (1000 nm) Smaller (20–400 nm)
■■ How antiviral drugs work

Outside the cell, viruses are effectively in a state of suspended animation and so cannot be
targeted by drugs. However, inside the cell they are incorporated into the host, hence it is
difficult to kill the virus without killing the cell. For this reason it is only relatively recently that
drugs capable of controlling viral diseases have been developed.
Antiviral drugs can theoretically act at a number of points in the viral lifecycle. The first
step in viral infection is the adsorption of the virus on to the cell surface, often onto specific
receptor proteins. Unfortunately, there are no antiviral drugs currently available to prevent the
adsorption of viruses on to cell membranes.
The second possible point of attack for antiviral drugs is penetration, usually via
engulfment of the virus particle by a small portion of the cell membrane during a process
called exocytosis. Amantadine (Symmetrel) (Figure 25.85) appears to prevent the release
H3C H NH2 and uncoating of viruses from within the endosome (the virus surrounded by
NH2 C cell membrane from exocytosis) inside the cell and has been used to treat rubella
(German measles) and influenza (flu). Rimantadine is a related molecule used to treat
the common cold. Both drugs have become less effective due to the appearance of
viral strains resistant to both drugs.
The third step of the viral lifecycle involves the shedding of the protective protein
■■ Figure 25.85 Structures of capsid, which is an enzyme-controlled process. The anti-malarial drug chloroquine is the
amantadine and rimantadine only drug found to inhibit the uncoating of a virus (Newcastle disease virus).
The most promising point of attack for antiviral drugs is during the synthesis of
viral proteins and viral nucleic acids. Phosphonoformic and phosphonoacetic acids
(Figure 25.86) are two antiviral agents that inhibit the action of the viral DNA
polymerase, the enzyme responsible for the production of viral DNA.
■■ Figure 25.86
O OH
Structures of C OH O
OH
phosphonoformic
HO P O C P
(foscarnet) and
O CH2
phosphonoacetic acid OH
OH
(fosfonet)
O Another approach is to use what is called the anti-metabolite concept, which usually
H3C
involves the synthesis of modified chemical bases used in the synthesis of nucleic acids.
H
HO N An example of such a drug is zidovudine (Retrovir or AZT) (Figure 25.87) which is one of
H the few drugs used with some success in the clinical treatment of AIDS.
C
H O N O Once AZT is incorporated into growing DNA strands it causes chain termination and
H C C the enzyme, reverse transcriptase, is no longer able to extend the DNA chain. Two similar
agents that block DNA replication in HIV are dideoxyinosine (ddI, DDI or Videx) and
C CH2
dideoxycytidine (ddC or Hivid).
N3
H The final stage of the influenza A and B virus replication cycle can also be targeted by
■■ Figure 25.87 Structure of antivirals. Two such drugs, oseltamivir (Tamiflu; Figure 25.88) and zanamivir (Relenza),
azidothymidine (AZT) prevent the release of viruses from the cells by inhibiting the active sites of certain viral
enzymes known as neuraminidases. These enzymes trigger the process of budding, which
allows viruses to depart through the outer cell membrane of the host cell. The inhibition
of neuraminidases prevents viruses from departing from the cell and slows their spread around
the body. Tamiflu may be given as a preventative measure either during a flu outbreak or
following close contact with an infected individual.
■■ Figure 25.88
Oseltamivir (Tamiflu)
Both oseltamivir and zanamivir target the same enzymes, and their molecules have many
similarities (Figure 25.89). Both molecules contain a six-membered ring with three chiral carbon
atoms (marked with asterisks in Figure 25.89). Both drugs engage in a variety of favourable
interactions, including hydrogen bonding and ionic interactions with the active sites of
neuraminidases.
■■ Figure 25.89 OH
O O
The structures of
*
oseltamivir and CH2
C O C CH2 CH2 * C O C
H3C CH * O CH3 HO CH * OH
zanamivir (the chiral
carbon atoms are CH2 * OH *
H3C HN * HN *
marked with *;
common structural C NH2 C HN NH2
H3C O H3C O C
features are shown in
green) NH
However, the side-chains in oseltamivir and zanamivir contain different functional groups,
which affect the pharmacological properties of these drugs. In particular the presence of an ester
group makes oseltamivir inactive in its original form.
In the body the ester group is rapidly metabolized (hydrolysed) into a carboxyl group,
producing an active metabolite with enhanced antiviral activity. The zanamivir molecule
already has a carboxyl group so it is active in its original form. Zanamivir has the disadvantage
of having to be administered as a dry powder, rather like an asthma inhaler. However, it is
reported that no flu virus currently has resistance to zanamivir.
The different ways in which antiviral medications work
In general there are four types of actions for antiviral drugs:
■ Preventing the genetic material from being injected through the cell membrane:
viruses have to interact and bind with specific receptors (proteins or glycoproteins) on the
cell membrane of a cell and release its genetic material. To block entry, antiviral molecules
can be synthesized that are structurally similar to the virus-associated protein so they bind
strongly to the receptor or even bind to the viral capsid (protein coat).
■ Inhibiting the replication of the virus: the drug may mimic nucleotides, the monomers of
DNA or RNA, so that they are incorporated into the enzyme-controlled synthesis of DNA
or RNA, which is then inhibited.
■ Inhibiting the action of reverse transcriptase: reverse transcriptase is present in retroviruses,
for example HIV. It converts the viral RNA of HIV into DNA, which enters the nucleus of
the host cell. The new DNA is integrated (under enzyme control) with the DNA of the host
8 Find out about
cell and will control the production of new viral RNA and protein by the host cell.
enfuvirtide, the first
of a new class of ■· Preventing new viruses from leaving the cell: new DNA and viral proteins self-assemble into
drugs approved for new viruses (viral particles). Following rupture of host cell membranes (or budding), these
the treatment of viruses leave the host cell; this then results in new infections in other cells of the body.
HIV.
Drugs may be developed that prevent the exit of the mature viruses.
Nature of Science Research into viral entry methods

Recent research in the biological community has improved our understanding of how viruses
invade human and bacterial cells. Using a combination of imaging techniques, researchers have
determined that the T4 bacteriophage infects bacterial cells by piercing the cell’s outer membrane,
digesting the bacterial cell wall and injecting virus DNA into the cell. These findings explain how
viruses invade cells and offer a new way to deliver genes and drugs directly into cells.
The researchers combined X-ray crystallography, which provides a three-dimensional picture
of the virus’s proteins, with cryo-electron microscopy images to determine how T4 proteins
rearrange themselves during cell infection. Now that scientists have established the relationships
among T4 component proteins they are analysing other processes that occur during a viral
infection. These studies provide hope that engineered viruses might be used to seek out and
destroy specific cells or deliver a ‘payload’ that might include new genes or medicinal drugs.
The development of antivirals over recent decades for treating life-threatening or debilitating
diseases is the result of the scientific collaboration and exchange of information on a global
scale. The availability of protein, DNA and RNA sequences and crystal structures of viral
enzymes, cultivation of viruses in the laboratory and extensive medical data accessible via shared
databases has greatly expanded biochemical knowledge of the interactions between viruses and
host cells at the molecular level.
Greater understanding of the structure, function and lifecycle of viruses leads to the development
of new drugs that target viral infections at all stages of the viral lifecycle. The progress in antiviral
therapy has already changed the way of treatment of many viral infections and will probably have the
same effect on modern medicine as the discovery of antibiotics in the 20th century.
However, the high cost of developing antiviral drugs has limited the number of viral diseases
of sufficient market size to a relatively short list. The fact that antiviral drugs are likely to be
highly specific for one single infectious agent means that accurate diagnosis of an infection
needs to be made before therapy.
■■ Acquired immune deficiency syndrome (AIDS)

Drug treatment for AIDS
Very few antiviral compounds have been found to be effective against HIV. The first clinically
available drugs are the nucleoside-based inhibitors of the viral enzyme reverse transcriptase, such as
AZT. More recently a cell fusion inhibitor and integrase inhibitor have been made available to clinics.
HIV has been shown to undergo several mutations, resulting in new strains becoming
increasingly resistant to drugs, many of which are significantly toxic. Using two or more drugs
against different targets is more successful than using a single drug against a single target since it
is more difficult for the virus to gain resistance against a drug ‘cocktail’.
One approach in the development of drugs and vaccines to combat HIV is centred on a
protein called HIV-1 protease, an essential enzyme needed for the production of the virus.
Inhibition of this enzyme leads to the production of incomplete and non-infectious HIV particles.
There have been two approaches to drug development in this area. The first involves
production of peptide-based inhibitors of HIV protease that mimic the transition state of the
enzyme’s substrate. The second approach involves synthesizing small non-peptide molecules that
are able to bind to the active site of the protease. Many of these molecules have been designed
by computer-based molecular modelling using information derived from X-ray diffraction studies
of crystallized HIV-1 protease (Figure 25.90).
■■ Figure 25.90
Computer model
of the structure of
HIV-1 protease and
associated water
molecules (determined
by neutron diffraction).
The blue represents a
bound drug candidate,
KNI-272
Societal and cultural factors

Although treatments for AIDS and HIV can slow the course of the disease, there is currently no
vaccine or cure. Antiretroviral treatment prolongs the lives of people with HIV, but these drugs are
expensive and routine access to antiretroviral medication is not available in all countries. Ninety-five
per cent of HIV-positive people live in developing countries. Less than eight per cent of those needing
retroviral therapy receive it. Due to the difficulty of treating HIV infection, preventing infection is
a key aim in controlling the AIDS epidemic, with health organizations promoting safe-sex programs
in attempts to slow the spread of the virus. Condoms, if used correctly without oil-based lubricants, is
the single most effective available technology to reduce the sexual transmission of HIV.
25.6 Environmental impact of some medications 55
AIDS stigma exists around the world in a variety of forms, including discrimination, rejection
and avoidance of HIV-infected people, compulsory HIV testing without prior consent or protection
of confidentiality, violence against HIV-infected individuals and the quarantine of HIV-infected
individuals. The fear of violence prevents many people from seeking HIV testing, returning for
their results or securing treatment. In many developed countries, there is an association between
AIDS and homosexuality or bisexuality, and this association is correlated with anti-homosexual
attitudes (homophobia). There is some evidence that homosexuality is inherited and influenced
by several genes on the X chromosome. Epigenetic inheritance may also be involved. Epigenetics
involves genetic control by factors other than an individual’s DNA sequence.
The AIDS epidemic
Although news about HIV/AIDS is sometimes replaced by more recent disease outbreaks such as
H1N1 and ebola, the virus remains a global threat. In 2009, the Joint United Nations Programme
on HIV/AIDS and the World Health Organization estimated that 33.4 million people around the
world are living with HIV. The organizations’ report, AIDS Epidemic Update, also estimated 2.7
million new HIV infections and 2 million deaths from AIDS in 2008, indicating that advances in
treatment, preventative methods and education are still urgently needed. Treatment for HIV/AIDS
has slowly evolved since drugs such as AZT were first made available in 1989. Since the late 1980s,
more than 30 possible vaccines have been tested; none has succeeded. About 1000 children die
every day from HIV/AIDS. This is three times the number of children who die from cancer.
Many HIV cases and AIDS-related deaths have occurred in Africa, the origin of the HIV
virus (Figure 25.91). As a result life expectancy has fallen sharply in some African countries, which
has had a significant social and economic impact. Southern and sub-Saharan African countries
are those most affected. The recent small increases in life expectancy are due to internationally
supported programmes in healthcare and education.
■■ Figure 25.91 AIDS in
65
Africa: life expectancy Zimbabwe Uganda
60 South Africa Zambia
in selected African Botswana
Age in years
countries 55
50
45
40
35
1950–55 1970–75 1990–95 2000–05
25.6 Environmental impact of some medications

– the synthesis, isolation and administration of medications can have an effect on the
environment
■■ Introduction
Water is one of the substances required to sustain life and may be the source of many illnesses
to humans. Over the years, surface and groundwater sources have become contaminated due to
increased industrial and agricultural activity. However, there is also increasing demand for water
free of colour, turbidity, taste, odour, nitrate, harmful metal ions, and a wide variety of organic
chemicals such as pesticides and chlorinated solvents.
As a population increases, the demand for water grows accordingly, especially when this
is accompanied by improved standards of living. In many situations in areas short of water,
recycling of treated waste water will be required to avoid affecting industrial development.
Perhaps the most challenging environmental field at present is the treatment and disposal of
industrial and hazardous wastes. Because of the great variety of wastes produced from established
industries and the introduction of wastes from new processes, a knowledge of chemistry is
essential to finding a solution for most of the problems. Some problems may be solved with
a knowledge of inorganic chemistry; others may require a knowledge of organic, physical or
colloidal chemistry biochemistry or even nuclear chemistry.
■■ Medical waste and the environment

For many years the impact of medical waste substances on the environment has been largely
ignored as chemists and biologists focused on well-known contaminants and pollutants generated
by the agricultural (e.g. nitrates) and industrial (e.g. heavy metals and hydrocarbons) sectors.
Pharmacologically active compounds (PACs) used in medicine and biochemical studies
have traditionally not been treated as potentially harmful and have been released to the
environment. PACS detected in sewage, surface water and groundwater include analgesics,
antibiotics, anti-epileptics, caffeine, anti-rheumatics, chemotherapeutics (organic and
inorganic), steroid hormones and X-ray contrast media, for example barium sulfate. PACs also
include illegal drugs, such as cocaine and ecstasy. Granular activated carbon may be used
to adsorb and remove hormones and some pharmaceuticals from water, but many of these
compounds are not eliminated during the processing of waste water and the production of
drinking water.
Environmental xenobiotics are artificial bioactive compounds that are found as pollutants
in the natural environment (usually in soil and water). The prefix xeno- means foreign.
Together with industrial products, environmental xenobiotics include PACs as well as
hospital disinfectants such as phenol, bisphenol (used to make certain plastics and epoxy
resins), polychlorinated biphenyls (PCBs), azo dyes, aromatic hydrocarbons and steroids
and steroid-based hormones. Concentrations of these chemicals are often monitored on
a long-term basis. A variety of analytical techniques are used to detect and measure the
concentrations of PACs and environmental xenobiotics, including liquid chromatography/
mass spectrometry (LC-MS) (see Chapter 21).
However, prolonged exposure to PACs may cause significant changes in the metabolism and
behaviour of various organisms, including humans. Of particular concern is the uncontrolled
release of antibiotics to the environment which may lead to the selection of antibiotic-resistant
bacteria. Other synthetic oestrogenic compounds such as PCBs, bisphenol and phthalates can
act as endocrine disruptors, increasing the risk of breast cancer and reproductive disorders in
humans, and causing reduced sperm counts.
Another type of environmental pollution is caused by radioactive materials used in
medical treatment (radiotherapy) and radio-diagnostics. There are international guidelines for
radioactive waste disposal from departments of nuclear medicine.
Radioactive waste from nuclear medicine procedures can be dealt with either by simply
storing the wastes safely until radioactive decay reduces the activity to a relatively low level or by
disposal of low-activity waste (with monitoring) into the sewerage system. Controlled disposal is
defined as disposal with permission from the regulatory authority and appropriate monitoring.
The waste must be diluted at the discharge point (from the hospital into the sewerage system) to
a relatively low concentration to protect the local community.
Certain radioisotopes can undergo bioaccumulation and biomagnification, increasing the
risk of radiation exposure for predators at the peak of a food chain. This has been demonstrated
for caesium-137 in river ecosystems where there is a fourfold increase in each trophic (feeding)
before natural selection level.
The synthesis, production, storage and distribution of pharmaceutical drugs also contributes to
environmental pollution though the release of greenhouse gases (such as carbon dioxide), ozone-
after natural selection depleting substances (such as chlorinated solvents) and toxic materials, including left-over solvent
residues, excess acid or base, and biologically active by-products of organic synthesis. Inhaled
anaesthetics from operating theatres in hospitals are potent greenhouse gases. These harmful effects
can be greatly reduced by the introduction of sustainable industrial processes or green chemistry.
final population of bacteria
■■ Antibiotic resistance
The widespread use of penicillins and other classes of beta-lactam antibiotics, such as
antibiotic resistance level
cephalosporins, in the last half of the 20th century led to the selection and increase in the
low high
frequency of antibiotic resistance (Figure 25.92) in many strains of pathogenic (harmful) bacteria.
■■ Figure 25.92 The large numbers of bacterial cells, combined with the short generation times, facilitate
Mechanism of the development of mutants. In a typical bacterial population of 1011 bacterial cells (for
antibiotic resistance example, in an infected patient) there can easily be 1000 mutants. If a mutant confers a
selective advantage upon the bacterium (e.g. the ability to survive in the presence of an
antibiotic) then that resistant bacterium will be selected and continue to grow while the
neighbouring bacteria will die. This can happen in a matter of days in patients being treated
with antibiotics.
As a result the efficiency of traditional antibiotics against common diseases has significantly
decreased, so medical chemists need to synthesize and test new synthetic and semi-synthetic
antibiotics in order to treat severe bacterial infections. However, it becomes progressively more
difficult as bacteria constantly evolve and become resistant to increasing numbers of antibiotics
and in some strains become multi-drug resistant.
Antibiotic resistance in bacteria is caused by several factors (Figure 25.93), including the over-
prescription of antibiotics for mild bacterial infections, non-compliance of patients in finishing
a course of treatment (that is, not taking the prescribed number of tablets at the required times),
the use of antibiotics in farm animals to prevent infection, and the release of antibiotic waste by
hospitals and the pharmaceutical industry into the water supply.
■■ Figure 25.93 animals receive

The spread of antibiotics and patient receives antibiotics
develop resistant and develops resistant
antibiotic resistance
bacteria in their guts bacteria in the gut
antibiotic drug-resistant patient stays at home

bacteria can remain on and in the general
meat from animals; community; spreads
when not handled antibiotic-resistant bacteria patient gets care
or cooked properly, at a hospital,
the bacteria can nursing home or
spread to humans other inpatient
care facility
antibiotic-resistant
fertilizer or water germs spread directly
containing animal to other patients or
faeces and drug- indirectly on unclean
resistant bacteria is hands of healthcare workers
used on food crops
antibiotic-resistant
drug-resistant bacteria bacteria spread to
in the animal faeces can other patients from
remain on crops and be surfaces within the
patient goes healthcare facility
eaten; these bacteria can
home
remain in the human gut
In all cases, exposure to low levels of antibiotics

