AU2008202203B2 - Combinations of quinuclidine derivatives with antimuscarinic activity and beta-2 agonists and /or corticosteroids - Google Patents

Description

Australian Patents Act 1990 - Regulation 3.2 ORIGINAL COMPLETE SPECIFICATION STANDARD PATENT Invention Title "Combinations of quinuclidine derivatives with antimuscarinic activity and beta-2 agonists and/or corticosteroids" The following statement is a full description of this invention, including the best method of performing it known to me/us:- COMBINATIONS OF QUINUCLIDINE DERIVATIVES WITH ANTIMUSCARINIC ACTIVITY AND BETA-2 AGONISTS AND/OR CORTICOSTEROIDS This application is a divisional of Australian Patent Application No. 2004234069, the entire content of which is incorporated herein by reference. This invention relates to organic compounds, their preparation and use as pharmaceuticals. In one aspect the invention provides compounds of formula I R I R2 ON O. CR N 1- 4 R4 in salt or zwitterionic form wherein RI and R 3 are each independently a C 3 -Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or -CRR 2

R

3 together form a group of formula

R

2 R where R is a bond, -0-, -S- , -CH2-, -CH=CH-, -CH2-CH2-, amino or -N(CH3)-;

R

2 is hydrogen, halo, hydroxy, C1-Cs-alkoxy or Ci-C8-alkyl optionally substituted by hydroxy;

R

4 is Ci-Ce-alkyl substituted by -NHRS, -NR 5 -CO-R', -NRs-CO-NH-R7, -NR 5 -SO2-R 8 , -CO-NR9R' 0 , -OR 1 , -O-CO-NHR1 2 , -O-CO-R1 3 or -CO-O-R 1 4 , or R 4 is C3-Cio-alkynyl optionally substituted by a C-Cis-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; RS is hydrogen or C1-Cs-alkyl; R' is Ci-Co-alkyl, C2-CB-alkenyl, C2-Cio-alkynyl or C-C8-alkoxy in each case optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R6 is a C3-C1s-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R7 is a C 3 -Cis-carbocyclic group; WO 2004/096800 PCT/EP2004/004605 2

R

8 is a C 3 -CIs-carbocyclic group; R9 is hydrogen or CI-Cs-alkyl;

R

1 0 is hydrogen, C-Ce-alkyl optionally substituted by cyano, amino, nitro, carboxy, C-C 8 alkoxy, a C 3 -Cis-carbocyclic group, or by a 4- to 12-membered heterocyclic group having at least one ring heteroarom selected from nitrogen, oxygen and sulphur, or RIO is a C 3 -Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

1 is hydrogen, Ci-Cs-alkyl, Ci-Cs-alkyl-Ci-Cs-alkoxy or Ci-Cs-alkyl-O-R 1 5 ;

R

12 is a C 3 -Cir-carbocyclic group;

R

13 is Ci-Cs-alkyl or a C3-Cis-carbocyclic group;

R

14 is hydrogen, a C3-Cls-carbocyclic group, Ci-Ce-alkenyl, or Ci-Cs-alkyl optionally substituted by a C3-ClS-carbocyclic group; and R's is a C3-Cls-carbocyclic group. Terms used in the specification have the following meanings: "Optionally substituted" means the group referred to can be substituted at one or more positions, e.g. 1, 2 or 3 positions, by any one or any combination of the radicals described. "Ci-Co-alkyl" as used herein denotes straight chain or branched alkyl having 1 to 8 carbon atoms. Preferably, Ci-Cs-alkyl is Ci.C 4 -alkyl. "C-Ca-alkylene" as used herein denotes straight chain or branched alkylene that contains 1 to 8 carbon atoms. Preferably, C-Cs-alkylene is Ci-C-alkylene.

"C

2 -Cs-alkenyl" as used herein denotes straight chain or branched hydrocarbon chains that contain two to eight carbon atoms and one or more carbon-carbon double bonds. Preferably "C-Cs-alkenyl" is "C2-C4-alkenyl". "C-Cio-alkynyl" as used herein denotes straight chain or branched hydrocarbon chains that contain two to ten carbon atoms and one or more carbon-carbon triple bonds. Preferably "C 2 Cio-alkynyl" is "C3-C-alkynyl".

WO 2004/096800 PCT/EP2004/004605 3

"C

3 -Cis-carbocyclic group" as used herein denotes a carbocyclic group having 3 to 15 ring carbon atoms, for example a monocyclic group, either cycloaliphatic, such as a C 3 -Cs cycloalkyl, or aromatic such as phenyl, which can be substituted by one or more, usually one or two, CI-Cr-alkyl groups, or a bicyclic group such as bicyclooctyl, bicyclononyl including indanyl and indenyl, and bicyclodecyl including naphthyl, again any of which can be substituted by one or more, usually one or two, C-Ce-alkyl groups . Preferably the C 3 Ci carbocyclic group is a C3-Clo-carbocyclic group, for example cyclopropyl, cyclopentyl, cyclohexyl, cycloheptyl, phenyl, indanyl or naphthyl. The C3-Cis-carbocyclic group can be substituted or unsubstituted. Preferred substituents include halo (e.g. fluoro, chloro or bromo), cyano, hydroxy, amino, nitro, carboxy, Ci-Cg-alkyl (e.g. methyl or ethyl), halo-Cl-Cs-alkyl, C. Co-alkoxy, Ci-Cg-alkylcarbonyl, Ci-Co-alkylsulfonyl, -SO 2

