Nikethamide

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Nikethamide
Nikethamide.png
Clinical data
SynonymsNicotinic acid diethylamide
AHFS/Drugs.comInternational Drug Names
ATC code
Pharmacokinetic data
Elimination half-life0.5 h
Identifiers
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
E number{{#property:P628}}
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Chemical and physical data
FormulaC10H14N2O
Molar mass178.231
3D model (JSmol)
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Nikethamide is a stimulant which mainly affects the respiratory cycle. Widely known by its former trade name of Coramine, it was used in the mid-twentieth century as a medical countermeasure against tranquilizer overdoses, before the advent of endotracheal intubation and positive-pressure lung expansion. It is now considered to be of no value for such purposes, and may be dangerous.[1]

In alternate terminology, it is known as nicotinic acid diethylamide, which meaningfully emphasizes its laboratory origins, and of which its common name is derived as a blend.

Former and current medical use

Coramine was used by suspected serial killer John Bodkin Adams when treating patient Gertrude Hullett, whom he was suspected of murdering.[2] However, the toxicity of nikethamide is quite low (Template:LD50 rabbits 650 mg/Kg oral, LD50 rats 240 mg/Kg s.c.).

Theodor Morell, Adolf Hitler's personal physician, would inject the German ruler with Coramine when Hitler was unduly sedated with barbiturates. In addition, Morell would use Coramine as part of an all-purpose "tonic" for Hitler.[3]

It is available as a short-acting over-the-counter drug in several South American and European countries, combined with glucose in form of lozenges. It is especially useful for mountain climbers to increase endurance at high altitudes. Contraindications include hypertension, cardiovascular pathologies and epilepsy.[4]

Use in sports

In some sports, nikethamide is listed by the World Anti-Doping Agency as a banned substance. Croatian tennis player Marin Čilić was suspended from competition for nine months after he tested positive for nikethamide in April 2013.[5] This ban was later reduced to four months after Cilic appealed and claimed he had unintentionally ingested it in a glucose tablet bought at a pharmacy.[6] Polish kart driver Igor Walilko was given a two-year ban, later reduced to eighteen month, from competition in 2010 due to testing positive for nikethamide after a win in Germany in July, 2010.[7]

References

  1. Martindale, The Extra Pharmacopoeia, 30th ed, p1229
  2. Cullen, Pamela V., "A Stranger in Blood: The Case Files on Dr John Bodkin Adams", London, Elliott & Thompson, 2006, ISBN 1-904027-19-9
  3. Doyle D (February 2005). "Adolf Hitler's medical care" (PDF). J. R. Coll. Physicians Edinb. 35 (1): 75–82. ISSN 1478-2715. OCLC 49953788. PMID 15825245. Retrieved 2009-03-15.
  4. Nikethamid, III-3.3, Toxcenter
  5. "Marin Cilic: Croatian banned for nine months". BBC News. 16 September 2013. Retrieved 16 September 2013.
  6. "Cilic cleared to play again after suspension reduced". Tennis. 25 October 2013. Retrieved 25 October 2013.
  7. FIA Igor Walilko ruling

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