60 allows some mutated bacteria to survive and reproduce,
MRSA
50 eventually developing the ability to tolerate higher and
VRE
Incidence/%
40 FQRP
higher concentrations of the antibiotic. Bacteria may
30 be resistant because either they have no mechanism to
20 transport the drug into the cell or they do not contain or
10 rely on the antibiotic’s target process or protein.
0 Such bacteria pass (via a process known as
1980 1985 1990 1995 2000
conjugation) their genetic resistance (on small strands
Year of DNA called plasmids) to new generations of bacteria,
MRSA = methicillin-resistant Staphylococcus aureus gradually replacing non-resistant strains. This simple
VRE = vancomycin-resistant enterococci process of evolution by natural section can take place
FQRP = fluoroquinolone-resistant Pseudomonas aeruginosa
both in individual patients and in the environment.
■■ Figure 25.94 Rise of antibiotic resistance in various common In the latter case, exposure to antibiotics increases the
bacterial infections antibiotic resistance (Figure 25.94) of the whole bacterial
population.
Over the past 30 years the use of antibiotics in agriculture (farming) has nearly doubled and
now contributes to over half of the global consumption of meat, milk and eggs. Most of these
antibiotics are given to healthy animals to prevent infectious diseases and promote growth of
animals, such as cows, sheep, goats and chickens. Although this practice allows increased output
and reduced prices in agricultural production, it is also the major source of antibiotic waste in
the environment. Since antibiotics are never completely metabolized in animal organisms, a
significant percentage of each antibiotic is excreted in unchanged form in the urine and released
into the groundwater or absorbed by other organisms. Some of these antibiotics are eventually
consumed by humans in meat, dairy products and water, further accelerating the development of
resistant bacteria.
Restrictions on the use of antibiotics
Since 2006 the use of antibiotics as growth promoters in animal feed for farm animals has been
banned in the European Union (EU); they have also been banned in some other countries, for
example in South Korea in 2011. However, these measures had no immediate effect on bacterial
resistance in humans while the rates of death and bacterial disease in animals increased significantly.
Excessive antibiotic intake has been shown to weaken the development of immune systems
of children and make them more susceptible to infections. Antibiotics may also be promoting
growth and obesity in the human population. Some people develop severe allergic reactions to
antibiotics, including penicillins.
Many scientists believe antibiotic therapy should be restricted to the most severe cases of
infections with multiplying bacteria while non-medical use of antibacterial drugs should be
banned completely. At the same time, the amount of antibiotic waste from hospitals and the
pharmaceutical industry must be reduced to a minimum and thoroughly processed before being
released into the environment.
In addition, new antibiotic drugs must be produced and used under strict control to prevent
the development of antibiotic resistance. To be effective, these measures need to be taken by all
countries and coordinated at the international level. The discovery of new antibiotics has slowed
down significantly. Developing new antibiotics has become too expensive and unattractive for
pharmaceutical companies and no new classes of antibiotics have appeared since 2003 (lipopeptides).
■■ Nuclear waste
Many medical procedures involve the use of radionuclides – unstable isotopes of certain
elements that undergo spontaneous radioactive decay (see section 25.8) and release beta or
gamma radiation. Some of these isotopes are administered to patients as water-soluble salts or
radiopharmaceutical drugs where one or more atoms are radioactive (see section 25.8), whereas
other radionuclides, such as cobalt-60, are used in medical equipment as sources of ionizing
radiation. During medical procedures radionuclides and ionizing radiation come into contact
with various materials that also become mildly radioactive. These materials together with
left-over or spent radionuclides produce nuclear waste, which must be disposed of according to
specific procedures.
Most radionuclides used in departments of nuclear medicine in hospitals and medical
research centres have very low activity and short half-life times. The waste containing small
amount of radionuclides is known as low-level waste and typically consists of contaminated
syringes, clothes, swabs, paper, filters and protective clothing, for example gloves. Such waste
has limited environmental impact, does not require shielding and is usually suitable for shallow
land burial or incineration. Some types of low-level waste, such as concentrated solutions of
medical radionuclides, must be stored for several days or weeks in lead-shielded containers until
most of the radioactive nuclides have decayed and the radiation level has dropped to what is
deemed a ‘safe’ level.
Medical equipment for radiotherapy may contain large quantities of radioactive isotopes such
as cobalt-60 and caesium-137. These radionuclides remain active for many years and produce
very high levels of ionizing radiation. This intermediate-level waste requires shielding during
handling, processing and storage, but does not generate significant heat. Shielding can be
barriers of lead, steel or concrete.
High-level nuclear waste is produced in nuclear reactors and contains a complex mixture
of nuclear fission products (see section 24.3) with unused nuclear fuel (usually uranium).
Many radionuclides in high-level nuclear waste have very long half-lives ranging from
hundreds to billions of years. Due to nuclear reactions, high-level nuclear waste releases
heat (as well as neutrons and gamma radiation) and must be constantly cooled and shielded
with water for several years. When the radioactivity level decreases, high-level nuclear waste
can be reprocessed and partly recycled. The remaining waste is fused with borosilicate glass
(vitrification) or immobilized in certain minerals, producing water-resistant and chemically
stable solid materials. These materials are encased in steel cylinders, covered with concrete,
and buried deep underground in geologically stable locations. The containers must be
continually cooled to avoid thermal stress and to prevent possible changes in the glass
structure. Depending on how much heat is generated, stored containers can be cooled by
natural or forced air convection
The treatment, transportation (by train, lorry and ship) and disposal of nuclear waste
presents serious risks due to possible release of radionuclides to the environment. In high
doses ionizing radiation is harmful to all living organisms, causing extensive cellular
damage and genetic damage to DNA. Low doses of radiation increase the number of
mutations and the risk of developing cancer, birth defects and reproductive disorders.
In addition, ionizing radiation weakens the immune system by triggering apoptosis
(programmed cell death) in lymphocytes (white blood cells that digest bacteria) and rapidly
dividing bone marrow cells.
The effects of ionizing radiation can be cumulative. For example, radioactive materials
discarded together with antibiotic waste can increase the mutation rate in bacteria and
accelerate the appearance of drug-resistant mutant strains.
■■ Waste products from the pharmaceutical industry

Many pharmaceutical drugs are produced on an industrial scale using a wide range of
technological processes and synthetic approaches often using catalysts. Some of these processes
traditionally involve the use of toxic chemicals that have to be recycled or disposed of after
the synthesis is complete. Organic solvents used in the pharmaceutical industry constitute a
significant proportion of chemical waste.
Most organic solvents, especially chlorinated solvents, are toxic and systemic poisons to
living organisms, primarily affecting the respiratory system, liver, nervous system, kidneys
and reproductive organs. Most of these compounds have an anaesthetic or narcotic effect,
causing people to feel intoxicated if overexposed. Some solvents such as benzene (C6H6),
methylbezne (C6H5CH3) and chloroform (CHCI3) (also used as an anaesthetic) increase
the risk of cancer in humans and other animals. In addition, many solvents are highly
flammable while the molecules of their vapours contribute to the greenhouse effect and
hence global warming (see Section 24.5).
Chlorinated solvents such as carbon tetrachloride (CCl4, also known as
tetrachloromethane; used in fire extinguishers), chloroform (CHCl3), dichloromethane
(CH2Cl2) and trichloromethane (CHCl3) are environmental hazards. Due to the relatively
low bond enthalpies of the C–Cl bonds, these compounds act as ozone-depleting agents (due
to formation of chlorine radical in the presence of ultraviolet radiation) and contribute to
the formation of photochemical smog in large industrial cities. Some chlorinated solvents
and chlorine-based pesticides have limited biodegradability and may accumulate in the
groundwater causing long-term damage to local ecosystems.
The disposal of chlorinated solvents is an expensive and complex process. Chlorine-
containing compounds cannot be incinerated together with common organic waste
because their incomplete combustion could produce highly toxic phosgene (carbonyl
chloride, COCl2) and solvents must be oxidized separately at very high temperatures or
recycled by distillation.
Research and rare diseases

Do pharmaceutical companies have a responsibility to do research on rare diseases that will not provide
them with significant financial profit?
A rare disease is a disease that affects only a small percentage of a population yet they may
affect between 10 and 20 million people in the USA alone. Pharmaceutical drugs are often
‘orphaned’ or are not produced and sold on the market, even when a compound is thought to be
useful for the treatment of a rare disease. Due to the relatively small number of patients and the
lack of money they would provide in sales revenue, pharmaceutical companies do not have any
incentive to develop drugs and treatments for rare diseases.
Therefore the pharmaceutical company may have the ability to supply orphan drugs where,
that is, there is a demand, but this demand is not significant enough to manufacture the needed
product. This is also partially due to the lack of sponsorship, and no one to ‘adopt’ the orphan
drug, to conduct the necessary testing (in the USA) to obtain the necessary approval from the
Food and Drug Administration (FDA).
Pharmaceutical companies are faced by restrictions as to where time and money can actually
be invested. They have limited resources available to them for research and development (R&D),
so research must be prioritized. The drugs or treatments that will bring in the largest amount of
money will be of most importance, while developing treatments for rare diseases will fall very
low on the priority list.
Bringing a drug into the market can be very costly and time consuming. The estimated
cost of bringing a single drug through screening processes and FDA procedures to obtain
approval is some US$350–500 million, and it can take up to ten years to bring a single drug
into the market.
Beyond the costs to itself, listed drug companies have an additional responsibility to their
shareholders. In order to fulfil a shareholder’s investment, a company must continue to grow
and bring in money. An additional issue faced by the pharmaceutical industry is that many
of the compounds found to treat rare diseases cannot be protected by a patent. A patent is
the exclusive right to make, use or sell a product. Therefore, competitors are not able to sell a
product that is the same as a product already protected by a patent.
Without this type of protection a company would be exposed to immediate competition
with generic drugs. Generic drugs are less expensive than brand-name drugs, even
though they are chemically identical and meet the FDA standards for safety, purity and
effectiveness. The introduction of a generic drug into the market drives market prices
down due to competition and therefore reduces the amount of revenue a non-generic
could have potentially brought in. The high costs of bringing a drug into the market,
added to the concerns about the amount of sales revenue a drug can actually provide, the
financial responsibility to shareholders and the lack of patent protection all outweigh a
pharmaceutical company’s wishes or ethical obligation to provide drugs to treat people with
rare diseases.
The US government realized the need to create incentives for pharmaceutical
companies to develop drugs for rare diseases. It is the government’s responsibility to
ensure the ‘base-line well-being of its citizens’ and the government is already active in
health issues and formulating health-related policies. The US government used to be
involved in developing new drugs and treatment and new drugs were often developed
in federally operated laboratories, non-profit medical research centres as well as the
pharmaceutical industry. However, by the 1960s, most new drugs were manufactured for
profit and the focus of federal laboratories and research universities concentrated on basic
research and clinical studies.
■■ Green chemistry
A quarter of the world’s human population have to survive on less than US$1 a day.
Millions of people have no healthcare. The world’s population is expected to increase
by about another 3 billion over the next 50 years. Even in developed nations, poverty,
education and healthcare could be improved. To help tackle this situation, the world’s
economy needs to grow; in particular, the economies of developing nations need to expand.
However, economic growth is often linked to global warming and environmental pollution
problems, such as acid rain and water pollution.
The challenge is to develop in a way that meets the needs of the present generation without
compromising the ability of future generations to meet their own needs – in other words,
without causing environmental damage and wasting limited resources. This type of development
is called ‘sustainable development’ and it will be increasingly critical as the population of the
world continues to rise.
One of the ways in which the chemical industry is working towards sustainable development
is by using ‘green chemistry’. One of the basic ideas of green chemistry is to prevent pollution
and the production of hazardous materials instead of producing materials and then cleaning
them up. This means that green chemistry is safe, conserves raw materials and energy, and is
more cost effective than conventional methods.
There are three main ways to make chemical processes ‘greener’. Companies can redesign
production methods to use different, less hazardous starting materials; use milder reaction
conditions, better catalysts and less hazardous solvents; and use production methods with fewer
steps and higher atom economy.
The concept of percentage yield is useful, but from a green chemistry and sustainable
development perspective it is not the only issue. This is because yield is calculated by
considering only one reactant and one product. One of the key principles of green chemistry is
that processes should be designed so that the maximum amount of all the raw materials ends
up in the product and a minimum amount of waste is produced. A reaction can have a high
percentage yield but also generate large amount of waste product. This kind of reaction has a
low atom economy. Both the yield and the atom economy have to be taken into account when
designing a green chemical process.
Green chemistry is essentially a way of thinking rather than a new branch of chemistry.
It is about using a set of principles that seek to reduce the environmental impact of chemical
processes and products. It involves pulling together tools, techniques and technologies that can
help chemists and chemical engineers in research, development and production to develop more
eco-friendly and efficient products and processes, which may also have significant financial
benefits. Green chemistry aims to improve the way that chemicals are both produced and used
in chemical processes in order to reduce any impact on humans and the environment. It is not
just about industrial production.
Green solvents
The main idea behind the use of green solvents is to minimize the impact they have on the
environment. Four factors are involved in the movement towards the use of green solvents:
■ substitution of hazardous solvents with those that have better environmental health and
safety properties, for example glycerol;
■ the use of solvents that are produced by renewable resources;
■ substituting organic solvents with those that are environmentally harmless;
■ the use of ionic liquids that show low vapour pressure (resulting in less emissions).
Traditionally solvents are disposed of in two ways – either recycled through a distillation process
or treated in a waste incineration plant.
Supercritical fluids
If a volatile liquid, such as water, is heated in an open container, it gradually evaporates as
it changes to a vapour (a gas near its boiling point). If the heating is carried out in a sealed
container, the molecules at the surface of the liquid evaporate, increasing the pressure and
density of the vapour. This is known as the critical point.
Eventually, as the temperature increases, a point is reached where the vapour and liquid
have the same density, and the surface between the two disappears. Fluids above their critical
temperature and pressure are known as supercritical fluids.
Supercritical fluids combine some of the properties of both liquids and gases. For example,
they are effective solvents for a range of substances, but they have relatively low viscosities and
high diffusion rates (a property normally associated with polar liquids, such as water).
In recent years, supercritical fluids have found a range of uses in chemistry and are now
used in industry.
Supercritical water has very different properties from normal liquid water. It is relatively
non-polar and dissolves hydrocarbons and other non-polar substance. It is a strong oxidizing
agent and can be used to oxidize pollutants. However, it is corrosive, which means reactions
must be carried out in specialized and expensive equipment.
A more commonly used supercritical fluid is liquid carbon dioxide. Liquid carbon dioxide
does not exist at atmospheric pressure but the gas can be liquefied at pressures above 5
atmospheres. One of the first uses of supercritical carbon dioxide was in the extraction of
molecules that give flavour to foods. Decaffeinated coffee was originally made by extracting
the caffeine with the organic solvent dichloromethane, CH2Cl2. However, this also removed
some of the molecules that give coffee its distinctive flavour. In addition it is a toxic organic
solvent. It has been replaced by the ‘green’ solvent, supercritical carbon dioxide.
The use of supercritical carbon dioxide allows the removal of almost 100 per cent of the
caffeine, while leaving most of the flavour. The supercritical carbon dioxide is circulated
through the beans, and then into a second vessel at lower pressure which contains water.
The caffeine dissolves in the water, and the carbon dioxide is repressurized and recycled.
There are no problems with the contamination of the coffee beans with the solvent, and
there is no harmful organic liquid to dispose of. The extracted caffeine is sold to manufacturers
of carbonated (soft) drinks.
Figure 25.95 shows the phase diagram for carbon dioxide. The critical point marks
the conditions above which a liquid does not exist. The system indicated by the shaded
condition, bounded by the dashed lines, is a supercritical fluid. Carbon dioxide is an
especially useful supercritical fluid since it has a conveniently low critical point
(31 °C and 73 atmospheres) and is cheap, easily removed after the process and
completely non-toxic.
■■ Figure 25.95
Phase diagram for
supercritical
carbon dioxide
fluid
solid
Pressure
liquid
critical point
gas
Temperature
Green synthesis
Ibuprofen is a popular over-the-
O O
counter drug that has analgesic and H H
anti-inflammatory properties. It was C C
step 1 AlCl3 H C O C H
originally developed in the 1960s by
the Boots Company of England. The H H
Boots synthesis of ibuprofen involved
a six-step process, known as the Brown
process, that generated a large quantity CH3
C
of unwanted waste (Figure 25.96) due
to reactants of the process not being O
incorporated into the product because of step 2 NaOC2H5 CH2ClOOOC2H5
poor atom utilization.
The synthesis of ibuprofen begins
with the compound isobutyl benzene CH3
(2-methylpropylbenzene).
H2O
COOC2H5
Step 1 Friedel–Crafts acylation that step 3 H+ O
uses the Lewis acid aluminium
chloride and generates O
aluminium trichloride hydrate as
a waste by-product
Step 2 Darzens reaction with ethyl- step 4 NH 2OH
chloroethanoate that results in an
epoxy ester compound OH
N
Step 3 decarboxylation and
hydrolyzation forming an
aldehyde
Step 4 reaction with hydroxylamine step 5
giving an oxime
Step 5 the oxime is converted to a
nitrile N
C
Step 6 hydrolyzation of the nitrile
resulting in the final product step 6
2,4-isobutylphenyl-propanoic
acid.
This process has a 40 per cent atom
economy which translates into 60 per COOH
cent waste products. The solution to
this problem was developed in 1991 and
involves a green synthesis of ibuprofen ■■ Figure 25.96 The Brown process for synthesis
that only required three steps of ibuprofen
(Figure 25.97). This process also
incorporated most of the reactants
into the final product, reducing or
eliminating most of the waste by-
products. The switch from the Brown
process to the BHC process has
resulted in a more efficient synthesis of
ibuprofen.
The green synthesis of ibuprofen also begins

with the compound isobutyl benzene:
Step 1 Friedel-Crafts acylation using O O
hydrogen fluoride as the catalyst that H H
C C
can be recovered and reused HF H C O C H step 1
Step 2 involves hydrogenation with nickel,
H H
which is recovered and reused, to
produce an alcohol
Step 3 the alcohol undergoes carbonylation
with the catalyst palladium, CH3
also recovered and reused, to C
produce ibuprofen or 2,4-isobutyl- O
phenylpropanoic acid. H2 nickel step 2
Atom economy
One of the most important concepts of
chemistry is atom economy (Figure 25.98), H
which expresses the efficiency of a synthesis CH3
C
reaction as the ratio between the molar
mass of the important target molecule OH
and the sum of all the molar masses of the CO Pd step 3
reactants (reagents) in the reaction. Atom
economy also must consider substances such
as solvents, separation agents and drying
agents that are used in the process but are
COOH
not directly part of the chemical reaction.
Using a green chemistry approach,
chemists attempt to either reduce the
■■ Figure 25.97 This process has a 99% atom
amount of or eliminate completely as many
economy, which includes the recovered ethanoic
of these substances as possible. Those that
acid that was generated in step 1. This means that
cannot be eliminated are reused or recycled
only 1% is waste by-products
when possible. Atom economy describes the
conversion efficiency of a chemical process
in terms of all atoms involved (desired
products produced). In an ideal chemical
process, the amount of starting materials or
reactants equals the amount of all products
generated and no atom is wasted.
■■ Figure 25.98 O O
Atom economy for the
C C
synthesis of aspirin OH O O H+ OH
+ C C O + CH3COOH
C
OH CH3 O CH3 O CH3
salicylic acid acetic anhydride acetylsalicylic acid acetic acid
MW 138.1 MW 102.1 MW 180.2
% atom economy = 180.2 × 100% = 75.0%

