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{{drugbox | verifiedrevid = 414566780 | IUPAC_name = 3-{2-ethyl}quinazoline-2,4(1H,3H)-dione | image = Ketanserin.png | CASNo_Ref = | ChemSpiderID_Ref = | ChemSpiderID = 3690 | UNII_Ref = | UNII = 97F9DE4CT4 | InChI = 1/C22H22FN3O3/c23-17-7-5-15(6-8-17)20(27)16-9-11-25(12-10-16)13-14-26-21(28)18-3-1-2-4-19(18)24-22(26)29/h1-8,16H,9-14H2,(H,24,29) | InChIKey = FPCCSQOGAWCVBH-UHFFFAOYAA | smiles = c1ccc2c(c1)c(=O)n(c(=O)2)CCN3CCC(CC3)C(=O)c4ccc(cc4)F | ChEMBL_Ref = | ChEMBL = 51 | StdInChI_Ref = | StdInChI = 1S/C22H22FN3O3/c23-17-7-5-15(6-8-17)20(27)16-9-11-25(12-10-16)13-14-26-21(28)18-3-1-2-4-19(18)24-22(26)29/h1-8,16H,9-14H2,(H,24,29) | StdInChIKey_Ref = | StdInChIKey = FPCCSQOGAWCVBH-UHFFFAOYSA-N | CAS_number = 74050-98-9 | ATC_prefix = C02 | ATC_suffix = KD01 | ATC_supplemental = QD03AX90 (WHO) | PubChem = 3822 | IUPHAR_ligand = 197 | IUPHAR_ligand = 88 | DrugBank = | KEGG_Ref = | KEGG = D02363 | chemical_formula = | C=22|H=22|F=1|N=3|O=3 | molecular_weight = 395.43 g/mol | bioavailability = | protein_bound = | metabolism = | elimination_half-life = | excretion = | pregnancy_AU = | pregnancy_US = | pregnancy_category= | legal_AU = | legal_CA = | legal_UK = | legal_US = | legal_status = | routes_of_administration = }} Ketanserin is a drug with affinity for multiple G protein-coupled receptors (GPCR). Initially it was believed to be a highly selective antagonist for serotonin 5-HT_2A receptors, however this is not true. Ketanserin only has good selectivity for 5-HT_2A receptors over 5-HT_2C receptors (~20-30 fold). Ketanserin also has high affinity for alpha-1 adrenergic receptors, and very high affinity for histamine H1 receptors. Therefore, ketanserin can not be used to reliably discriminate between the effects of 5-HT_2A and 5-HT_2C receptors when both are present in an experimental system. Furthermore, when alpha-1 and H1 receptors are present, the effects of ketanserin can potentially represent a complex interaction of serotonin, adrenergic, and histamine receptor systems. Complicating the matter further is the fact that ketanserin has moderate affinity for alpha-2 adrenergic (~200 nM) and 5-HT₆ (~300 nM) receptors as well as weak affinity for dopamine D1 and D2 receptors (~300 nM and ~500 nM respectively). Ketanserin at levels of 500 nM or greater are thus potentially affecting at least 8 different GPCRs from 4 different families. (All affinity levels taken from the NIMH Psychoactive Drug Screening Program database )

Receptors for which ketanserin has high affinity binding:

• 5-HT_2A = 2-3 nM (rat and human)
• 5-HT_2C = 50 nM (rat), 100 nM (human)
• alpha-1 adrenergic = ~40 nM
• Histamine H1 = 2 nM

Ketanserin was discovered at Janssen Pharmaceutica in 1980.

Uses

Antihypertensive

It is classified as an antihypertensive by the World Health Organization and the National Institute of Health.

It has been used to reverse hypertension caused by protamine (which in turn was administered to reverse the effects of heparin overdose).

The reduction in hypertension is not associated with reflex tachycardia.

It has been used in cardiac surgery.

As a radioligand

With tritium (H) radioactively labeled ketanserin is used as a radioligand for the serotonin 5-HT_2A receptor, e.g. in receptor binding assays and autoradiography. This radiolabeling enables the study of the serotonin-2A receptor distribution in the human brain.

An autoradiography study of the human cerebellum has found an increasing binding of H-3-ketanserin with age (from below 50 femtomol per milligram tissue at around 30 years og age to over 100 above 75 years). The same research team found no significant correlation with age in their homogenate binding study.

References

1. NIMH Psychoactive Drug Screening Program
2. ATC/DDD Index
3. Ketanserin
4. van der Starre PJ, Solinas C (1996). "Ketanserin in the treatment of protamine-induced pulmonary hypertension". Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 23 (4): 301–4. PMC 325377. PMID 8969033.
5. Hodsman NB, Colvin JR, Kenny GN (1989). "Effect of ketanserin on sodium nitroprusside requirements, arterial pressure control and heart rate following coronary artery bypass surgery". British journal of anaesthesia. 62 (5): 527–31. doi:10.1093/bja/62.5.527. PMID 2786422. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
6. Elbers PW, Ozdemir A, van Iterson M, van Dongen EP, Ince C (2008). "Microcirculatory Imaging in Cardiac Anesthesia: Ketanserin Reduces Blood Pressure But Not Perfused Capillary Density". J. Cardiothorac. Vasc. Anesth. 23 (1): 95. doi:10.1053/j.jvca.2008.09.013. PMID 19058975. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
7. Simon B. Eickhoff, Axel Schleicher, Filip Scheperjans, Nicola Palomero-Gallagher & Karl Zilles (2007). "Analysis of neurotransmitter receptor distribution patterns in the cerebral cortex". NeuroImage. 34 (4): 1317–1330. doi:10.1016/j.neuroimage.2006.11.016. PMID 17182260.{{cite journal}}: CS1 maint: multiple names: authors list (link)
8. A. Pazos, A. Probst, J. M. Palacios (1987). "Serotonin receptors in the Human Brain—IV. Autoradiographic mapping of serotonin-2 receptors". Neuroscience. 21 (1): 123–139. doi:10.1016/0306-4522(87)90327-7. PMID 3601071.{{cite journal}}: CS1 maint: multiple names: authors list (link)
9. Sharon L. Eastwood, Philip W. J. Burnet, Rebecca Gittins, Kate Baker, Paul J. Harrison (2001). "Expression of serotonin 5-HT_2A receptors in the human cerebellum and alterations in schizophrenia". Synapse. 42 (2): 104–114. doi:10.1002/syn.1106. PMID 11574947. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

• 5-HT2 antagonists
• Organofluorides
• Ketones
• Piperidines
• Quinazolines
• Lactams
• Ureas
• Imides