spirocyclic heterocyclic compound, pharmaceutical composition, method to bind opioid receptors, methods to prevent or treat pain, gastrointestinal dysfunction, a urogenital tract disorder, an immunomodulatory disorder, an inflammatory disorder, a respiratory function disorder, anxiety, mood disorder, a stress-related disorder, sympathetic nervous system disorder, cough, and a motor disorder, method for treating traumatic injury to the central nervous system, methods for preventing or treating stroke, cardiac arrhythmia, glaucoma, and sexual dysfunction, methods for treating a condition selected from the group consisting of shock, cerebral edema, cerebral ischemia, cerebral deficit after cardiac surgery (bypass) and graft, systemic lupus erythematosus, hodgkin's disease, sjogren's disease, epilepsy, and rejection in organ transplants and skin grafts, and to treat substance dependence, method to improve organ and cell survival, and cardioprotection after myocardial infarction, methods to

摘要

"Heterocyclic compound spirocyclic, PHARMACEUTICAL COMPOSITION, METHOD FOR CONNECTING opioid receptors, METHODS TO PREVENT OR TREAT PAIN, dysfunction GASTROINTESTINAL, a disorder TRACT UROGENITAL, a disorder immunomodulatory, a disorder inflammatory, ONE OF FUNCTION respiratory disorder, anxiety, mood disorder, A STRESS-RELATED DISORDER, SYMPATHIC NERVOUS SYSTEM DISORDER, COSSE, AND A MOTOR DISORDER, A METHOD FOR TREATING A CENTRAL NERVOUS SYSTEM, METHODS TO PREVENT CARTULAR AND TRACTULAR ARMS, A SELECTED CONDITION OF THE GROUP CONSISTING OF SHOCK, CEREBRAL EDEMA, CEREBRAL ISCHEMIA, CEREBRAL DEFICIT AFTER HEART SURGERY, SYSTEMIC LUPUS ERYTHESIS, HODGENE EPOGRAPHIC DISEASE, PEOPLE AND EPODYCLE DISEASE , AND TO TREAT SUBSTANCE DEPENDENCE, MET GOODS TO IMPROVE SURGERY OF ORGANS AND CELLS, AND CARDIOPROTECTION AFTER MYOCARDIAL DISORDER, METHODS TO REDUCE ANESTHETIC NEEDS, TO PRODUCE OR MAINTAIN AN ANESTHETIC STATE, COMPLETE DIOCED DOMATIC COMPOSITE, DIAGNOSTIC IMAGE ". Spirocyclic heterocyclic derivatives, pharmaceutical compositions containing such compounds, and methods for their pharmaceutical use are described. In certain embodiments, the spirocyclic heterocyclic derivatives are opioid receptor ligands and may be useful, among other things, for the treatment and / or prevention of pain, anxiety, gastrointestinal disorders, and other opioid receptor mediated conditions. .