138.1 + 102.1
Another important aspect of green chemistry is the use of biotechnology and bioengineering
in organic synthesis. Enzyme-catalysed biochemical reactions are highly selective, efficient and
proceed in aqueous solution under relatively mild conditions of temperature and pH. Many
pharmaceutical drugs or synthetic intermediates (primary precursors) can be produced from
25.7 Taxol – a chiral auxiliary case study (AHL) 65
O OH renewable materials by genetically modified organisms. One such intermediate, shikimic acid
(Figure 25.99), is a precursor to the antiviral drug for treating flu known as oseltamivir (Tamiflu).
For many years shikimic acid was extracted from the Chinese star anise, a spice plant, using
solvent extraction with hot water and column chromatography. Roughly 80–90 per cent of the
world’s star anise is grown in south-western China, primarily in Guangxi and Yunnan provinces.
HO OH An estimated 66 per cent of China’s star anise harvest is used to make Tamiflu.
OH Outbreaks of ‘bird flu’ have increased the demand for Tamiflu and led to a worldwide
■■ Figure 25.99
shortage of this drug due to a limited supply of star anise. Modern biosynthetic technologies
Structure of shikimic
allow shikimic acid to be produced on an industrial scale by genetically modified E. coli bacteria,
acid
which effectively prevents any shortages of Tamiflu in the future.
The industrial use of natural products leads to various ecological and social issues, such as the
extinction of plant species and the increasing of food prices. At the same time some non-hazardous
substances branded as ‘green’ or ‘environmentally friendly’ still require toxic chemicals or large
amounts of energy for their production. Therefore the criteria used to assess the ‘greenness’ of a
substance or process must include all direct and indirect environmental implications.
Standards and practices in the pharmaceutical industry vary greatly around the world.
Widespread adoption of green technological processes in developed countries has significantly
reduced the emissions of many hazardous chemicals, such as chlorinated solvents and
greenhouse gases. Although green technologies often involve expensive equipment and recycling
facilities, they reduce the costs of environmental remediation, waste management and energy
consumption, making green chemistry a commercially attractive and sustainable alternative to
traditional organic synthesis.
An important issue in the chemical industry, including the pharmaceutical industry, is the
E factor. This is the actual amount of waste formed, including solvent losses, acids and bases
used in work-up and in principle waste from energy production.
It can be derived from the amount of raw materials purchased/amount of product sold; that
is, from the mass balance E = [raw materials − product]/product. In the pharmaceutical industry
product tonnage varies from 10 to 103 tonnes and the E factor from 25 to >100.
There are a number of origins for this waste: stoichiometric Brönsted acids and bases (e.g.
aromatic nitration with HNO3/H2SO4), stoichiometric Lewis acids (e.g. Friedel–Crafts acylation,
for example AlCl3), stoichiometric oxidizing and reducing agents (for example KMnO4 and
LiAlH4) and solvent losses (via air emissions and aqueous effluent).
Green chemistry came from law enacted in the USA, and because laws result from political
compromise and agreement among interested parties in order to get broad support, the ethical
principles that underlie green chemistry reflect ethical beliefs regarding the environment that a
large portion of the public share.
25.7 Taxol – a chiral auxiliary case study (AHL) –

chiral auxiliaries allow the production of individual enantiomers of chiral molecules
■■ Introduction
Plants have always been a rich source of lead compounds for the development of drugs, for example
morphine, cocaine, digitalis (used to treat heart failure), quinine (used to treat malaria) and
nicotine. Many of these lead compounds are drugs in themselves, for example morphine extracted
from opium, and others have been the basis for semi-synthetic drugs, for example heroin.
Plants are and will continue to remain a promising source of new drugs. A clinically useful
drug that has been isolated from plants is the anti-cancer drug Taxol (paclitaxel). Plants contain
a ‘library’ of rich, complex and highly varied chemical structures that are difficult to synthesize
in the laboratory. Many plant secondary metabolites remain undiscovered.
The discovery, isolation and development of Taxol (paclitaxel) is a good example of the time
and resources required to extract a new drug or drug lead from natural material. It shows many of
the difficulties and challenges and the multi-disciplinary nature of this process.
■■ Taxol
Taxol (paclitaxel) is a potent anti-cancer natural product that is active against leukemia and
tumours in the breast, ovary, brain and lungs. Taxol was isolated from the bark of the Pacific yew
tree in 1971. In the initial extraction 12 kg of air-dried stem and bark were extracted with
95 per cent ethanol and the solution was concentrated.
The isolation of active compounds was followed by biological testing by measuring the
inhibition of solid tumour cells. Activity was recorded as a T/C value, where T/C is defined as:
T mean tumour mass of treated animal

= × 100
C mean tumour mass of control animals
The smaller the T/C value relative to the dose used, the more active the sample. The
concentrate was partitioned between water and a solvent containing chloroform
(trichloromethane) and methanol (4 : 1). The organic layer yielded 146 g of solids active against
solid tumours. These solids were further fractionated using two different solvent systems and the
most active tubes were passed on to the next stage. Finally, trituration with benzene gave 0.5 g
of a single pure compound, namely Taxol, an overall yield of 0.004 per cent. Taxol is a white
crystalline powder. It is highly lipophilic and hence highly insoluble in water.
Trituration is used to purify crude chemical compounds containing solid impurities. A
solvent is chosen in which the desired product is insoluble and the undesired by-products are
very soluble (or vice versa). The crude material is washed with the solvent and filtered away,
leaving the purified product in solid form and any impurities in solution.
Figure 25.100 shows the principle of multi-step liquid–liquid extraction of Taxol or other
active compounds from biological material. The aqueous and solvent layers are both tested with
tumour cells. After each step all the active fractions are combined, inactive fractions discarded
and the process repeated using different solvents or combinations of solvents. Each extraction
step produces an extract with progressively increasing anti-cancer activity.
solvent extract
from plant
material
partition
with water
aqueous organic
layer layer
partition partition
with solvent with water
aqueous organic aqueous organic

layer layer layer layer
partition partition partition partition
with solvent with water with solvent with water
aqueous organic aqueous organic aqueous organic aqueous organic

layer layer layer layer layer layer layer layer
■■ Figure 25.100 Multi-step liquid–liquid extraction
The structure of Taxol was determined by X-ray crystallography and chemical degradation and
analysis of the fragments in 1971. Subsequent research showed that it prevented cell replication
by binding to the polymerized form of tubulin, a protein present in structures called microtubules
involved in chromosome movement during cell division.
Clinical trials began in 1983, but Taxol was in short supply since it is present in only minute
amounts in nature. The Pacific yew tree (Figure 25.101) is an environmentally protected species
and one of the slowest growing trees in the world. Removal of the bark kills the tree and six
100-year-old trees are needed to treat just one patient.
25.7 Taxol – a chiral auxiliary case study 67
Research efforts were then directed towards developing a total synthesis of Taxol from
commercially available precursors. This was achieved after over ten years' efforts by many
research groups worldwide who developed different syntheses.
In addition, a more efficient and sustainable semi-synthesis of Taxol was developed from a
naturally occurring related compound called 10-deactylbaccatin III (Figure 25.102), a precursor
that is easily coupled with a side-chain to give Taxol. This compound was discovered in the
needles or leaves of the related European yew tree, Taxus baccata. This source is renewable
and sufficient quantities of Taxol were prepared for clinical trials. The latest approach to Taxol
production involves the cultivating of Pacific yew cells in tanks. The European yew tree has
been investigated for the presence of other anti-cancer agents and screening has revealed the
■■ Figure 25.101 presence of a compound related to Taxol, which promises to be an even more potent anti-cancer
Pacific yew (Taxus agent than Taxol. Biotechnologists have obtained Taxol from cultivated callus cell of Taxus
brevifolia) brevifolia. This area of research hopes to cultivate the Taxol-producing cells and speed up their
production. On a large scale Taxol could be produced in tanks to supply the huge demand for
Taxol and a related compound called Taxotere.
Taxol, whose structure is shown in Figure 25.103, is a relatively complex molecule that can be
divided into two main parts: the side-chain and the Taxol skeleton. Many structural features of
the side-chain and the Taxol skeleton are required for maintaining its anti-tumour activity.
O
HO O OH
O OH
O H3C O
HO H
NH O
H O
AcO O
HO O H
O
OH O CH3
OH
O O O
O
10-Deacetylbaccatin III
■■ Figure 25.102 Structure of

10-deacetylbaccatin III
(Ac = ethanoyl (acetyl))
■■ Figure 25.103 Structure of Taxol (paclitaxel)
The total synthesis of Taxol is highly challenging to synthetic organic chemists because of
the presence of the following structural features: a double bond in a six-membered ring that
is a bridgehead within the molecule, the central eight-membered ring and the unstable four-
membered oxetane ring. In addition, the large number of oxygen atoms (in different oxidation
states) coupled with nine chiral centres (implying 29 stereoisomers) posed further problems.
There are 11 chiral (stereogenic) centres if the 2 in the side-chain are included.
Taxotere(docetaxel) has been synthesized on an industrial scale and is currently being
administered in clinical trials. The structure of Taxotere (Figure 25.104) differs from Taxol in the
presence of a tertiary butoxycarbonyl group instead of a benzoyl
group on the Taxol side-chain and a hydroxy group instead
HO O OH of the acetyl group on the Taxol skeleton. The advantages of
O
10 Taxotere over Taxol are its easier administration due to its greater
7
solubility in water and its more potent anti-cancer properties
O NH O
3 against a variety of tumours, especially breast cancer.
13
3′ 2′ 1 O The steps that make up the synthesis of a complicated
O H
O natural product like Taxol are planned by a mental process
HO O
OH called retrosynthetic analysis (see Chapter 20). In this approach,
O
O the ‘target’ molecule, in this example Taxol, is repeatedly
disconnected or fragmented into progressively simpler ‘building
blocks’ which can then be further simplified to readily available
starting materials. Retrosynthesis is a ‘paper exercise’ and is not
■■ Figure 25.104 Structure of Taxotere actually carried out as an experimental procedure.
A number of total syntheses of Taxol have been carried out and part of one of these
syntheses is very briefly outlined below. Robert Holton of Florida State University used one of
the enantiomers of a cyclic alcohol called borneol as his starting compound. This is a natural
product obtained from Dryobalanops aromatica, a member of the teak family. This was converted
in a series of 13 synthetic steps to an unsaturated ketone. Further reactions were carried out,
including a rearrangement to create two of the rings present in Taxol – a so-called linear route.
The third ring was then introduced later (Figure 25.105).
■■ Figure 25.105
A summary of Holton’s
Taxol synthesis
O
OH
13 steps
(–)-borneol homocamphor O
tertiary alcohol
O H OH
O
OH
O
O
HO HO
H Taxol A, B-rings H Taxol A, B C-rings
Another approach, as exemplified by K. C. Nicolaou of the Scripps Research Institute, is

to utilize a so-called convergent route where the three carbocyclic rings of Taxol are made
separately and then joined together.
Although a number of different total syntheses have been carried out for Taxol, all are very
complex, use chiral auxiliaries and are not easy to perform. This, coupled with their low yields,
means that they are, at the present time, not economically feasible for the industrial manufacture
of Taxol. Their main use is for designing analogues of Taxol in an effort to develop a range of
active anti-cancer compounds based upon the Taxol skeleton. This is arguably more important, for
stimulating and testing new, generally applicable synthetic reagents, transformations and strategies.
■■ Chiral auxiliaries
To synthesize Taxol or Taxotere from their precursor molecules, the side-chains of these drugs
need to be synthesized in the laboratory. Since these chains contain two chiral centres their
synthesis from achiral molecules would lead to a mixture of several stereoisomers, which would
need separation.
Hence both side-chains are synthesized using a chiral auxiliary (see Section 25.1), which
converts an achiral molecule S into the preferred enantiomer, A or B. This avoids the need to
separate enantiomers from a racemic mixture. In other words it converts the problem into one
based on diastereo-control and the easier separation of diasteroisomers. A chiral auxiliary (X)
works by bonding itself to the non-chiral molecule S to produce the stereochemical intermediate
structure required to make the reaction favour the desired ‘stereochemical’ direction (i.e. the desired
enantiomer). Once the new intermediate stereoisomer molecule X–A or X–B is formed, the chiral
auxiliary molecule X can be cleaved and recycled, leaving the desired enantiomer required, A or B.
A chiral auxiliary is a control element temporarily incorporated into the structure of the
substrate in order to direct the stereochemistry at new stereogenic centre(s) formed in a reaction.
The auxiliary is removed (either immediately during work-up or in a separate subsequent step)
and may be recovered for re-use. The sequence is shown in diagrammatic form in Figure 25.106.
25.7 Taxol – a chiral auxiliary case study 69
■■ Figure 25.106
substrate reagent cleavage
The action of a chiral reaction X stereoisomer X + stereoisomer
(achiral)
A A
auxiliary molecule S conditions
for A
X can be
+ X S recycled
chiral reagent
cleavage
auxiliary reaction stereoisomer stereoisomer
X X +
molecule X conditions B B
for B
The chiral auxiliary used in the synthesis of Taxol and Taxotere is a single stereoisomer of trans-2-
phenylcyclohexanol (Figure 25.107). It is a large molecule with two chiral carbon centres, which favour
the formation of specific diasteroisomers in the subsequent steps of the synthesis. It is also known as
HO Whitesell’s chiral auxiliary and its chirality is ultimately derived from a plant-derived terpene.
■■ Figure 25.107
The use of chiral auxiliaries allows specific stereoisomers to be synthesized in a
The structure of the
stereoselective reaction, but small quantities of the other stereoisomer are always formed
chiral auxiliary trans-2-
along with the target molecule. Since the configuration of the chiral centre(s) in the chiral
phenylcyclohexanol
auxiliary is fixed, the unwanted stereoisomers will be diastereoisomers which will have specific
chemical properties and physical properties, for example solubility and melting point. Unwanted
diastereoisomers can be separated and removed from the reaction mixture by fractional
crystallization, solvent extraction or high-pressure liquid chromatography (HPLC). The identity
and purity of chiral compounds can be determined using a polarimeter and analysing a sample of
the chiral substance, either as a pure liquid or in solution.
■ Optical activity
Enantiomers have the property of rotating the plane of polarized light as it passes through a
sample of the molecules. Such molecules are said to be optically active. The most common cause
of optical activity is the presence of one or more chiral (asymmetric) carbon atoms.
Optical activity is an integral property of many natural products and biomolecules.
Medicinal chemistry is often involved with their isolation, study and synthesis. Hence the
medicinal chemist will usually need to measure an optical rotation at some stage during drug
development.
Ph For example, for the commercial compound propoxyphene (Figure 25.108), one
Ph enantiomer is an analgesic whereas the other shows antitussive (anti-coughing) properties.
Ph Even the names of the two enantiomers are mirror images.
N O O New drugs are often prepared by a stereoselective reaction and usually contain only
H3C CH3 a single enantiomer or stereoisomer of the active compound. The levels of the other
Darvon enantiomer or stereoisomers are usually kept at a minimum because often only one
CH3 isomer has a therapeutic effect, and sometimes the other enantiomer is toxic or otherwise
(analgesic)
detrimental.
The instrument used to measure optical rotation is called a polarimeter. Plane polarized
Ph
light is obtained by passing light from a sodium lamp through a polarizer. This light is
Ph
then passed through the sample, either as the pure liquid or in solution, which causes
Ph
the polarization plane to be rotated to an extent depending on the optical activity of the
O O N sample.
H3C CH3
To describe the outcome of these measurements we need to use the following terms:
novraD
H3C ■ A dextrorotatory compound rotates the plane of polarized light in a clockwise direction
(antitussive)
and is designated as d or (+).
■■ Figure 25.108
■ A levorotatory compound rotates the plane of polarized light in an anticlockwise
Darvon and novraD are
direction and is designated as l or (−).
enantiomers of each other
with different biological There is no relationship between (+)/(−) and the R/S system of denoting absolute
properties configurations (Chapter 20).
Optical rotation is the rotation of the plane of polarized light by an angle a. If it is clockwise
it is designated (+), whereas if it is anticlockwise the designation is (−). Each optically active
isomer (enantiomer) has a unique rotation angle and hence a pure isomer of an unknown
compound can be identified by its rotation angle.
Specific rotation [α] is the optical rotation of a non-racemic mixture of a chiral substance in
solution at a specified concentration (g/100 mL) in a cell of specified length (dm).
When quoting the specific rotation of a sample of an enantiomer, it is necessary to give
the concentration of the solvent, as well as the temperature of the solution at which the
measurement was recorded, because these factors affect the value obtained.
For example, the specific rotations are +123 and −123 degrees for the (+) and (−) enantiomers
respectively of limonene (a hydrocarbon present in lemon peel) at 25 °C for a concentration of
1 g/100 mL).
A racemic mixture of two enantiomers (1 : 1 mixture by amount) will be optically inactive
as the opposing effects of the two enantiomers will cancel each other out. Other proportions of
enantiomers will produce rotation angles from +X° to −X°, where +X and −X are the rotation
angles of the pure enantiomers.
The optical purity of a mixture of enantiomers can be calculated from the following
expression: (observed specific rotation/specific rotation of pure enantiomer) × 100.
For example, a sample of (+) limonene contaminated with (−) limonene has an observed
specific rotation of +106° but the literature value of the pure enantiomer is +123°. Hence the
optical purity = (+106/+123) × 100 = 86%.
Nature of Science Vinblastine and vincristine
Vinblastine and vincristine are alkaloids (weak bases) found in the Madagascar periwinkle,
Catharanthus roseus (formerly known as Vinca rosea). The natives of Madagascar traditionally
used V. rosea to treat diabetes. It has also been used for centuries throughout the world to treat
all kinds of ailments from wasp stings, in India, to eye infections in the Caribbean.
When researchers began to analyse the plant in the 1950s they discovered it contained over
70 alkaloids. Some were found to lower blood sugar levels and others to act as hemostatics (to
stop bleeding), but the most interesting were vinblastine and vincristine, which were found to
lower the number of white cells in blood. A high number of white cells in the blood indicates
leukemia and so a new naturally occurring anti-cancer drug had been discovered.
Vinblastine and vincristine work by preventing mitosis (cell division) by binding to the
protein tubulins that form microtubules, thereby preventing the cell from making the spindle it
needs to be able to divide. The spindle consists of microtubules that pull the chromosomes to
the poles of the dividing cell. This is different from the action of Taxol, which interferes with
cell division by keeping the spindle from being broken down.
Vinblastine is mainly useful for treating Hodgkin’s disease (a form of lymphoma), advanced
testicular cancer and advanced breast cancer. Vincristine is mainly used to treat acute leukemia
and other lymphomas.
The periwinkle plant produces these compounds in very low concentrations, ranging
from less than 0.0005 per cent to 0.3 by mass. As a result, the market price for vinblastine
and vincristine extracted from the plant are relatively high. The supply of these compounds is
limited by the availability of the plant. Chemists are seeking total syntheses for vinblastine and
vincristine as well as cell cultures of the periwinkle.
There is an unequal availability and distribution of certain drugs and
medicines around the globe
More than 10 million children die each year, most from preventable causes and almost all in poor
countries. Six countries account for 50 per cent of worldwide deaths in children younger than 5
years; these include three countries in South Asia. These deaths are preventable, but in many poor
countries basic healthcare remains financially and often physically out of reach for millions of people.
A small number of infectious diseases, including diarrhoea, are treatable with inexpensive generic
drugs but still account for 70–90 per cent of all childhood illness and deaths in the developing
world. Existing access to essential medicines for many of the world’s poor is very inadequate. A large
percentage of the most vulnerable populations live hours or days from the nearest doctor or hospital.
25.8 Nuclear medicine (AHL) 71
The health situation of the developing world poor is characterized by a high incidence of
communicable diseases. Communicable diseases spread from one person to another or from
an animal to a person. The majority of deaths still occur largely due to conditions that are
preventable or could be stopped by early intervention. In the poorest parts of the world, illnesses
associated with poverty remain major contributors to the burden of disease. The most common
illnesses causing death include neonatal disorders, respiratory infections, diarrhoeal diseases and
nutritional deficiency disorders.
Diarrhoea kills more children than HIV/AIDS, malaria and tuberculosis combined, yet
compared to these diseases it receives little financing and is not prioritized by governments in
donor countries. A report by WaterAid shows that between 2004 and 2006 only $1.5 billion
was spent globally on improving sanitation. In the same period, $10.8 billion was spent on
interventions for HIV/AIDS (responsible for 315 000 child deaths in that period) and $3.5 billion
on interventions for malaria (responsible for 840 000 child deaths).
25.8 Nuclear medicine (AHL) – nuclear radiation, whilst

dangerous owing to its ability to damage cells and cause mutations, can also be used to
both diagnose and cure diseases
■■ Introduction
Nuclear chemistry deals with the study of nuclear particles, nuclear forces and nuclear reactions.
This branch of chemistry began with the discovery of radioactivity (see Chapter 2). A great
deal of knowledge was accumulated during the next few decades and this led to the discovery of
artificial radioactivity. The release of huge amounts of energy through nuclear reactions became
possible with the development of artificial radioactivity. Nuclear chemistry is important not only in
providing alternatives to fossil fuels but also in providing radioisotopes for use in nuclear medicine.
Nuclear medicine is the use of radioactive materials (usually in the form of soluble complexes
or salts) in medicine for diagnostic imaging and therapy (usually cancer therapy). In therapy, the
aim is to localize the radioactive material in cancerous (malignant) cells so they are killed by
the ionizing radiation. Since the normal cells surrounding the diseased tissue must not be killed,
short-range ionizing radiation (alpha and beta radiation or emission) is used.
■■ Ionizing radiation
Ionizing or nuclear radiation is usually composed of three types of radiation, which differ in their
nature and properties (Table 25.5).
■■ Table 25.5 The properties of ionizing radiation
Alpha particle Beta (minus) particle Gamma ray