NH

2 , a C3-Cis-carbocyclic group and a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur. "C3-CS-cycloalkyl" as used herein denotes cycloalkyl having 3 to 8 carbon atoms. Preferably "C3-CS-cycloalkyl" is "C3-C6-cycloalkyl". "Ci-Co-haloalkyl" as used herein denotes CI-Cs-alkyl as hereinbefore defined substituted by one or more halogen atoms, preferably one, two or three halogen atoms. Preferably "C-C 8 haloalkyl" is "C-C 4 -haloalkyl". "Cl-C-alkylcarbonyl" as used herein denotes CI-C8-alkyl as hereinbefore defined linked to a carbonyl group. Preferably "C-Cs-alkylcarbonyl" is "C-C4-alkylcarbonyl". "Ci-Cs-alkylthio" as used herein denotes Ci-Ca-alkyl as hereinbefore defined linked to -S-. Preferably "Ci-Cr-alkylthio" is "C-C4-alkylthio". "Ci-C8-alkylsulfonyl" as used herein denotes Ci-C8-alkyl as hereinbefore defined linked to SO 2 -. Preferably "C-C8-alkylsulfonyl" is "Ci-C4-alkylsulfonyl". "Ci-Ca-alkoxy" as used herein denotes straight chain or branched alkoxy having 1 to 8 carbon atoms. Preferably, C-Ca-alkoxy is CI-C-alkoxy. "Ci-Cs-haloalkoxy" as used herein denotes CI-Ca-alkoxy as hereinbefore defined substituted by one or more halogen atoms, preferably one, two or three halogen atoms. Preferably "C Ca-haloalkoxy" is "C-C4-haloalkoxy".

WO 2004/096800 PCT/EP2004/004605 4 "di(Ci-C8-alkyl)sulfamoyl" as used herein denotes -S0 2

-NH

2 where the nitrogen atom is substituted at two positions by Ci-Cs-alkyl as hereinbefore defined, which may be the same or different. Preferably di(C-Ca-alkyl)sulfamoyl is -S0 2

-N(CH

3

)

2 . "Halo" or "halogen" as used herein denotes a element belonging to group 17 (formerly group VII) of the Periodic Table of Elements, which may be, for example, fluorine, chlorine, bromine or iodine. Preferably halo or halogen is fluorine, chlorine or bromine. "Aminocarbonyl" as used herein denotes amino attached through the nitrogen atom to a carbonyl group. "4- to 12- membered heterocyclic group containing at least one ring heteroatom selected from nitrogen, oxygen and sulphur" as used herein denotes a monoheterocyclic, biheterocyclic or triheterocyclic group, which may be saturated or unsaturated, that has 4 to 12 ring atoms. Monoheterocyclic groups include azetidinyl, tetrahydrofuranyl, furyl, pyrrolyl, pyrrolidinyl, pyrazolyl, imidazolyl, triazolyl, tetrazolyl, thienyl, thiazolyl, thiadiazolyl, isothiazolyl, oxadiazolyl, pyridinyl, oxazolyl, isoxazolyl, piperidinyl, pyridinyl, pyrazinyl, pyridazinyl, pyrimidinyl, piperazinyl, morpholinyl, triazinyl, oxazinyl, thiazolyl or tetrahydropyranyl. Biheterocyclic groups include thienothienyl, benzazolyl, benzothienyl, benzimidazolyl, benzodioxinyl, indazolyl, benzothiazolyl, imidazopyridinyl and naphthyridinyl. Preferred 4 to 12- membered heterocyclic groups include azetidinyl, tetrahydrofuranyl, furyl, pyrrolyl, pyrazolyl, triazolyl, thienyl, thiazolyl, thiadiazolyl, oxazolyl, isoxazolyl, tetrahydropyranyl, piperidinyl, pyridinyl, pyrazinyl, pyrimidinyl, thienothienyl, benzazolyl, benzothienyl, benzimidazolyl, benzodioxinyl, indazolyl and benzothiazolyl, imidazopyridinyl, naphthyridinyl. The 4- to 12-membered heterocyclic group can be unsubstituted or substituted at one or more positions, e.g. 1, 2 or 3 positions, by any one or any combination of substituents. Preferred substituents include halo (e.g. fluoro, chloro or bromo), cyano, oxo, hydroxy, carboxy, nitro, Cl-Cs-alkyl (e.g. methyl or ethyl), halo-CI-Co-alkyl (e.g. trifluoromethyl), C1-Cs-alkylcarbonyl, di(Ci-Cs-alkyl)sulfamoyl and Ci-Cs-alkoxy optionally substituted by aminocarbonyl. Especially preferred substituents include halo, oxo, C-C 4 -alkyl and Ci-Ce-alkylcarbonyl. Throughout this specification and in the claims that follow, unless the context requires otherwise, the word "comprise", or variations such as "comprises" or "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integers or steps.

