DERIVATIVES OF HEXAHYDROPIRAZINE (1'2 ': 1,6) -PIRIDO (3,4-B) INDOL-1,4-DIONA FOR THE TREATMENT OF CARDIOVASCULAR DISORDERS AND ERECTILE DYSFUNCTION.

摘要

The biochemical, physiological and clinical effects of PDE5 inhibitors suggest its usefulness in a variety of pathological conditions, in which modulation of smooth muscles, renal, hemostatic, inflammatory, and / or endocrine function is desirable. The compounds of formula (I) are therefore useful in the treatment of a number of disorders, such as temple, stable, unstable, and variant angina pectoris, (Prinzmetal), hypertension, pulmonary hypertension, congestive heart disease, acute dysneic syndrome, acute and chronic renal failure, atherosclerosis, clinical pictures of reduced permeability of blood vessels (for example, post-percutaneous transluminal carotid or coronary angioplasty or graft stenosis in post-bypass surgery), peripheral vasculopathy, vascular disorders, such as Raynaud's disease, thrombocythemia, inflammatory diseases, stroke, bronchitis, chronic asthma, allergic asthma, allergic rhinitis, glaucoma, osteoporosis, premature delivery, benign prostatic hypertrophy, peptic ulcer, male erectile dysfunction, female sexual dysfunction and diseases characterized by disorders of the intestinal motility (for example, bowel irritation syndrome able). An especially important use is the treatment of male erectile dysfunction, which is a form of impotence and constitutes a common medical problem. Impotence can be defined as lack of power, in the male, to copulate and may mean the inability to achieve an erection or ejaculation or both. The incidence of erectile dysfunction increases with age, and approximately 50% of men over 40 suffer from erectile dysfunction to some extent. In addition, another important use is the treatment of female arousal disorder. Female arousal disorders are defined as a recurring inability to achieve or maintain an adequate lubrication / tumescence response of sexual arousal until sexual activity ends. The excitement response consists of vasocongestion in the pelvis, vaginal lubrication and expansion and tumescence of the external genitalia.