Relative charge and relative mass +2 and 4 −1 and 0 0 and 0
Nature Helium nucleus or helium ion High-speed electron Electromagnetic wave with very
short wavelength <10 −10 m
Representation 4
2He
0 e
−1
0
0γ
Action of magnetic field Deflected towards cathode Deflected towards anode Not deflected
(negative) (positive)
Velocity 1/10 speed of light Up to 9/10 speed of light Speed of light (3.00 × 10 8 m s−1)
Ionizing power Very high: nearly 100 × that of Low: nearly 100 × less than that Low
beta particles of gamma rays
Penetrating power Low; easily stopped by air 100 × that of alpha particles 10 × that of beta particles
Kinetic energy High Considerably less than alpha Zero
particles
Nature of product Product obtained by the loss Product obtained by the loss of There is no change in atomic
of one alpha particle has an one beta particle has an atomic number or mass number
atomic number less 2 units and number greater by 1 unit, without
a mass number less 4 units any change in mass number
The emission of a beta (minus) particle is accompanied by the emission of another particle, the
anti-neutrino, but this is not required for the current IB Chemistry syllabus.
Another type of radioactive decay is positron emission. A positron is a particle that has
the same mass as an electron but an opposite charge. It is the anti-particle of the electron.
The positron is represented as 01e. The isotope carbon-11 undergoes decay by positron
emission:
11C
6 → 115B + 01e
Positron emission causes the atomic number to decrease from 6 to 5. The emission of a positron
has the effect of converting a proton to a neutron, thereby decreasing the atomic number of the
nucleus by 1:
1p
1 → 10n ++10e
The positron has a very short life because it is annihilated and converted to energy (gamma rays).
0e +−10e→ 200γ
1
This process is used in positron emission tomography (PET) ■■ Table 25.6 Nuclear symbols
(see Chapter 2): compounds containing radionuclides that
Particle Symbol
decay by positron emission are injected into a patient. These 1n
Neutron
compounds are chosen to allow researchers to monitor blood 0
1H or 1p
Proton
flow and oxygen and glucose metabolic rates. The changes in 1
0
1
Electron −1e
how glucose is metabolized by the brain may suggest cancer, 4 He or 4α
Alpha particle
epilepsy, Parkinson’s disease or schizophrenia. 2 2
−1e, −1β or β
Beta particle 0 0 −
Table 25.6 summarizes the nuclear symbols used to 0 e, 0β or β+
Positron
represent the various nuclear and subatomic particles +1 1
commonly found in nuclear reactions.

Positron emission topography
PET provides images of blood flow or biochemical functions, depending upon the type
of molecule that is radioactively tagged. PET can show images of glucose metabolism in
the brain, or rapid changes in biochemical activity in various areas of the body. However,
there are usually relatively few PET centres in most countries because they must be located
near a particle accelerator device that produces the short-lived radioisotopes used in the
technique. Cost and availability are clearly important factors in determining the use of PET
by patients.
■■ Nuclear equations
1 Nuclear reactions are written like a chemical reaction: the reactants in a nuclear reaction
are written on the left-hand side and the products on the right-hand side with an arrow in
between them.
2 The mass number and atomic number of each element are written in a nuclear reaction.
They are inserted as superscripts and subscripts respectively on the symbol of the element.
For example, 2713Al represents a nuclide of aluminium with a mass number of 27 and an atomic
number 13. A nuclide is a nucleus of a particular mass number.
3 Mass number and atomic number are conserved. In a nuclear reaction the sum of the mass
numbers and the sum of the atomic numbers are balanced on the two sides of the reaction
(recall that in a chemical reaction the total numbers of atoms of the various elements are
balanced on the two sides).
4 The energy involved in the nuclear reactions may be indicated in the product as +Q or –Q
for reactions accompanied by release or absorption of energy, respectively.
For example a nitrogen-14 nucleus reacts with a helium-4 nucleus to form an oxygen-17
nucleus and a proton. Energy is absorbed:
14N
7 + 42He → 178O + 11H + −Q
25.8 Nuclear medicine 73
■■ Types of nuclear reactions

There are two types of nuclear reactions: natural nuclear reactions and artificial nuclear reactions.
In natural nuclear reactions, a nucleus of a single atom (element) undergoes a spontaneous change.
Alpha and beta decays are examples of natural nuclear reactions.
In artificial nuclear reactions, two nuclei of different elements (atoms) are brought to
interact artificially. This is done by bombarding a relatively large nucleus (non-radioactive)
with a lighter nucleus, e.g. protons, alpha particles or helium atoms. For example, the
artificial radionuclide phosphorus-15 is prepared by bombarding aluminium-27 with alpha
particles:
27
13Al + 42He → 15
30P + 1n
0
Many of the radionuclides used in nuclear medicine are directly or indirectly prepared by
these types of reactions, such as iodine-131 and technetium-99m (molybdenum-90 reactor
produced). Two other important nuclear reactions are nuclear fission and nuclear fusion
(see Chapter 24).
■■ Production of artificial isotopes

Most of the radioactive nuclides used in nuclear medicine do not occur naturally. Some are
produced in nuclear fission reactors at nuclear power stations from natural, often stable isotopes;
others are produced in a cyclotron (a particle accelerator). Usually a sample of the natural isotope is
bombarded (irradiated) with neutrons obtained as a by-product in the reactors (see Chapter 24).
For example, the radioisotope sodium-24 can be produced from non-radioactive sodium-23 by
neutron bombardment:
23
11Na + 10n → 24 0
11Na + 0γ
Not all the nuclides will be changed and it is not possible to separate the two isotopes on a
chemical basis. Therefore it is not possible to have a pure sample of the radioactive sodium.
Sodium-23 is said to be the carrier for the radioisotope sodium-24.
Neutrons are often used as projectiles in many transmutation processes. Since neutrons are
electrically neutral and not strongly repelled by the target nuclei, high kinetic energy neutrons
are not necessary. They are sufficiently accelerated by heat, hence called thermal neutrons,
which have just enough energy to bind to the target nuclei.
Neutron bombardments are often used to produce radioisotopes such as cobalt-60 from
cobalt-59 or iron-59 from iron-58:
59 60
27 Co + 10 n → 27 Co + Y 58
26
Fe + 10 n → 59
26
Fe
9 Complete the following nuclear equations and identify the other products.
13 1 4 53 4 1
a 6 C + 0 n → 2 He + _____ d 24
Cr + 2He → 0 n + _____
14 4 1 250 11 1
b 7 N + 2He → 0 n + _____ e 98
Cf + 5 B → _____ + 4 0 n
253 4 1
c 99
Es + 2 He → 0 n + _____
■■ Natural radioactivity
Radioactive elements (radioisotopes) are generally heavy elements which are unstable; the origin
of that instability is the nucleus. This unstable nucleus undergoes a spontaneous breakdown
with the emission of either an alpha particle or a beta particle. This may also be accompanied by
gamma radiation.
The decay is a random process; that is, each and every atom has an equal chance for radioactive
decay at any time. The number of atoms that decay per second is directly proportional to the
number of remaining undecayed radioactive atoms present at any time. The decay is independent of
temperature, pressure and whether the radioisotope is an element or part of a compound.
A daughter nuclide is different from its parent nuclide, not only in its radioactive properties
but also in other chemical and physical properties. Such a process is termed transmutation,
meaning one element has been converted into another element.
■■ Types of radioactive decay

The three most common types of ionizing radiation released when a radioisotope decays are
alpha, beta (negative and positive) and gamma radiation.
During alpha decay (Figure 25.109) an alpha particle, composed
238 234 4 of two protons and two neutrons, is released. When a nucleus
U Th He decays by alpha particle emission, proton number or atomic number
92 90 2
the protons and (Z) decreases by two and its mass number or nucleon number (A)
two protons and two neutrons leave decreases by four.
neutrons from nucleus nucleus as an During beta (minus) decay (Figure 25.110) the mass or nucleon
alpha particle
number (A) remains unchanged, but the atomic number (Z) increases
by one. During this process, a neutron splits into a proton and an
energy electron (and an anti-neutrino). The proton number increases and the
energetic electron leaves the nucleus as a beta particle.
In a special type of beta decay, known as beta positive decay
■■ Figure 25.109 Alpha decay of uranium-238 (Figure 25.111), a positron is emitted. The positron is the anti-particle
of the electron. The positron has a positive charge +e and the mass of
a positron is equal to that of the electron. (A neutrino is also released,
but not shown in the nuclear equation.)
131 131 0
I Xe e
53 54 1
a neutron becomes a proton (which stays 40 40 0
K Ar e
in the nucleus) and an electron (which is 19 18 1
ejected from the atom) a proton becomes a neutron (which stays

in the nucleus) and a positron (which is
e
ejected from the nucleus)
e
energy
energy
■■ Figure 25.110 Beta (minus) decay of ■■ Figure 25.111 Beta (positive) decay of
iodine-131 potassium-40
In the nucleus, protons and neutrons are bound together by a very strong nuclear binding
energy, which is effective only over a very short distance (within ~10−15 m). Both nuclear
particles also appear to exist in a set of quantized energy shells, analogous to electronic
shells in atoms.
The emission of gamma rays (Figure 25.112) has no effect on the nucleon number or the
proton number of the nucleus. Gamma rays are usually emitted at the same time as alpha
and beta particles. For some radioactive nuclides, the emission of alpha and beta particles
from the nucleus leaves the protons and neutron in an excited arrangement. The protons
and neutrons undergo transitions within the nuclear energy levels and release energy as
gamma photons.
■■ Figure 25.112 60 60 0 60
Co Ni* e Ni -photon
Gamma and beta 27 28 1 28
emission from beta emission
cobalt-60 excited state e
gamma
photon
Balancing nuclear equations involving alpha and beta particles

Deduce what product is formed when radium-226 undergoes alpha decay.
This is best solved by writing a nuclear equation for the process.
The periodic table shows that radium has an atomic number of 88. The nuclide notation
for radium-226 is therefore 226
88Ra. An alpha particle is a helium-4 nucleus, and so its nuclide
notation is 42He. The alpha particle is a product of the nuclear reaction, and so the nuclear
equation is:
226 Ra
88 →A 4
ZX + 2He
where A is the mass number of the product (daughter) nucleus and Z is the atomic (proton)
number. Mass numbers and atomic numbers must balance, so:
226 + A + 4; 88 = Z + 2; hence A = 222 and Z = 86.
From the periodic table, the element with Z = 86 is radon (Rn). The product is therefore 222
86Rn,
and the nuclear equation is:
226Ra
88 → 222 4
86Rn + 2He
■■ Decay series
When the product of a radioactive disintegration is itself unstable, then a further
radioactive disintegration will occur. Thus a whole series of spontaneous radioactive
disintegration can occur (see the uranum-235 decay series in Figure 25.113), each step
involving the loss of either an alpha or a beta particle or very occasionally both, until
eventually a stable isotope is formed.
■■ Figure 25.113 234 238
The uranium decay 92 U U
25ky 109y
series 91 230 Pa
1m
90 Th Th
10ky 24d
89 226
88 Ra
2ky
87 222
β
86 218 Rn
z
4d
At α
85 210 214 1d
84 Pb
Po Po Po
138d 1s 2m
83 206 Pb
Bi Bi
5d 2m
82 Pb Pb
Pb Pb
22m 27m
81 Pb
Tl Pb
TI
4m 1m
124 126 128 130 132 134 136 138 140 142 144 146
N
10 Balance the following nuclear equations:

94Ra → 2He + ____
a 239 4
19K →−1e + ____

b 40 0
c 99 Tc → 99 Ru + ____
43 44
84Po → 82Pb + ____

d 218 214
11 Deduce the final product from the decay of uranium-235. One alpha particle and two beta particles are
emitted.
12 Write balanced nuclear equations for the alpha decay of uranium-238 and the beta decay of lead-210.
13 Write a nuclear equation showing the emission of gamma radiation from an excited xenon-131 nucleus.
14 Deduce which element undergoes alpha decay to form lead-208.
■■ The kinetics of radioactive decay

Nuclear activity is the rate of nuclear decay. The SI unit of nuclear activity is called the
becquerel (Bq), where 1 Bq = 1 event/s or 1 disintegration/s.
With time, the number of parent nuclei decreases because of radioactive decay. This decrease
obeys the law of radioactive decay. At the initial instant of time, t = 0, let there be Δt nuclei of
the same element that will remain undecayed by time t. Since we are dealing with spontaneous
changes, it is natural to assume over a longer interval of time that a greater number of nuclei will
decay. If we have N undecayed nuclei present at time t, and N − ΔN undecayed nuclei existing
at time t + Δt then the change in the number of undecayed nuclei, that is, the number of nuclei
decaying in time Δt, will be proportional to N; that is:
ΔN = NΔt or ΔN = −λNΔt
where λ is a positive proportionality factor called the decay constant, which it has a definite
value for each nuclide. The minus sign on the right-hand side of the equation indicates that ΔN
decreases with time. Thus it follows that the decay constant is the fractional decrease in the
number of nuclei decaying per unit time:
dN
or using calculus notation: = λN
dt
In other words, the decay constant represents the proportion of nuclei decaying per unit time,
or the decay rate. The decay constant is independent of the surrounding conditions (such as
pressure and temperature) and is only determined by the internal properties of the nucleus. It
has dimensions of |λ| = T −1.
In order to find the time dependence for radioactive decay we can show that the number of
atoms of the original nuclei remaining after time t is:
N = N0exp(−λt) (this equation is given in Table 1 of the IB Chemistry data booklet)
where N0 is the initial number of radioactive nuclei existing at t = 0 and N is the number of
radioactive nuclei present at time t. A plot of ln(N/N0 ) as a function of time shows the decrease
is exponential. The decay constant λ can be found from the slope of the curve.
In practice the stability of radioactive nuclei against decay and the decay rate are most often
estimated in terms of the half-life, t 12 , rather than the decay constant λ.
The half-life is defined as the time at which half of the original nuclei have decayed. The half-
life is the time after which one-half the original number of nuclei remains unchanged.
By this definition and on the basis of the exponential decay law, t 12 and λ are related;
cancelling N0 and taking a logarithm, we obtain:
ln 2 0.693
t 12 = = λ (this equation is given in Table 1 of the IB Chemistry data booklet)
λ
The half-life represents a 50 per cent chance that a nuclide will decay during that period. The
activity of a radioactive substance is normally given in the form of its half-life, from which the
rate constant, k, can be calculated. For example,
14 14 0
6C → 7N + −1β
t 12 = (0.693/k) = 5730 years; k = (0.693/5730 years) = 1.21 × 10−4 year−1
The data booklet also has the following equation that can be used in radioactivity calculations:
Nt = N0(0.5)t/k
This equation is a way of enabling direct calculation of N from time and half-life, t, except it is
using the rate constant, k, instead of the half-life in the expression used earlier in Section 1 of
the IB Chemistry data booklet.
Worked example
The half-life of radium is equal to 1590 years. Determine the number of nuclei in 1 g of radium and find its
decay constant.
The number of radium atoms per gram is equal to Avogadro’s constant, NA , divided by the molar
mass:
= 2.67 x 1024 g−1
Then the activity of 1 g of radium will be:
= 3.7 x 1010 s−1
That is, the number of decays per second in 1 g of radium is 37 000 million.
Since the decay constant is a constant, then the half-life of a particular radioisotope is
independent of the amount of radioisotope. Whatever the amount of radioisotope present at a
particular time, it will always decay to half of that amount at the end of one half-life. This can
be illustrated in the form of Table 25.7, where x represents the amount of radioisotope at the
start (that is, when time = 0).
■■ Table 25.7 Number of half-life Mass initially Mass of substance that has Mass of remaining
Decay of a radioisotope periods present undergone decay radioactive substance
0 x 0 x
1 x x/2 x/2
2 x/2 x/4 x/4
3 x/4 x/8 x/8
4 x/8 x/16 x/16
Because radioactive decay is a first-order process the activity of a radionuclide decreases

exponentially with time. Each radionuclide has a specific and constant half-life which can vary
from less than a second to many millions of years. The concept of radioactive decay and half-life
is shown in Figure 25.114.
■■ Figure 25.114 100

The half-life concept 90
Percentage of radioactive
– the time it takes 80

nuclei remaining
for one-half of a 70 50% remaining

60 after 1 half-life
radioactive sample to
50 25% remaining
decay 40 after 2 half-lives
30 12.5% remaining
after 3 half-lives
20 3.125% remaining
6.25% remaining
10 after 5 half-lives
after 4 half-lives
0
0 1 2 3 4 5 6
Half-lives
The half-life is a measure of the radioactivity of the element since the shorter the half-life
of an element, the greater is the number of the decaying atoms and hence the greater its
radioactivity. The half-lives of different radioisotopes vary widely, from a few seconds to
millions of years.
Calculating the percentage and amount of radioactive material decayed
and remaining after a certain period of time using the nuclear half-life
equation
Shown below are a wide range of examples of calculations involving the half-life concept and a
range of different mathematical expressions related to radioactive decay.
Worked examples
Technetium-99m is used for brain scans. If a laboratory receives a shipment of 200 g of this isotope and
after 24 hours only 12.5 g of this isotope remains, what is the half-life of technetium-99m?
Total time of decay = number of half-lives × number of years/half-life

Number of years/half-life = total time of decay/number of half-lives
Fraction of sample remaining = final mass sample/initial mass sample = 12.5 g = 0.0625 = 1
200 g 16
1 × 1 × 1 × 1 = 1 so four half-lives have passed
2 2 2 2 16
Number of hours/half-life = 24 = 6 hours
4
The half-life of uranium-232 is 70 years. How many half-lives will it take for 10 g of it to be reduced to 1.25 g?
Number of years/half-life = total time of decay/number of half-lives

Fraction of sample remaining = final mass sample/initial mass sample = 1.25 g = 0.125 = 1
10 g 8
After one half-life has passed = 1 ; after two half-lives 1 × 1 = 1 ; after three half-lives 1 × 1 × 1 = 1 ;
so three half-lives have passed 2 2 2 4 2 2 2 8
The disintegration constant of 55Fe is 0.2665 years−1. Calculate the half-life of the radioisotope.
λ = 0.2665 years−1
t ½ = 0.693/λ
0.693 = 2.6 years
t½ =
0.2665
The half-life of 45Ca is 165 days. Calculate the disintegration constant of the radioisotope.
t ½ = 165 days
0.693
λ=
t½
0.693
λ= = 0.0042 days−1
165
The half-life of technetium-99 m is 6 hours. Calculate the percentage remaining after 4 hours.
λ = 0.693
t½
0.693
λ= = 0.116 hours−1
6
Percentage remaining = 100 × e −kt = 100 × e −0.1155×4 = 63.00%
0.250 kg of radium-226 emits alpha particles at a measured rate of 9.00 × 1012 s−1. What is the half-life of
radium-226? (The Avogadro constant is 6.02 × 1023 mol−1.)
t ½ = 0.693/λ
dN/dt = −λN
226 g of radium-226 contains 6.02 × 1023 atoms, hence
250 × 6.02 × 1023 = 6.65 × 1024 atoms
N=
260
−9.00 × 1012 s−1 = −λ × 6.65 × 1023
λ = 9.00 × 1012 s−1/6.65 × 1023 = 1.35 × 10 −11 s−1
t1/2 = 0.693 × 10 −11 s−1 = 5.1 × 1010 s ≈ 1620 years
1.35
The half-life of radium is 1.62 × 103 years. Calculate what fraction of radium would remain after 1.00 × 103 years.
λ = ln2/t1/2 = 0.693/1.62 × 103

λt = (0.693/1.62 × 103) 1.00 × 103 = 0.617 ln 2
N = N 0e −kt
N/N 0 = e −kt = e −0.617ln2 = 0.652
■■ Radiation hazards
The radiation hazards to humans arise from exposure of the body to external nuclear radiation
and ingestion (eating) or inhalation (breathing in) of radioactive materials. The effect of
the nuclear radiation depends on the nature of the radiation, the part of the body irradiated
(exposed to radiation) and the dose received.
The hazard from alpha particles is small, unless the source enters the body, since they cannot
penetrate the outer layers of unbroken skin. Beta particles are more penetrating in general, but
most of their energy is absorbed by surface tissues. Gamma rays are the most hazardous since they
penetrate deeply into the body. Alpha and beta emitters can be harmful if ingested; for example,
there was increased risk of thyroid cancer in children exposed to fallout from the Chernobyl
disaster.
Intense nuclear radiation can cause immediate damage to tissue and, depending on the dose,
is accompanied by radiation burns (redness of the skin followed by blistering and sores which are
slow to heal), radiation sickness, loss of hair and, in extreme cases, death.
Damage to body cells is due to the formation of a range of ions that upset cellular reactions
or even kill them. The most susceptible parts of the body are the reproductive organs, blood-
forming organs such as the liver, and to some extent the eyes. Delayed effects such as cancer
(especially leukemia) and eye cataracts may appear many years later. Hereditary defects
(mutations) may also occur in children due to damage to the DNA of sex cells.
The absorbed dose D is the energy absorbed (in joules per kilogram) by unit mass of the
irradiated material. The unit of D is termed the gray (Gy), where 1 Gy = 1 J kg−1 although the unit
rad (radiation absorbed dose) is more commonly used, where 1 rad = 10−2 J kg−1 and 1 Gy = 100 rad).
Equal doses of nuclear or ionizing radiation provide the same amount of energy in a given
absorbing tissue, but they do not have the same biological effects on the human body. To
allow for this the dose equivalent (H) is used as a measure of the effect that a certain dose of
radiation has on a person. It takes into account the type of radiation as well as the amount of
energy absorbed and is obtained by multiplying D by a number termed the relative biological
effectiveness. The unit of H is the sievert (Sv).
dose equivalent = absorbed dose × relative biological effectiveness
For beta particles, X-rays and gamma rays the relative biological effectiveness is about 1; for alpha
particles and fast neutrons it is about 20.
The traditional unit of radiation dose that takes into account the type of radiation and its
relative biological effectiveness (RBE) value is called the rem (Table 25.8), where
1 rem = 1 rad × RBE; 1 rem = 0.01 Sv.
■■ Table 25.8
Dose (in rem) Clinical effects
Effects of short-term
exposures to radiation 0–25 No detectable effect
25–100 Temporary decrease in white blood cell counts

50+ Temporary sterility in men
100–200 Strong decrease in white blood cell counts
Mild radiation sickness: vomiting, diarrhoea and tiredness in a few hours
Reduction in infectious resistance
Possible bone growth retardation in children
300+ Permanent sterility in men and women
500+ Serious radiation sickness: marrow and intestine destruction
50% death of exposed population within a month
1000+ Acute illness; death within days
When ionizing radiation passes through living tissue, electrons are removed from water
molecules, forming highly reactive H2O+ ions. An H2O+ ion can react with another water
molecule to form an oxonium ion, H3O+, and a neutral •OH molecule.
15 Find out about H2O+ + H2O → H3O+ + •OH

the poisoning
of Alexander The •OH species is a highly reactive hydroxyl free radical. In cells and tissues, this hydroxyl
Litvinenko in free radical reacts with a variety of biological molecules damaging them and releasing more free
London with radicals. Hence, the formation of a single free radical can initiate a large number of reactions
polonium-210.
that may disrupt the normal activities of cells.
Nature of Science Protection from radiation

It is generally assumed that even very small doses of ionizing or nuclear radiation can potentially
be harmful (this is known as the linear no-threshold hypothesis). This implies that a person
must be protected from ionizing radiation at all dose levels. This includes the nuclear medicine
patient, members of their family, doctors and nurses working with nuclear medicines, and the
general public. People should be protected by optimizing protection, justifying the exposure to
the radioisotope and limiting the dose.
This is the system of radiological protection as defined by the International Commission on
Radiological Protection (ICRP), a non-governmental international organization.
The recommended system of radiation protection by the ICRP is based upon three principles.
The benefit of a practice must offset the radiation detriment (justification). Exposures and
likelihood of exposure should be kept as low as reasonably achievable, economic and social
factors being taken into account (optimization). Dose limits should be set to ensure that no
person faces an unacceptable risk in normal circumstances.
No use of ionizing or nuclear radiation is justified if there is no benefit. All applications must
be medically justified. This applies to even the smallest exposures that are potentially harmful,
and the risk must be offset by a benefit. When radiation is to be used then the exposure should
be optimized to minimize any possibility of harm.
This means radiation exposure should be limited as much as possible, keeping in mind the
risk/benefit relation of radiation and its applications. For example, it is unreasonable to refuse
an X-ray after a bone fracture because statistically the X-ray exposure may shorten your life
expectancy by just one day and the benefits of the X-ray with its diagnostic value by far outweigh
the risk associated with the radiation exposure.
■■ Nuclear diagnosis
Radioactive nuclides or radioisotopes are used in nuclear medicine. The radioactive materials
used are radiopharmaceuticals which are a pharmaceutical (medicine) and a radionuclide. The
pharmaceutical used will depend on the organ to be studied, for example iodine-131, 131I, is used
to study the thyroid gland.
In nuclear diagnosis, radioisotopes are injected into the bloodstream and their passage
through an organ followed and measured with a detection instrument. Alternatively, specific
organs of the body can be radiolabelled with a specific radioisotope. Biochemical processes
involving a series of chemical reactions can be followed using a radioactive isotope of an
element. Table 25.9 shows some of the medical uses for a range of radioactive tracers.
■■ Table 25.9 Medical Organ or tissue Tracers Uses
uses for selected General body 24 Na and 42K Used to measure volumes of body fluids, and estimate
radioisotopes as tracers composition quantities of salts
Blood 32P, 125I and 132I Used to measure volumes of blood and the different
components of blood (plasma and red blood cells)
Bone 45Ca, 47Ca and 99mTc Used to investigate absorption of calcium ions, location
of bone disease and how bone is metabolizing minerals
Cancerous tumours 32P, 133Xe, 99mTc
and 131I Used to detect, locate and diagnose tumours
Thyroid 123Iand 99mTc Tests of thyroid function and morphology
Kidney 99mTc agents (with gamma Kidney function tests
camera)
The quantity of tracer used must be as small as possible to minimize exposure to harmful
ionizing radiation. Exposure time is reduced if the radioactive substance that is labelled
with a tracer is quickly eliminated from the body, when the radioisotope has a short
half-life.
The effective lifetime of the tracer must be matched to the time scale of any process being
studied. Often, a short half-life is useful, as in monitoring blood flow, which can be studied
in a short period of time. The tracer should be easy to detect and its position within the body
identified accurately. The preferred type of radiation is gamma because gamma rays travel easily
through biological tissue and cause little ionization. Gamma radiation is long-range radiation
that can be monitored from outside the patient’s body. Low beta radiation is also useful. Most
the isotopes in Table 25.9 are a mixture of beta, positron and gamma emitters, but technetium-
99m is a pure gamma emitter.
Technetium-99m – the most common radioisotope used in nuclear medicine
One of the most useful tracers in nuclear medicine is an isotope of the element technetium
99m Tc (half-life six hours). The m indicates that it is a metastable nuclide, meaning that the
43
nucleons in its nucleus are at an energy level higher than in a stable technetium nucleus. The
excited nuclei return to the ground state with a half-life of six hours, emitting gamma rays
with an energy that makes them easy to detect. The decay produces 99 43Tc, which is a naturally
occurring radioactive isotope of half-life 216 000 years, and so is relatively stable, emitting very
little radiation.
If the radionuclide has a long half-life then the patient would receive a dangerously
high radiation dose. Technetium-99m has a half-life of six hours, which limits the radiation
dose. However, there is the issue of the time required to transport the radionuclide from the
production site (nuclear reactor) to the hospital. One approach to this problem is to use a
long-lived ‘parent’ radionuclide, for the transportation stage, which decays to a radioactive
material with a short half-life for use with patients. The two substances must be easily
separated.
Technetium-99m is produced from molybdenum-99 which decays to technetium-99m by
beta emission with a half-life of 67 hours. The molybdenum-99 is transported to the hospital in
a generator (Figure 25.115) which consists of a saline (salt) reservoir, an alumina column which
contains adsorbed molybdenum (as ammonium molybdenate, (NH4)2MoO4) and a filter which
sterilizes material passing through it. The column is shielded with lead to protect the user from
gamma radiation.
■■ Figure 25.115 sterilized sodium

Technetium generator chloride solution
ammonium molybdenate
absorbed on ammonia
ion
exchange
column
eluted solution
contains 99mTc in
technetate(VII) ions
Saline (salt) solution is passed through the column containing the adsorbed molybdenum. The
technetium is soluble in the salt solution, but molybdenum is insoluble. This elution produces a
solution of sodium technetate(vii), NaTcO4. This can be diluted and divided into a number of
patients’ doses.
Technetium is a transition metal and exists in several stable oxidation states (+3, +4 and +7)
and readily forms complex ions with various ligands which can be administered by injection and
delivered to specific organs or tissues.
Lutetium-177 and yttrium-90 – common isotopes used for radiotherapy
Lutetium-177 is a radioisotope with a half-life of 6.7 days and is a beta/gamma emitter.
Lutetium-177 is often used in conjunction with a peptide (small protein) to selectively target
neuro-endocrine tumours.
Yttrium-90 has a half-life of 2.67 days and is a beta emitter. Yttrium-90 therapy is often
used in the treatment of liver cancer. Large numbers of small plastic or glass beads containing
yttrium-90 are injected directly into the arteries that supply blood to the liver.
Radioisotopes used in diagnostic nuclear medicine should ideally be gamma emitters, since
alpha radiation is easily absorbed and would cause unnecessary exposure to highly ionizing
radiation. Also for in vivo measurements inside the body it would not be detected outside the
body. Beta radiation in vivo would be partly absorbed and would cause unnecessary exposure
to ionizing radiation. Beta transport is typically only a few millimetres so is also not detected
externally.
■■ Examples of nuclear diagnostic tests

Kidney function (in vivo)
The patient is usually given a large glass of water about 30 minutes before an intravenous
injection of a fluid termed hippuran labelled with iodine-123 (half-life 13 hours). A
radiation detector connected to a chart connector is held against the kidney to record the
activity in the kidney over 15 minutes. The reading from a normal kidney rises and then
decreases as the radioactive iodine passes through (Figure 25.116). However, the reading
from a blocked kidney would rise but not decrease. Many kidney studies now use gamma
cameras for imaging.
■■ Figure 25.116 chart chart
Kidney test with recorder recorder
iodine-123
patient
normal blocked
kidney kidney
detector detector
amplifier shield amplifier
Thyroid tests
The thyroid gland absorbs iodine to maintain its function of producing a hormone (thyroxine).
The rate of uptake is measured by giving the patient a solution containing a solution containing
sodium iodide labelled with radioactive iodine (Figure 25.117). The activity of the patient’s
thyroid and the activity of a ‘phantom’ solution prepared at the same time is measured 24 hours
later. The percentage uptake by the patient is calculated from the following expression:
corrected count rate of the thyroid
× 100%
corrected count rate of the phantom
A normal thyroid has a percentage uptake of 20 – 50 per cent after 24 hours.
to counter Blood flow through the brain (in vivo)

In this diagnostic test, the head is positioned against two counters, each
lead shield against one hemisphere. No more than 0.5 cm3 of sodium technetate(vii),
NaTcO4, labelled with 99mTc is injected intravenously and the counters
photomultiplier detect the movement of the sample through the brain’s blood vessels
tube
scintillation a few seconds later. By comparing the traces with each other and with
crystal traces known to be normal, information on blood through the brain’s
hemispheres is obtained. Another approach is to use a Tc-99m labelled
lead plate cerebral blood flow agent and gamma camera imaging.
for background
count only Positron emission tomography
PET offers a number of unique advantages compared to other medical
imaging techniques. PET (see Chapter 2) measures the two annihilation
thyroid gland
photons that are produced after positron emission (Figure 25.118) from a
radionuclide tagged tracer molecule, which is chosen to mark a specific
function in the body. Hence PET provides molecular imaging of biological
table
function instead of anatomy. The detection of both annihilation photons
■■ Figure 25.117 Thyroid test yields increased sensitivity and accuracy over all other forms of medical
imaging.
Only small amounts of imaging substrate need to be injected (tracer
positron-emitting
nucleus
principle) because of the high sensitivity of PET. In addition, positron-
positron emitting isotopes that are used in medical imaging (C-11, N-13, O-15,
path F-18) are relatively short-lived, which enables optimal use of imaging
photons while keeping the radiation dose low. Furthermore, many of these
~0.5 mm
isotopes can be incorporated into biological substrates (glucose, water,
positron–electron
annihilation
ammonia, carbon dioxide and oxygen) and pharmaceuticals without
altering their biological activity.
annihilation The most common substance used in PET is 2-fluoro-2-deoxyglucose
photons (FDG) containing a radiotracer, fluorine-18 (Figure 25.119). Fluorine-18 is
■■ Figure 25.118 General principle produced by irradiation of the stable oxygen-18 isotope with high-energy
of PET imaging protons (18 MeV) from a cyclotron:
18O + 1p → 18F + 1n
8 1 9 0
OH
O
The target is water.
HO When FDG is injected into the circulation it is distributed around the
HO blood and the body in a similar manner to glucose. FDG is taken up by body
18
F cells that are high users of glucose such as brain and cancer cells. The presence
OH of fluorine in the molecule stops the body from metabolizing it as a normal
■■ Figure 25.119 FDG with a fluorine-18 glucose molecule. Once the fluorine has decayed to oxygen-18 the normal
radiotracer metabolic process proceeds. Fluorine-18 has a half-life of 100 minutes.
Positrons (the anti-particles of electrons) are emitted by fluorine-18
scintillators photomultipliers nuclei and undergo an interaction (‘collision’) with electrons, producing
pairs of high-energy photons (gamma rays) moving in opposite directions:
18F → 18O + 0e
9 8 +1
+10e + −10e → 2γ
These pairs of photons can be detected by a gamma camera (Figure 25.120)

head and the raw data processed and displayed in a computer producing a two-
or three-dimensional image of the brain or other part of the body.
The intensity of the gamma radiation detected is proportional to the
gamma photons concentration of FDG, which is dependent on the metabolic activity
emitted in pairs of cellular tissues. Any unusual variation in such activity may suggest a
■■ Figure 25.120 Arrangement of PET pathological problem, such as cancer, brain degeneration or damage or
scanners for a PET scan heart problems.
rotation Ionizing radiation therapy

axis
Ionizing radiation in a narrow beam can be directed at a tumour
from different directions, either by moving the patient or by moving
the radioactive source. This movement is necessary to ensure healthy
tissue in the path of the beam is exposed much less than the target
tissue. X-rays are used for tumours near the surface, but gamma
lead
container radiation from cobalt-60 was traditionally used for deeper tumours
(Figure 25.121). The radioisotope has a half-life of five years and is
cobalt-60
enclosed in a thick lead container in which the source is rotated to
source
the inner end of the exit channel when it is to be used. External
gamma therapy from cobalt-60 sources is increasingly used only for
superficial skin conditions and is being replaced by linear particle
exit channel for
accelerator (LINAC) therapy.
gamma radiation
Proton beam therapy or proton therapy is a recent development
gamma lead collimator of nuclear medicine where protons are used to irradiate cancerous
beam plates
tissue. This is a very expensive technique that uses a linear
■■ Figure 25.121 Gamma therapy
accelerator to impart high kinetic energies to protons in a narrow
beam which is then directed at a tumour. The protons damage the
DNA of cells, ultimately causing them to die or be unable to divide.
Cancer cells are particularly vulnerable to DNA damage because of
their high rate of cell division.
Bragg’s peak In contrast to other types of nuclear or ionizing radiation the
100
absorption of protons reaches a maximum within a narrow range,
Radiation dose/%
deep inside the patient’s body. This phenomenon is known as

50
Bragg’s peak effect (Figure 25.122) and allows the proton beam to be
focused on the tumour with minimal damage to surrounding healthy
tissue. The Bragg peak effect occurs because all the protons in the
0 beam have the same speed and hence the same kinetic energy.
Depth in tissue/arbitrary units To treat tumours at greater depths, the proton accelerator must
■■ Figure 25.122 Absorption of protons produce a beam of protons with higher kinetic energy. Tumours closer
(with high kinetic energy) by cells in body to the surface of the body are treated with protons with lower kinetic
tissue energy. In most treatments, protons of different kinetic energies with
Bragg peaks at different depths are applied to treat the entire tumour.
Radiotherapy
Radiotherapy, also called radiation therapy, is the treatment of cancer and other diseases
with ionizing radiation. Ionizing radiation injures or destroys cells in the area being treated by
damaging their DNA, making it impossible for these cells to continue to grow and divide.
Although ionizing radiation damages both cancer cells and normal cells, the latter are able to
repair themselves and function normally. Radiotherapy may be used to treat localized solid tumours,
such as cancers of the skin, tongue, larynx, brain, breast or uterine cervix. It can also be used to treat
leukemia and lymphoma (cancers of the blood-forming cells and lymphatic system, respectively).
One type of radiation therapy commonly used involves X-rays. Depending on the amount
of energy they possess, X-rays can be used to destroy cancer cells on the surface or deeper in the
body. The higher the energy of the X-rays, the deeper the X-rays can go into the target tissue.
Linear accelerators are machines that produce X-rays of increasingly greater energy. The use of
machines to focus radiation such as X-rays on a cancer site is called external beam radiotherapy.
Gamma rays are another form of electromagnetic radiation used in radiotherapy. Gamma rays
are produced spontaneously as certain elements (such as radium, uranium and cobalt-60) release
ionizing radiation as they decay. Each element decays at a specific rate and releases energy in the
form of gamma rays and other particles. X-rays and gamma rays have the same effect on cancer cells.
Another investigational approach is particle beam radiation therapy. This type of therapy
differs from photon radiotherapy in that it involves the use of fast-moving subatomic particles to
treat localized cancers. A very sophisticated machine is needed to produce and accelerate the
particles required for this procedure. Some particles (neutrons, protons and heavy ions) deposit
more energy along the path they take through tissue than do X-rays or gamma rays, thus causing
more damage to the cells they interact with. This type of radiation is often referred to as high
linear energy transfer (LET) radiation.
Radioactive sources can be packed into metal tubes, metal needles and plaques. These kinds of
sources can be used in three different ways. Surface applicators are arrays of sources placed near or
in contact with the patient’s skin. They are used in treating cancer of the eye. Interstitial implants
use radioactive wire, pellets or arrays of needle-like radioactive sources implanted directly into the
target organ. They can be used for breast cancer. This technique is known as internal radiotherapy
or brachytherapy. With intercavitary methods, the sources are sealed into special containers and
inserted into the body cavity. They can be used for the treatment of cancer of the cervix.
Radiation therapy may be used alone or in combination with chemotherapy or surgery. Like
all forms of cancer treatment, radiation therapy can have side effects. Possible side effects of
treatment with radiation include temporary or permanent loss of hair in the area being treated,
skin irritation, temporary change in skin colour in the treated area, and tiredness. Other side
effects are largely dependent on the area of the body that is being treated.
■■ Techniques in nuclear medicine

Targeted alpha therapy
Cancer is a major health problem for older people in developed countries. Unfortunately,
radiotherapy and chemotherapy, even though often effective, have low success rates against
cancers that have formed metastases and have spread around the body.
Targeted alpha therapy is a new and promising approach to cancer
β− 212Po α treatment. It combines alpha particle emitting radioisotopes such as lead-212
β− decay decay
212Pb decay 212
84
(Figure 25.123), with tumour-selective carrier molecules, such as monoclonal
Bi 208Pb
82 83 82 antibodies or peptides (small proteins). Often a chelating or complexing
α 208
TI β− agent is used. In addition to lead-212, bismuth-213 and actinium-225 can be
decay 81 decay
used for targeted alpha therapy.
■■ Figure 25.123 The decay chain of lead-212 A monoclonal antibody is obtained from an immune system B cell (grown
in culture) that produces a single antibody. Monoclonal antibodies with specific
properties can be produced in large quantities and may be used to develop
alpha particles
emitted kill the antibody drugs,
cancer cell
Peptides and monoclonal antibodies have the ability to selectively target
chelator binding
(chelating agent)
tumour cells even if they are spread throughout the body. They recognize the
antigen target targeted cancer cells through antigens (proteins specific to cancer cells) that are
antibody
cell cancer cell located on the outer surface of the cell membrane and can bind selectively to
nucleus cancer cell these cells (compare with the lock and key model of enzyme activity). In targeted
■■ Figure 25.124 Targeted alpha alpha therapy (Figure 25.124) these carrier molecules transport the radioisotopes
therapy to the cancer cells to kill them. This is called the ‘magic bullet’ approach.
Radioisotopes that emit alpha particles are very suitable for selectively destroying cancer
cells. Alpha particles have a high kinetic energy (due to their large mass) and a very short path
length in human tissue corresponding to less than the diameter of ten cells. Hence, alpha
emitters allow the specific targeting and killing of individual cancer cells, while avoiding
damaging surrounding healthy tissue.
The use of alpha emitters is most useful in treating cancers where individual cancer cells
or small clusters of cancer cells need to be targeted, for example leukemia, treatment of micro-
metastases (small groups of cancer cells that have spread from the original tumour) or surgical
removal of a large tumour.
Radium-223 is another widely used radioisotope in alpha targeted therapy. It is used to treat
prostate cancers that have spread to the bones. Radium is very similar to calcium. Like calcium it is
taken up by active bone cells. This makes it a good way of targeting bone cancer cells. Cancer cells are
more active than normal bone cells and so are more likely to absorb and assimilate the radium-223.
Boron neutron capture therapy
High intensity boron neutron beams are used in boron neutron capture therapy, which uses
the ability of stable boron-10 nuclei to absorb neutrons. After capturing a low-energy (thermal)
neutron, the nucleus of the boron-10 atom is transmuted into an unstable boron-11 atom, which
immediately undergoes alpha decay:
10B
5 + 10n → [115B] → 73Li + 42He
The recoiling lithium-7 ions and alpha particles have high

cancer cell
1. boron compound (B)
2. neutron kinetic energies and cause extensive cellular damage, but
beam within a very limited range, 0.005–0.01 mm, which is
selectively absorbed
by cancer cell B approximately the diameter of a cell. Hence tumours can be
B B destroyed by boron neutron capture therapy (Figure 25.125)
B B
N+B N+ provided they accumulate sufficient boron-10. The boron-10
4. boron atoms decay,
isotope is administered to the patient by intravenous
emitting cell-killing 3. boron atoms
radiation absorb neutrons injection of an organo-boron compound.
A wide variety of boron delivery agents have been
■■ Figure 25.125 Boron neutron capture therapy synthesized, but only two of these currently are being used
in clinical trials. The first, which has been used primarily
in Japan, is a polyhedral borane anion, sodium borocaptate
2- BSH (Na2B12H11SH) (Figure 25.126), and the second is a
SH
dihydroxyboryl derivative of the amino acid phenylalanine,
B referred to as boronophenylalanine or BPA (Figure 25.127).
H H The latter has been used in clinical trials in the USA,
B B H
B Europe, Japan, Argentina and Taiwan. Following
2Na+ B B H = Na2B12H11SH administration of either BPA or BSH by intravenous
H B B infusion, the tumour site is irradiated.
H H B H sodium borocaptate Boron neutron capture therapy can be used to treat cancers
B B that are normally treated with radiotherapy, such as lymphomas
H
B H and skin cancers, as well as cancers of the brain, breast, lung,
head and neck, bone, prostate, pancreas and cervix. In addition,
H when surgical removal of a tumour is planned, boron neutron
■■ Figure 25.126 Structure of sodium borocaptate capture therapy may also be used to help reduce the size of the
tumour and to reduce the associated normal tissue loss. Boron
neutron capture therapy is less demanding for the patient than
OH conventional radiotherapy as it can be given several times over
10 a period of 2–4 days; in contrast conventional radiotherapy
B
NH2 OH needs to be given up to 30 times over a period of 6 weeks.
Unlike some forms of ionizing radiation, such as X-rays,
O
alpha particles do not require oxygen to enhance their
biological effectiveness. A rapidly expanding tumour frequently
OH
outgrows its blood supply, so that some regions receive less
■■ Figure 25.127 Structure of borophenylalanine oxygen than normal tissues do. As a result of this oxygen
depletion, the tumour can become more resistant to the effects
of conventional photon or electron (beta particle) radiation
therapy. Tumour sensitivity to alpha particles is retained,
to however, even when the tumour has limited oxygen supply.
computer
display Gamma camera
lead A gamma camera (Figure 25.128) is used to detect gamma
shield electronic circuit
radiation. It consists of a series of photomultiplier tubes.
photomultiplier
tubes If a gamma ray (emitted from a radioactive substance in a
sodium patient’s body) interacts with an ionic crystal such as sodium
iodide
crystal lead iodide, the gamma photon is converted into a photon of
collimator visible light. The crystal is said to scintillate, and because of
grid this effect the gamma camera scan is termed a scintigram.
construction
The number of photons of visible light emitted depends
■■ Figure 25.128 Gamma camera
upon the energy of the gamma rays. Scintillation was used
by Rutherford in his discovery of the nucleus (Chapter 2).
The photons then strike a photocathode, a material that ejects electrons when
bombarded by photons. This is termed the photoelectric effect. The number of
electrons is then multiplied using a sequence of charged plates called dynodes.
The array of photomultiplier tubes is connected to a recoding and display
system. An image is formed which matches the distribution of gamma rays
emitted from the patient with the radioactive gamma emitter.
Gamma knife
■■ Figure 25.129 Gamma knife
The gamma knife (Figure 25.129) is used for brain surgery but is non-invasive (it is
performed without cutting the skin or muscles and the skull does not need to be
opened), though a frame needs to be attached to the skull using four screws (fitted
under local anaesthetic).
The gamma knife has a large number of cobalt-60 sources, which emit gamma rays and have
a half-life of 5.26 years. The sources are positioned in a hemisphere inside the unit. The patient’s
head, held in the frame, is held inside a helmet with a large number of holes to precisely target
the radiation. When treatment starts, the patient’s head is moved inside the unit.
Magnetic resonance imaging (MRI)
MRI depends on the magnetic properties of some nuclei, most notably the protons in the hydrogen
atoms of water, and was developed from its parent technique NMR spectroscopy, which is widely used
in chemical analysis. It relies on the use of magnetic field gradients to provide spatial information,
and these field gradients can be manipulated electronically, giving the technique great versatility.
Modern MRI scanners use superconducting magnets to create powerful magnetic fields (up to
a million times stronger than the relatively weak magnetic field of the Earth). The MRI scanner
also produces electromagnetic radiation of low energy and frequency and long wavelength (radio
waves). The photons have insufficient energy to break bonds in molecules.
When a patient is placed inside the magnetic field, hydrogen atoms (protons) of water
molecules in the body absorb radio waves to generate an NMR signal, which decays by a process
called relaxation. The relaxation time varies with the type of tissue. The MRI scanner detects
the NMR signal produced by the hydrogen nuclei as an oscillating voltage induced in a coil
placed around the patient.
The technique relies on using a magnetic field gradient (Figure 25.130). The two hydrogen
atoms (protons) in two water molecules at different places in the human body would resonate at
the same frequency if placed in the same applied magnetic field.
An MRI scanner therefore places the patient in a magnetic field that varies linearly between
the poles of the magnet. Two identical hydrogen atoms now resonate at different frequencies
depending on their position in the magnetic field –
magnetic field that is depending on their position in the body. A
constant varies with
magnetic field distance hydrogen atom in a region where the magnetic field
Magnetic Magnetic is stronger resonates at a higher radiowave frequency
field field than in a region where the magnetic field is weaker.
strength strength
The patient is irradiated with a pulse of a range
of radio frequencies and the absorption of the
Distance
radiation measured. This allows the measurement of
Distance
the concentration of 1H nuclei in water molecules
H2O H2O
H2O H2O at a corresponding position. This is repeated with a
succession of a range of pulses at different frequency
radio frequency radio frequency
pulse pulse ranges to measure the number of 1H nuclei at the
different positions in the scanner. In this way, a
‘map’ of the 1H nuclei throughout the body can
Both water molecules experience The water molecules experience be built up. These maps can be combined by the
the same magnetic field and emit different magnetic fields and hence
at the same frequency emit at different frequencies computer software to give a three-dimensional or
tomographic image with a resolution better than
■■ Figure 25.130 MRI scanners rely on a magnetic field gradient to 1 mm.
give different frequency signals from 1H nuclei in different positions
in the body
MRI is a non-invasive technique and produces more spatially detailed images of the
human body than nuclear medicine or PET scanning techniques. The protons in water, lipids,
carbohydrates and proteins have different chemical environments in both healthy and diseased
tissue (which often has a lower concentration of water), which can be easily distinguished by 1H
NMR chemical shifts.
Because the concentrations of water and organic compounds in various tissues are different,
MRI provides highly detailed images of soft tissues such as the brain, heart, muscles and body
fluids. There are many ways of increasing the contrast in MRI images, for example by making
use of the different relaxation times in different kinds of tissues. The technique does not use
ionizing or nuclear radiation so can be used repeatedly without increasing the risk of cancer to
the patient. The only drawbacks of MRI are the high cost of the equipment and the interaction
of magnetic fields with metal body implants such as prosthetics (for example, hip replacements)
and heart pacemakers.
Multinuclear MRI
As well as proton or 1H NMR, modern MRI instruments can detect other nuclei, including
carbon-13, sodium-23, nitrogen-14 and phosphorus-31. Each nuclide or element has a
characteristic resonance frequency, so a series of NMR spectra can be recorded examining
each nuclide in turn.
Multinuclear MRI studies are particularly useful for the imaging of organs that have
insufficient contrast in 1H NMR. For example, images of the air spaces (alveoli) in the lungs can
be obtained by 3He or 129Xe NMR where a noble gas (helium or xenon respectively) is inhaled
by the patient during the MRI scan. Another nucleus, naturally occurring 31P, can provide
important information about the metabolism of phosphorylated compounds such as ATP.
ToK Link
MRI and NMR
There is no reference to the term ‘nuclear’ in MRI. Are names simply labels or do they influence our other
ways of knowing? How does public perception influence scientific progress and implementation?
Magnetic resonance imaging (MRI) is a form of nuclear resonance spectroscopy applied to the living human body.
The term ‘nuclear’ refers to the fact that the technique is studying the spin of hydrogen nuclei (protons). However,
the term ‘nuclear’ to the general public means nuclear power stations and nuclear bombs. The use of the term
‘nuclear’ is therefore linked with ionizing or nuclear radiation. Hence the term MRI is used rather than NMR. If MRI
was given the label NMR, then many patients who required an MRI scan may not have the procedure due to the
negative connotations associated with the word ‘nuclear’. MRI does not use ionizing radiation which, even in small
doses, will create a radiation hazard. Radio waves and a powerful magnetic field are used and both are believed to
be safe. Names are simply ‘labels’ and interchangeable, but they influence emotion as a way of knowing.
One way the public can influence scientific progress is via emotion or ethics. Two current examples of ethical
principles and perhaps emotion hindering scientific progress are stem cell research and the development of
genetically modified organisms (GMO).
25.9 Drug detection and analysis (AHL) – a variety

of analytical techniques is used for detection, identification, isolation and analysis of
medicines and drugs
■■ Analytical techniques
A variety of analytical techniques is used for the separation, detection and analysis of
pharmaceutical drugs. These techniques include chromatographic techniques, electrophoresis
(including a form known as capillary electrophoresis), infrared spectroscopy, ultraviolet–visible
spectroscopy, nuclear magnetic resonance (especially high resolution), mass spectrometry, X-ray
crystallography, titrations and electrochemical methods.
Illegal drugs are often detected by mass spectrometry, gas chromatography and combined
techniques, for example gas chromatography-mass spectrometry (GC-MS) and liquid
chromatography-mass spectrometry (LC-MS). Urine is easier to test than blood, largely because
it has higher drug concentrations and fewer proteins to complicate extraction.
25.9 Drug detection and analysis 89
100 ■ Spectroscopic identification of drugs

Many pharmaceutical drugs, such as aspirin, paracetamol
and omeprazole, are relatively simple and stable organic
% Transmittance
D
molecules containing various functional groups. The
50 presence or absence of these functional groups can be
C
NHCOCH3
determined by mass spectrometry and spectroscopic
techniques. Information about the detailed structure of a
E drug molecule is obtained from mass spectrometry and high-
OH F
resolution NMR.
A B
0 Figure 25.131 shows the infrared spectrum of paracetamol
4000 3500 3000 2500 2000 1500 1000 500 and Table 25.10 summarizes an interpretation of some of the
Wave number/cm–1 absorption bands.
■■ Figure 25.131 Infrared spectrum of paracetamol
■■ Table 25.10 Wave number/cm−1 Assignment Comment

Interpretation of A: 3360 N–H amide stretch This band can be seen quite clearly, although
selected peaks in it is on top of the broad O–H stretch
the IR spectrum of B: 3000–3500 Phenol–OH stretch Very broad due to strong hydrogen bonding
paracetamol and hence obscures (hides) other bonds in
this region
C: approximately 3000 C–H stretching Not clear due to underlying –OH absorption
D:1840–1940 Benzene ring Molecular vibrations
E: 1650 >C=O amide stretch
F: 1608 Aromatic C=C stretch
Figure 25.132 shows the high-resolution 1H NMR spectrum of paracetamol and Table 25.11
summarizes an interpretation of some of the peak assignments.
■■ Figure 25.132
High-resolution
1HNMR spectrum of
paracetamol
9 8 7 6 5 4 3 2 1 0
Chemical shift δ/ppm
■■ Table 25.11
Peak number (from right to left) Comment
Interpretation of peaks
1 Signal due to 3 × 1H on the sp3 –COCHH3 group which contains an
in the 1H NMR spectrum
electronegative oxygen atom (integration = 3). There are no 1H on the
of paracetamol neighbouring atoms so the signal is not split by coupling
2 Signal due to 2 × 1H on the aromatic, sp2 CH groups (integration = 2). The
signal is split into a 1 : 1 doublet by coupling to the 1H on the neighbouring
CH group
3 Signal due to 2 × 1H on the aromatic, sp2 CH groups (integration = 2). The
signal is split into a 1 : 1 doublet by coupling to the 1H on the neighbouring
CH group
4 Signal due to 1H on –OH group (integration = 1). This 1H rapidly exchanges
with 1H atoms in the solvent, causing the peak to be broad
5 Signal due to 1H on –NH group (integration = 1). This 1H rapidly exchanges
with 1H atoms in the solvent, causing the peak to be broad
Figure 25.133 shows the mass spectrum of paracetamol following its analysis by mass spectrometry.
■■ Figure 25.133 109

100.0
Mass spectrum of
paracetamol 75.0
%
50.0
43 80 151
25.0
53 111
63 68 9194 120 135 170 185
0.0
50.0 75.0 100.0 125.0 150.0 175.0 200.0
The peak at 151 is the molecular ion and the peak at 43 is due to the removal of a C2H3O group which
exists as a resonance stabilized ion. Not all of the peaks can be accounted for by fragmentations. Some
of the peaks are due to the presence of ions formed by rearrangements (Figure 25.134).
■■ Figure 25.134 H + H
H H
Mass spectral N+ N
fragmentation of
paracetamol O
HN CH3
OH m/z = 80
m/z = 109
+
OH
H3C C O
m/z = 151
m/z = 43
■■ Identifying unknown organic compounds

A common task for medicinal chemists is the identification of a pharmaceutical or illegal
drug from various analytical and chemical data. If information about the drug, such as molar
mass, elemental composition from elemental analysis and retention time, or retention factor
from chromatography has been determined, the molecule may identified by comparison with a
library of known compounds. Computers attached to analytical instruments, such as GC-MS,
may have a library of over 220 000 spectra that can be used to identify an unknown chemical
in the sample mixture. The library compares the mass spectrum from a sample component and
compares it to mass spectra in the library. It reports a list of likely identifications along with the
statistical probability of the match.
Confirmation of the identity of the drug can be obtained from its mass spectrum, its infrared
spectrum and high-resolution 1H NMR. All of this information together with the preliminary
data can be used to establish the identity of the molecule. It is helpful for the sample of the drug
to be free of impurities before being subjected to a detailed chemical and analytical analysis.
■■ Extraction and purification of organic compounds

When the last reaction for a multi-step drug synthesis has finished, the desired product is
described as being in a crude state. It is often contaminated by unused reactants, solvents or a
reaction by-product. Hence there is a requirement to separate and purify the product from these
impurities.
Some of the most commonly used separation techniques are listed in Table 25.12. The choice
of technique is governed by the physical state of the product and its impurities.
■■ Table 25.12
Technique Used to separate
Some commonly used
Distillation A liquid from a dissolved non-volatile solid or liquids with very different boiling points
physical separation
techniques Fractional distillation Liquids with similar boiling points
Steam distillation Two liquids with very different boiling points
Solvent extraction A solid or liquid from its solution
Recrystallization A solid from other solid impurities
Suction filtration An insoluble solid from a liquid
Chromatography Various types of mixtures
16 State which technique(s) could be used to separate the following mixtures:

a Propan-1-ol (bp 97 ˚C) and 1-iodopropane (bp 103 ˚C).
b Phenylamine (amino benzene) (bp 184 ˚C) and tin(II) chloride (s).
c Pentane (bp 36 ˚C), hexane (bp 69˚C) and heptane (bp 99 ˚C).
d Benzoic acid (a solid) contaminated by charcoal powder.
Solvent extraction
Many natural and synthetic products used in pharmaceuticals have to be isolated from their
mixtures with other compounds of differing solubilities. This is commonly done by liquid–
less dense layer
liquid extraction, a physical process that involves the distribution or partitioning of a solute
between two immiscible liquids.
more dense layer In a typical experiment a mixture of organic compounds is shaken with water and an
organic solvent (such as ethoxyethane or trichloromethane (chloroform)) and the resulting
emulsion is allowed to settle. Since water and the organic solvents are almost immiscible
(do not mix) they form two separate layers.
Polar compounds tend to be more soluble in polar solvents (such as water) – the ‘like
■■ Figure 25.135 Use of a dissolves like’ principle – and therefore remain in the aqueous layer, whereas non-polar
separating funnel substances dissolve in the organic layer. Each layer can be run into a different beaker using
a separation funnel (Figure 25.135).
The organic solvent and water can be evaporated from the separated layers, leaving the
components of the original mixture. For a complex mixture the separation process can be
repeated many times using the same or different solvents. In the case of the anti-cancer
drug Taxol (see section 25.7), the isolation of the target compound required several hundred
extractions and took over two years to complete. This process can now be automated.
The partition of a solute between two immiscible liquids can be described as a heterogeneous
equilibrium (Chapters 7 and 17) between different states of the same compound. For example,
when molecular bromine, Br2, is partitioned between water (‘aq’) and an organic solvent
(‘organic’) the following equilibrium takes place (at constant temperature):
Br2(aq) → Br2(organic)
The equilibrium constant of this equilibrium is known as the partition coefficient, Pc:
[Br (organic)]
Pc = 2
[Br2(aq)]
The partition coefficient depends on the chemical nature of the participating chemical species and
the temperature of the reaction mixture. Non-polar molecules and molecules with low polarity will
have high values of partition coefficients (due to their low solubility in water), but polar compounds
will have low values of partition coefficients (due to their high solubility in water).
Solvent extraction is often used to separate an organic product which is contaminated by an
aqueous solution. Such extracts will always contain a small amount of water and this is removed
by ‘drying’ it with an anhydrous ionic salt, such as magnesium sulfate. Usually, drying takes a few
hours, after which time the ionic salt, which is now partially hydrated, is filtered off.
Finally, volatile solvent must be removed from the dried extracts. This is easily achieved by
distillation. The resulting product is then further purified by fractional distillation (for liquids) or
recrystallization (for solids).
Worked examples
A solution contains 1.00 g of iodine dissolved in 20.00 cm3 of potassium iodide solution. The solution is
shaken with 20.00 cm3 of tetrachloromethane (CCl4), an organic solvent. Determine how much iodine will
be transferred into the tetrachloromethane. The partition coefficient between tetrachloromethane and
water at 25 °C is 85.00.
Pc = concentration of iodine in tetrachloromethane/concentration of iodine in water = 85.00

Assume that x g of iodine will enter the tetrachloromethane. This will leave (1 − x) g of iodine in the
water. Hence:
x g/20.00 cm3/(1.00 − x) g/20.00 cm3 = 85.00
So, x = 85.00(1.00 − x) and x = 85.00/86.00 = 0.988
Hence 0.988 g of iodine will be present in the tetrachloromethane and 0.012 g left in the water.
Use the value of the partition coefficient to determine how much iodine would have been removed from
the solution if it were shaken with (i) 40.00 cm3 of tetrachloromethane; (ii) 10.00 cm3 of tetrachloromethane
and then another 10.00 cm3 of tetrachloromethane. Compare the effectiveness of the two approaches with
using 20.00 cm3 of the solvent.
x g/40.00 cm3/(1 − x) g/20.00 cm3 = 85.00; so x = 170(1 − x) and x = 0.994

x g/10.00 cm3/(1 − x) g/20.00 cm3 = 85.00; x = 0.977. This leaves 0.023 g of iodine in 20.00 cm3 of
water. With the second 10.00 cm3 of solvent, if x g of iodine enters the solvent, (0.023 − x) g will be
left in the water. Therefore:
x g/10.00 cm3/(0.023 − x) g/20.00 cm3 = 85.00; 2x = 85(0.023 − x) and x = 0.0225.
By using two separate 10.00 cm3 portions, a total of 0.977 g + 0.0225 g = 0.995 g has been separated.
This is more efficient than using one 20.00 cm3 portion, which removed only 0.988 g. It is also more
efficient than using one portion of 40.00 cm3.
Polarity of drug molecules

The pharmacological properties of a drug depend, in part, on its polarity. Polar (hydrophilic)
drug molecules tend to stay in the plasma of the blood, which is an aqueous solution. Non-polar
(hydrophobic or lipophilic) drug molecules accumulate in lipid (adipose) tissues.
The polarity of a drug influences its solubility, absorption, distribution, metabolism and
excretion. Highly polar drugs do not easily cross the cell membranes of the small intestine. They
can be injected but they cannot be used against intracellular targets since they will not cross
cell membranes. If non-polar drugs are administered orally they are likely to be absorbed in fat
globules in the intestines and will be poorly absorbed. If they are injected, they are poorly soluble
in blood.
In medicinal chemistry the hydrophobicity of a molecule is normally measured by its log10 Pc
value, where Pc is known as the partition coefficient. Pc can be measured by measuring the
relative solubility of a compound in an octan-1-ol–water mixture, where
concentration of compound in octan-1-ol
Pc =
concentration of compound in water
The more hydrophobic the compound is, the greater the proportion of it will dissolve in the
organic layer, and the higher the value of Pc or log10 Pc. It is also possible to calculate log10 Pc
values for a given molecular structure using suitable software programs.
Many drugs exist as an equilibrium between an ionized and un-ionized form, but log10 Pc
measures the relative distribution of the un-ionized species between water and octan-1-ol. The
polarity of drugs can be changed easily by chemically modifying the functional groups. For
example, the log10 Pc values for morphine and diamorphine (heroin) are 0.9 and 1.6, which
explains the greater solubility of diamorphine to cross the blood–brain barrier and produce a
stronger analgesic effect in the brain.
With most drugs, activity in the body (in vivo activity) tends to
increase as the log10 Pc value increases. In other words, activity increases
with increasing hydrophobicity (lipophilicity). This is usually an
indication that increasing hydrophobicity allows easier movement of the
drug molecule through cell membranes in order to reach target sites.
thermometer
Fractional distillation
Fractional distillation (Figure 25.136) is used to separate liquids that
have similar boiling points. The fractionating column is a long tube
packed with small glass beads which provide a large surface area for
condensation. Vapour rising from the flask warms up the bottom of
the column and condenses back into liquid. As it falls, it meets fresh
hot vapour moving upwards. This process is repeated continually up
the column and each time the vapour becomes richer in the more
volatile component – that is, the one with the lower boiling point.
If the column is long enough, the vapour which escapes at the top
cooling
water is the pure, more volatile component, and this may be confirmed by
checking its boiling point on the thermometer.
fractionating column
packed with Steam distillation
glass beads
An organic liquid which has a high boiling point and very low
solubility in water, for example eucalyptus oil, may be removed from
a mixture by steam distillation (Figure 25.137). As steam is passed
through the hot mixture, a mixture of the two components distils
liquid out of the flask and the condensate is collected as shown in Figure
mixture 25.137. On standing, the condensate forms two layers; one is the
organic product, the other is aqueous. These are separated and any
■■ Figure 25.136 Fractional distillation product in the aqueous layer is removed by solvent extraction.
■■ Figure 25.137 thermometer

Steam distillation
steam cooling water out
condenser
mixture of
organic liquid water and the
and water cooling water in immiscible
gentle organic liquid
heat separate on
standing
Liquid–vapour equilibria and Raoult’s law

Any liquid left in a close container at a fixed temperature will establish an equilibrium with its
vapour:
Liquid ⇋ vapour
The pressure exerted at that temperature is known as the saturated vapour pressure (svp).
In a system consisting of a mixture of two miscible liquids at equilibrium, Raoult’s law states
that each component will exert a vapour pressure proportional to its mole fraction. Raoult’s law
can be expressed mathematically: P(A) = P o(A) − x(A), where P(A) is the vapour pressure of A
over the mixture of the two liquids (at a given temperature), P o(A) is the vapour pressure over a
pure sample of A at the same temperature and x(A) is the mole fraction of A, which is the ratio
of the amount of A to the sum of all the amounts of the component liquids in the mixture.
Worked example
At a given temperature, you have a mixture of benzene (vapour pressure of pure benzene = 745 mmHg) and
methylbenzene (vapour pressure of pure methylbenzene = 290 mmHg). The mole fraction of benzene in the
solution is 0.590. Assuming ideal behaviour, calculate the mole fraction of methylbenzene in the vapour
above the solution.
Since it is a binary mixture, the mole fraction of benzene in the solution is

xtotal = 1 − x benzene
The total vapour pressure, P total, can be calculated with Raoult’s law (ideal behaviour):
P total = x benzene × Pobenzene + xtotal Pototal
= 0.590 × 745 mmHg + (1 − 0.590) × 290 mmHg = 558.45 mm Hg
The partial vapour pressure of methylbenzene over the solution follows also from Raoult’s law:
P total = xtotal × Pototal = (1 − 0.590) × 290 mmHg = 118.90 mm Hg
From Dalton’s law of partial pressures follows the mole fraction of methylbenzene in the vapour, ytotal:
P
Ytotal = total = 118.90 = 0.2129 = 0.213
P total 558.45
This means that a graph of mole fraction against vapour pressure for each of the
liquids will be of the type shown in Figure 25.138 – that is, a straight line passing
pure component through the origin.
Vapour pressure
The total vapour pressure of the liquid mixture is found by adding the vapour
co
m po pressure reached by the partial pressures of the two components (two liquids) and
ne
nt it will vary with composition as shown in Figure 25.139.
in a
so The boiling point of a liquid is the temperature at which its vapour
lut
ion
pressure reached the external pressure. Since the component (liquid) with
the lower saturated vapour pressure will have a higher boiling point, a boiling-
1.0 0.5 0.0 point composition diagram of the type shown in Figure 25.140 can be drawn.
Mole fraction of Note that this graph has two curves since the liquid and vapour in
component in solution
equilibrium at any temperature will have different compositions. The vapour
■■ Figure 25.138 The relationship will always contain a higher proportion of the more volatile component – that
between vapour pressure and mole is, the substance with the lower boiling point. In Figure 25.140 a liquid mixture
fraction for a component in an ideal of composition M when heated will boil at temperature TM. The vapour in
mixture of liquids equilibrium with liquid of composition L1 will have composition V1 that is much
constant temperature
Vapour pressure at
PA boiling vapour
constant pressure
total composition
Boiling point at
vapo condensing TB
com ur pr
essu V1
po re TM
nen liquid
tA V2
PB V3
L1 composition
B L2
onent TA
comp L4 L3
M
Mole fraction A 1.0 0.5 0.0
Mole fraction A 1.0 0.5 0.0
Mole fraction B 0.0 0.5 1.0
Mole fraction B 0.0 0.5 1.0
where PA is the vapour pressure of pure A where TA is the boiling point of pure A
PB is the vapour pressure of pure B TB is the boiling point of pure B
■■ Figure 25.139 The relationship between mole ■■ Figure 25.140 The boiling-point composition
fractions and partial and total vapour pressures for an diagram for the ideal liquid mixture represented in
ideal mixture of two liquids Figure 25.139
richer in the lower boiling component A. This difference between the equilibrium liquid and
vapour compositions allows a mixture to be separated by distillation. If the vapour V1 is cooled
it will condense to a liquid of the same composition, L2. Boiling L2 will produce a vapour
V2 which is even richer in A. Meanwhile the proportion of A in the remaining liquid will
decrease and its composition will follow the liquid curve up until it is almost pure B.
Hence any mixture of liquid which obeys Raoult’s law may be separated by repeated distillation
(i.e. boiling and condensing). This is known as fractional distillation and is carried out using
a fractionating column designed to allow many such steps to take place over its length. Each
distillation step is known as a theoretical plate. If the column is efficient enough – that is,
contains enough theoretical plates – the thermometer at the top will indicate the boiling point
of the pure, more volatile (lower boiling point) component.
Liquid mixtures which obey Raoult’s law exactly are rare, but often the deviations are
sufficiently small that they may be sufficiently separated by fractional distillation. Raoult’s law is
obeyed by a pair of ideal liquids. When ideal liquids are mixed there is no enthalpy change and
no change in total volume.
However, when ethanol and water are mixed, there is a slight increase in the total volume.
This occurs because the very strong intermolecular hydrogen bonding in pure water is disrupted
by ethanol molecules which can form weaker hydrogen bonds. This reduction in intermolecular
attractions means that as well as an increase in volume, each component liquid vaporizes more
easily and therefore contributes more than expected to the total vapour pressure. This is known
as positive deviation from Raoult’s law.
Worked example
A solution is prepared by mixing 5.81 g of propanone (molar mass of propanone = 58.1 g mol−1) and 11.9 g
trichloromethane (molar mass of trichloromethane = 119.4 g mol−1). At 35 oC, this solution has a total vapour
pressure of 260 mmHg. Deduce whether this is an ideal solution. The vapour pressures of pure propanone
and pure trichloromethane at 35 oC are 345 and 293 mmHg, respectively.
P total = XA PoA + XB PoB

Npropanone = 5.81 g/(58.1 g mol 1) = 0.100 mol propanone
Ntrichloromethane = 11.9 g/(119 g mol 1) = 0.100 mol trichloromethane
Xpropanone = Xtrichloromethane = 0.500
Then
P total = (0.500) × (345 mmHg) + (0.500) × (293 mmHg) = 319 mmHg
Since the observed pressure is 260 mmHg (lower than expected), the solution does not behave ideally.
The dipole–dipole interaction between propanone and trichloromethane molecules lowers their
tendency to escape from solution.
Recrystallization
Recrystallization is used to separate an organic solid product from other solid impurities. In this
technique, a solvent is chosen in which:
■ the organic product readily dissolves when hot but hardly does so when cold;
■ the impurities must either not dissolve or remain dissolved at low temperatures.
Often, the selection of this solvent is simply a case of ‘trial and error’. A solid product can
sometimes be purified by recrystallization from water. The impure solid is dissolved in the
minimum quantity of hot water. Impurities which are insoluble in water can be removed by
quickly filtering through a fluted filter paper held in a hot funnel.
flat filter paper As the filtrate cools, any soluble impurities remain solution while
the pure product crystallizes out. The crystals are filtered off using a
vacuum filtration apparatus (Figure 25.141). Apart from giving a rapid
rubber bung stopper
(instead of Neoprene to vacuum filtration, vacuum filtration has the added advantage that the flow
adapter) of air past the crystals helps them to dry out. The final drying of an
clamp organic solid is carried out in either a desiccator at low pressure or an
thick-walled oven. The method chosen will depend on the properties of the solvent
rubber tubing and the solid, for example the latter might decompose in an oven.
■ Drug detection in sports and forensic

thick-walled flask studies
filter (Büchner flask)
■■ Figure 25.141 Suction filtration apparatus Anabolic steroids
The misuse of performance-enhancing substances in sports is
a serious international problem. The most common of these
substances, anabolic steroids, accelerate the synthesis of proteins and cellular growth, especially
in the skeletal muscles and bone tissues. Anabolic steroids are drugs whose molecules are
structurally related to the cyclic steroid ring system and have similar effects to testosterone in the
body. They are used medically to induce puberty and to treat chronic wasting conditions such as
cancer and AIDS.
Anabolic steroids are banned by most sports and athletics organizations including the
International Olympic Committee. Athletes and sports players are regularly required to provide
a urine and blood samples for laboratory analyses in which steroids and their metabolites
can be detected by a combination of gas chromatography (GC) or high-performance liquid
chromatography (HPLC) with mass spectrometry (MS) (Chapters 11 and 21).
Steroids are predominantly non-polar compounds, so they can be extracted from
biological materials with organic solvents (or solid-phase extraction techniques) and
concentrated for further studies. Each steroid produces a characteristic mass spectrum
(Figure 25.142) that can be compared with a library of known compounds. Modern
GC-MS and HPLC-MS instruments can detect anabolic steroids and their metabolites at
concentrations at low as 1 ng cm−3 (3 × 10−9 mol dm−3) giving positive results for many weeks
or even months after the use of these drugs was stopped.
■■ Figure 25.142 100

Mass spectrum of 90
Relative abundance/%
3-hydroxystanozolol 80
70
60
50
40
30
20
10
0
80 100 120 140 160 180 200 220 240 260 280 300 320 340 360
m/z
Competitive sports and steroids

Stanozolol is an anabolic steroid related to the natural hormone testosterone (Figure 25.143).
Taking stanozolol increases protein synthesis in cells and so allows athletes to build up muscle
and improve their performance. However, taking anabolic steroids for long periods of time can
have serious side effects, including the risk of heart attacks.
■■ Figure 25.143 OH OH
Structures of stanozolol
and testosterone, the
H H
male sex hormone
HN H H H H
N O
H
stanozolol testosterone
The rewards of fame, glory and money in commercial sport and competitions mean that some
athletes may be tempted to gain a competitive advantage by taking anabolic steroids and other
performance-enhancing drugs. This corruption of attitude has not been restricted solely to
individuals, or individuals and their coaches. Historical examples of state or governing-body
sponsored malpractice have been well-documented – the East German athletics team of the
1950s and 1960s is a case in point, with the pressure on individual athletes to conform being
immense.
Detecting and measuring the amount and concentration of a banned drug in an athlete’s
body is a challenging task for analytical chemists. In the body, drugs chemically break down to
form other compounds known as metabolites – and so the concentration of these compounds
must also be measured. In some cases only the metabolites can be detected in the athlete’s body.
Sampling for steroids is carried out on athletes’ urine samples
Urine contains a large number of different substances and detection of very low
concentrations is needed – less than 10 ng cm−3 (<0.01 ppm) by mass. Analysis for stanozolol
involves extraction from the urine on to a solid surface, hydrolysis by enzymes, extraction into a
non-polar solvent and chemical reaction to form stable compounds. The analysis is carried out
by GC-MS. The peaks in the mass spectrum and the gas chromatogram are characteristic of
stanozolol.
One of the most well-known uses of drugs at the Olympics occurred in 1988 when Ben
Johnson won the Olympic men’s 100 metre sprint title. He was stripped of his Olympic gold
medal and world record after testing positive for banned steroids. He returned to athletics in
1991 but in 1993 he again tested positive for steroids and was banned from competition for life.
The recent high-profile instances of doping in a range of sports, particularly road cycling, show
how intense the pressure to perform at the highest levels of human fitness and endurance can
create a culture of acceptance of illicit practices. The World Anti-Doping Agency was formed
in 1999 as a response to the rapidly increasing instances of the use of anabolic steroids in sports.
The Agency’s mission is to rationalize and unify the anti-doping policies and regulations of sport
governing bodies and governments so that there can be a consistency of practice and detection.
The development of the World Anti-Doping Code and its broad acceptance worldwide has been
a major achievement. Integral to this code is the specification that drug-testing laboratories
should be accredited to meet international standards.
Ethanol
Ethanol, the alcohol in alcoholic drinks, causes mild intoxication at around 30–50 milligrams
(mg) per 100 cm3 of blood, resulting in a sense of euphoria (great happiness). In people who
have not developed tolerance to ethanol, silly behaviour is observed. Once the concentration of
ethanol has reached 100 mg per 100 cm3, most people suffer neurological problems, resulting in
slurred speech and staggering.
Aggressive and dangerous behaviour is also common, even in experienced drinkers. At
concentrations of 200 mg per 100 cm3 blood, vision and movement are difficult and at 400 mg
per 100 cm3 of blood, coma and death are likely. The usual cause of death is respiratory distress
which is due to an inhibition of nerve impulses from the reticular formation in the brain to the
intercostal muscles between the ribs.
The actual mode of action of ethanol is not fully understood: at low concentrations it is a
stimulant, but at high concentrations it becomes a depressant. However, most of the problems
attributed to ethanol (C2H5OH) are probably due to the action of ethanal (CH3CHO) formed
from ethanol by the enzyme alcohol dehydrogenase in the liver. This compound interacts with
neurotransmitters to produce chemicals with psychotropic activity. Ethanal is then metabolized
to ethanoate ions (CH3COO−) and eventually to water and carbon dioxide. The average 70 kg
human male can oxidize about 10 grams of ethanol per hour.
The effects of alcohol on society are considerable. Studies have shown that there are strong
correlations between heavy drinking, strokes, cirrhosis of the liver, suicide rates and all cancers,
especially stomach cancer.
Long-term consumption of large quantities of alcohol can also lead to brain damage, due
to its dehydrating action. Mothers who drink during pregnancy run the risk of giving birth to
babies with fetal alcohol syndrome where the baby is born underweight and with brain damage.
Alcoholism is medically defined as a disease; it is often progressive and frequently fatal.
It often appears to run in families and has recently been established to have a strong genetic
component in some people. It seems to be related to the levels of specific enzymes inside the body.
Alcohol rapidly passes through the stomach wall and into the bloodstream. The majority of
the absorbed alcohol is decomposed into carbon dioxide and water. The remainder leaves the
body via sweat, in the breath or in the urine. The highest concentration of alcohol in the blood
is reached about an hour after drinking ceases, although this depends on a number of factors
(including the amount of food in the stomach, which tends to slow the absorption of alcohol
from the small intestine).
A sample of breath taken from deep in the lungs has an alcohol concentration related to the
alcohol concentration in the blood, because a rapid equilibrium is set up between the blood and
air in the lungs. The concentration of the alcohol in the breath is 1/2300 of that in the blood.
A measurement of the concentration of alcohol in the breath can therefore be used to calculate
the concentration of alcohol in the blood.
The ‘breathalyser’ (Chapter 13) was introduced in the UK in 1967 to test whether a driver
has exceeded the legal limit of alcohol in his or her blood (currently the value in many countries
around the world is 50 or (as in the UK) 80 milligrams per 100 cm3 of blood; this last value
corresponds to 35 micrograms per 100 cm3 of air). Drivers suspected of excessive drinking are
asked to blow through a previously sealed tube until they have provided a volume of one litre
(1 dm3). The tube is packed with potassium dichromate(VI) crystals and sulfuric acid on a silica
(silicon dioxide) support. Ethanol in the breath is oxidized to ethanal and then to ethanoic acid:
CH3CH2OH → CH3CHO + 2H+ + 2e−

ethanol ethanal
CH3CHO + H2O → CH3COOH + 2H+ + 2e−

ethanal
ethanoic acid
The orange crystals of potassium dichromate(vi) are reduced to compounds containing green
chromium(iii) ions:
Cr2O72− + 14H+ + 6e− → 2Cr3+ + 7H2O
The concentration of alcohol in the driver’s breath can be determined by seeing what length of
the crystals in the tube have changed colour.
In 1980 the British police started to use an electronic instrument, known as an Alcolmeter,
in place of the breathalyser. This instrument, like the breathalyser, makes use of the oxidation
of ethanol to ethanal and ethanoic acid, but the oxidation process forms one of the electrodes in
an electrochemical cell and the voltage of the cell is measured.
The cell consists of a permeable membrane containing phosphoric(v) acid or sodium
hydroxide in sintered glass – a form of porous glass – sandwiched between catalytic coatings
of silver or gold. When the driver breathes into the instrument the ethanol in their breath is
catalytically oxidized to ethanoic acid at the metal electrode on one side of the membrane:
CH3CH2OH + H2O → CH3COOH + 4H+ + 4e−
Oxygen is kept in contact with the metal on the other side to act as a reference electrode (c.f.
the standard hydrogen electrode). The oxygen is reduced to water:
O2 + 4H+ + 4e− → 2H2O
The instrument is calibrated by passing air with known ethanol concentrations through and
measuring the resulting cell voltage.
At the police station many drunk driver suspects are given a second type of breath test, where
the ethanol concentration is measured by absorption of infrared radiation (Chapter 21). The driver
is asked to breathe continuously into a breath testing instrument, known as the Intoximeter. The
breath passes into a cell where it is irradiated with infrared radiation (Figure 25.144). The amount
of radiation absorbed at a particular wavelength or frequency (specifically 2950 cm−1 to detect C–H
bonds) is proportional to the number of ethanol molecules present (Figure 25.145).
■■ Figure 25.144 rotating infrared reference

Components of the mirror chopper path chamber mirror
infrared analyser unit
of the Lion Intoximeter
3000
detector
infrared sample and
source breath cell breath interference
in out filter
■■ Figure 25.145 100

Infrared spectrum of 90
ethanol 80
% Transmittance
70
60
50
40
30
20
10
0
4600 3800 3000 2200 1800 1400 1000 800 600 400
Wavenumber/cm–1
3340 1090–1050
O–H stretch C–O and C–C stretch
2950 1450–1380
C–H stretch O–H and C–H bend
ethanol Alternatives to breath testing are also available and involve taking samples
of blood and urine and subjecting them to GC. The samples are injected into a
Detector signal
gas–liquid chromatograph (GLC) which separates out the different components.

Their presence in the sample is displayed as a series of peaks on a chart recorder
(Figure 24.146). The area under the peak due to alcohol is then used to calculate
the concentration of alcohol. Not only can alcohol be detected and measured,
but other drugs can be detected and measured at the same time.
Time Alcohol abusers frequently use alcohol in combination with other drugs.
■■ Figure 24.146 The reading from a
There is often a synergistic effect: the combination of the two drugs may be
chromatogram showing the presence of
more harmful than either drug alone.
alcohol in a person’s breath. The area
For example, when alcohol is used with cocaine, a substance called
under the peak gives the amount of
cocaethylene is formed, which may extend and enhance the cocaine ‘high’.
alcohol in the sample
However, cocaethylene is far more toxic than cocaine and alcohol used separately and causes
severe vasoconstriction (narrowing of blood vessels leading to a rise in blood pressure) and
cardiac arrhythmia (irregular heart beat).
Hyperacidity is a consequence of excess production of gastric juice and hence hydrochloric
acid. This is often caused by damage to the mucous membranes of the stomach wall by alcohol or
aspirin, or a synergistic combination of both drugs. If untreated a gastric ulcer is likely to develop.
Nature of Science Analytical chemistry and drug testing
Recent advances in the instrumentation used in analytical chemistry have dramatically
improved the sensitivity and accuracy of molecular drug analysis in medicine, forensic science
(crime investigation) and the pharmaceutical industry. Modern analytical techniques can detect
and measure trace amounts of illegal substances in the urine and blood of the human body and
distinguish between stereoisomers of biologically active compounds. They can also be used to
confirm the identity and purity (degree of contamination) of pharmaceutical drugs.
Safety and efficacy of pharmaceuticals are two fundamental issues of importance in drug therapy.
The safety of a drug is determined by its pharmacological–toxicological profile as well as the adverse
effects caused by the impurities. The impurities in drugs often possess unwanted pharmacological–
toxicological effects by which any benefit from their administration may be outweighed.
These technological changes improve the quality of our lives and protect individuals and
society from the harmful effects of drug abuse. At the same time an increasing number of people
are now legally required to provide samples of their blood or urine for random and routine drug
tests. This limits their personal freedom and affects the ethical choices of individuals.
Supporters of routine or random drug testing claim that employers have a moral right to a
fair day’s work in exchange for a fair day’s pay. They also have a right to inquire into any issue
that seriously interferes with an employee giving a fair day’s work. Drugs can significantly impair
a person’s work performance, lowering productivity. Employees who use drugs have double the
rate of absenteeism, have higher job turnover rates, and incur more medical benefits compared
to those who do not use drugs.
It can be argued that the government has a moral duty to protect the health and safety of its
citizens. Drug abuse in the workplace constitutes a serious hazard to others. According to one
survey, employees who use drugs have three times the accident rates of non-users. And, in some
cases, for example nuclear plants and air-traffic control, such accidents could involve the loss of
many lives.
Critics of drug-testing programs argue that employees have a basic right to privacy. Employers
cannot intrude on this privacy without serious cause and in a manner that is reasonable.
Routine and random drug testing, they claim, clearly violates an employee’s right to privacy.
First, these programs, by their nature, subject employees to humiliation and invade their privacy
routinely and randomly, not because there is reasonable suspicion of drug abuse. Second, drug
testing is not an effective means for screening out employees whose on-the-job performance
is being impaired by drugs. The results of drug testing only indicate that traces of a drug are
present in a person’s body and not whether a drug is affecting a person at work.
Examination questions 101
■■ Examination questions – a selection

1 Methicillin, a semi-synthetic penicillin, was in common and thus show similar peaks in
developed to counter various strains of penicillin- their spectra. State and explain one similarity
resistant bacteria, but now some bacteria have and one difference between the two spectra
even developed a resistance to methicillin. with respect to the bonds present. [2]
They are called MRSA (methicillin-resistant c State the number of peaks in the 1H NMR
Staphylococcus aureus). spectrum (ignore the peaks due to the
hydrogen atoms on the benzene ring and the
OCH3 reference sample) and describe the splitting
H H H pattern for each of the peaks. [2]
N S d A very soluble form of aspirin is prepared
CH3
by reacting it with a strong base, such as
CH3O O N CH3 potassium hydroxide. Explain why this process
O H can increase the bioavailability of the drug. [3]
methicillin HOOC e The use of aspirin can have beneficial effects
for the user, but can also produce some
a Define the term antibiotic.[1] unwanted side effects. State one beneficial
b State two reasons for chemically modifying the effect (other than its analgesic activity) and
side-chain in penicillins and other antibiotics. [2] one unwanted side effect. [2]
c A large number of penicillins exist: some are f Explain how aspirin produces an analgesic
narrow spectrum and some are broad spectrum. effect at the molecular level. [1]
Explain the difference between broad-spectrum
2-hydroxybenzoic acid
and narrow-spectrum antibiotics. [1] 100
d Describe the mode of action of penicillin in
preventing the growth of bacteria. [2]
Transmittance %
e Discuss one effect of over-prescription of

penicillin to humans. [1] 50
f Give one reason why a course of antibiotics,

such as methicillin, must be completed. [1]
g Explain the importance of the beta-lactam
ring in the action of penicillins. [3] 0
4000 3000 2000 1500 1000 500
h Antibiotics are present as pollutants in water. Wavenumber/cm–1
State the names of three other evironmental
2-(acetoxy)benzoic acid
xenobiotics that are non-radioactive. [3] 100
Q2 The bark of the willow tree contains

2-hydroxybenzoic acid which when extracted can
Transmittance %
be used as an antipyretic and to treat fever. It is

50
very irritating to the stomach and is now used as
2-(acetoxy)benzoic acid, or aspirin.
O O
0
C C 4000 3000 2000 1500 1000 500
OH H+ OH Wavenumber/cm–1
OH O Q3 The structures of some analgesics are shown on

page 38 of the IB Chemistry data booklet. Refer to
C
H3C O this table when answering parts (b) and (c) of this
2-hydroxybenzoic acid 2-(acetoxy)benzoic acid question.
a Explain the differences in the method of action
a Identify the type of chemical reaction used of mild analgesics and strong analgesics. [2]
to convert 2-hydroxybenzoic acid to aspirin. [1] b State the name of the nitrogen-containing
b The infrared spectra for 2-hydroxybenzoic acid functional group in paracetamol and heroin. [2]
and 2-(acetoxy)benzoic acid are shown below. c Naturally occurring morphine can be converted
Both molecules have many structural features into synthetic heroin by reaction with ethanoic
acid. Identify the group in the morphine Q5 Ganciclovir is an antiviral medication used to treat
molecule that reacts with ethanoic acid, the or prevent infection by cytomegalovirus infections.
name of the type of reaction and the other It prevents replication of viral DNA. It is usually
product of the reaction. [3] added to the eye or taken orally. One of its side
d Morphine, codeine and heroin are classified as effects is anemia. Ganciclovir and foscarnet show
strong analgesics. synergistic inhibition of cytomegalovirus.
i Name two functional groups common to
morphine, codeine and heroin. [2] O
ii A hospital patient has been prescribed N
morphine after surgery. State the main effect NH
and a major side effect of this drug. [2] HO
N N NH2
e For two comparable populations, the LD50 values O
(expressed as mg per kg body mass) for morphine
and heroin are 20 and 4, respectively. ganciclovir
i Explain what is meant by the term LD50.[2] OH
ii Identify which of the two substances
is more toxic with respect to these a Identify four functional groups in Ganciclovir and
populations.[1] outline why the molecule is water soluble. [3]
f Explain what is meant by the terms b Many drugs are taken orally. State two other
TD50 and ED50.[2] ways in which medicinal drugs are taken by
g Explain why diamorphine (heroin) is often a patient. State which method has the most
administered as an ionic salt, diamorphine rapid effect. [2]
hydrochloride.[2] c What term is given to a preparation which is
pharmacologically inert but which may have
Q4 Mylanta is a commercial antacid which often
a medical effect based solely on the power of
contains aluminium and magnesium hydroxides in
suggestion?[1]
equal proportions by mass.
d State what is meant by the term side effect. [1]
a Write an equation for the reaction of e State what is meant by the term synergistic
hydrochloric acid with one of the above effect.[1]
antacids.[2] f State what is meant by the term therapeutic
b Identify which antacid neutralizes the greater window. Explain why it is important for
amount of hydrochloric acid if 0.2 mol of each cytomegalovirus patients prescribed with
antacid is used to neutralize the hydrochloric ganciclovir.[2]
acid present in the stomach. [1] g Give one reason why viral infections can be
c Give one reason why potassium hydroxide is difficult to treat. [1]
not used instead of these antacids. [1] h State two differences in the structure and
d Explain how heartburn is caused. [1] replication of viruses. [2]
e Explain why dimethicone and alginates are
Q6 Acidified sodium dichromate(vi) is commonly used
added to some antacids. [2]
in roadside tests for ethanol in the breath of
f State one drawback to using calcium carbonate
drivers of motor vehicles. The ethanol, C2H5OH,
as an antacid. [1]
present in the breath reacts in a redox reaction to
g The pH of gastric juice is 2.00. Calculate how
3 form ethanoic acid, CH3COOH.
many milligrams of HCl there are in 1.000 cm
of gastric juice. [2] a State the function of sodium dichromate(vi)
h 4.28 g of ammonium chloride was added to during this redox reaction and give the colour
3 −3
250 cm of 0.50 mol dm ammonia solution. change that takes place. [2]
Calculate the pH of the resulting solution. The b Identify two other methods used in the police
pKa for the ammonium ion is 9.25. [2] station for the detection of ethanol in a
i Calculate the mass of sodium ethanoate needed person’s breath or blood that are considered to
3 −3
to be added to 500 cm of 0.10 mol dm ethanic be more accurate. [2]
acid to produce a buffer of 4.5. The pKa for c State one harmful effect of aspirin that is more
ethanoic acid is 4.76. [2] likely to occur if it is taken with ethanol. [1]
j Outline how the drugs rantidine (Zantac) and d Explain how anabolic steroids can be dectected
omeprazole regulate acid secretion. [2] in athletes using chromatrography and mass
spectrometry.[4]

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25

Option D Medicinal chemistry

25.1 Pharmaceutical products and drug action –

H chromatography. Some natural products are limited to a single species of plant or

International availability of drugs

■■ Figure 25.4 neurotransmitter neurotransmitter

target cell message

■■ Figure 25.5 agonist antagonist

■■ Figure 25.6 binding

unbound drug bound drug

■■ The placebo effect

■■ Developing new drugs

2nd phase of clinical studies

new drug application review by drug

10 final drug administration approval for one new drug

■■ Figure 25.10 Summary of common methods of drug delivery by injection

■■ Figure 25.12 lipid soluble (lipophilic)

after this point,

■■ Table 25.1 LD50

Toxic dosage and effective dosage

reaches the therapeutic level but continues to rise to a steady state

The therapeutic index 100

■■ Table 25.2 Clinical

■■ Figure 25.21 Geometrical isomerism in diamminedichloroplatinum(ii)

■■ Figure 25.26 glial cell capillary wall

■■ Figure 25.29 Disprin, a – O CH3

■■ Figure 25.30 Structure of the calcium form of

H3C C normal steps H3C C H3C C

■■ Figure 25.33 The

An imbalance in the production of angiotensin II results in high blood pressure, so

CH2 CH2 CH2

angiotensin I molecule N CH C N CH C N CH C O– 3 +NH3

25.2 Aspirin and penicillin – natural products with useful

COOH CH3 COOH CH3 O

CH2 CH2 CH2 CH

arachidonic acid PGE2

■■ Figure 25.41 ■■ Figure 25.42

Analysis of salicylic acid and aspirin

Evidence from infrared spectroscopy

■■ Figure 25.47 The IR 100

Evidence from nuclear magnetic resonance spectroscopy

The NMR spectra show that salicylic acid contains:

A combination of IR and NMR spectroscopy shows that salicylic acid

acid. A decision about which isomer salicylic acid is can be made by

■ Figure 25.50 IR spectrum of aspirin

■ Figure 25.51 1HNMR spectrum of aspirin

■ Figure 25.53 Mass spectrum of aspirin

Nature of Science Discovery of aspirin

amount of acid neutralized = (amount of HCl added)

= (MHCl × VHCl) − (MNaOH × VNaOH)

where M = molarity (mol dm−3) and V = volume in cubic decimetres (dm3).

Can cause an allergic reaction? Yes No, because it is not a salicylate

Potential for causing nausea and vomiting? More Less

Possesses anti-inflammatory action? Yes and hence used in Weakly anti-inflammatory

Potential to act as a suicide drug? Yes Yes

Antipyretic Yes Yes

How penicillins work

■■ Bacterial resistance to antibiotics

25.3 Opiates – potent medical drugs prepared by chemical modification of