WO 2004/096800 PCT/EP2004/004605 5 In a second aspect the invention provides compounds of formula I RI O C1 R 2 N+ R' in salt or zwitterionic form wherein

R

1 and R 3 are each independently a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or -CR 1

R

2

R

3 together form a group of formula

R

2 R where R is a bond, -0-, -S- , -CH 2 -, -CH=CH-, -CH 2

-CH

2 -, amino or -N(CH3)

R

2 is hydrogen, halo, hydroxy, Ci-Co-alkoxy or Ci-Cg-alkyl optionally substituted by hydroxy;

R

4 is Ci-Cs-alkyl substituted by -NHRS, -NRS-CO-R', -NR 5 -CO-NH1-R 7 , -NR 5 -S0 2

-R

8 ,

-CO-NR'R

10 , -OR" 1 , -O-CO-NHR 1 2 , -O-CO-R 13 or -CO-O-R 4 , or R 4 is C3-C1o-alkynyl optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

5 is hydrogen or Cl-CB-alkyl; R' is Ci-Co-alkyl, C2-Cs-alkenyl, C2-C1o-alkynyl or CI-Co-alkoxy in each case optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring hereroatom selected from nitrogen, oxygen and sulphur; R7 is a C3-Cls-carbocyclic group;

R

8 is a C3-Cis-carbocyclic group;

R

9 is hydrogen or Ce-Cs-alkyl; RIO is hydrogen, C-Cs-alkyl optionally substituted by cyano, amino, nitro, carboxy, CI-Ca alkoxy, a Cr-Cis-carbocyclic group, or by a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, WO 2004/096800 PCT/EP2004/004605 6 or R 1 o is a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R" is hydrogen, C-Ca-alkyl, Ci-Cs-alkyl-Ci-Cs-alkoxy or Ci-Cs-alkyl-O-R 3 ; R1 2 is a C3-Cls-carbocyclic group; R1 3 is C-Co-alkyl or a C3-Cis-carbocyclic group;

R

14 is hydrogen, a C3-Cis-carbocyclic group, or Ci-Cs-alkyl optionally substituted by a CrCu carbocyclic group; and

R

1 5 is a C3-Cus-carbocyclic group. In a third aspect the invention provides compounds of formula I R1 0 |R || R N+ 1 4 R in salt or zwitterionic form wherein

R

1 and R 3 are each independently a C3-C1s-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or -CR'R 2

R

3 together form a group of formula

R

2 | | R where R is a bond, -0-, -S- , -CH 2 -, -CH=CH-, -CH 2

-CH

2 -, amino or -N(CH3)

R

2 is hydrogen, halo, hydroxy, C-C8-alkoxy or C-C-alkyl optionally substituted by hydroxy;

R

4 is C-Co-alkyl substituted by -NHRs, -NR5-CO-R6, -NRS-CO-NH-R 7 , -NR 5

-SO

2

-R

8 , -CO-NR9R 10 , -OR", -O-CO-NHR 1 2 , -O-CO-RI 3 or -CO-O-R1 4 , or R 4 is C3-Cio-alkynyl optionally substituted by a C3-Cis-carbocyclic group or a 5- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R5 is hydrogen or C-Co-alkyl; R' is C-C8-alkyl or Ci-Cs-alkoxy in either case optionally substituted by a C3-Cis-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, WO 2004/096800 PCT/EP2004/004605 7 or R' is a C 3 -Cis-carbocyclic group or a S- to 12-membered heterocyclic group having at least one ring hereroatom selected from nitrogen, oxygen and sulphur;

R

7 is a C3-Cis-carbocyclic group; R1 is a C3-Cis-carbocyclic group;

R

9 is hydrogen or CI-C8-alkyl; RIO is hydrogen, Ci-Cs-alkyl optionally substituted by cyano, amino, nitro, carboxy, Ce-C s alkoxy, a C3-C15-carbocyclic group, or by a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 10 is a C 3 -CIs-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R" is hydrogen, Ci-Cs-alkyl, Ci-Cs-alkyl-Ci-Cs-alkoxy or C-Cs-alkyl-O-R 5 ; R1 2 is a C3-Cis-carbocyclic group;

R

1 3 is CI-Cs-alkyl or a C3-Cis-carbocyclic group;

R

14 is hydrogen, Ci-Cs-alkyl or a C3-Cis-carbocyclic group; and R's is a C3-Cis-carbocyclic group. Preferred compounds include those of formula I in salt or zwitterionic form, where RI and R 3 are each independently a C3-Cls-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R2 is halo or hydroxy;

R

4 is C-Cs-alkyl substituted by -NHR 5 , -NR 5 -CO-R', -NRS-CO-NH-R 7 , -NRS-SO 2 -R8,

-CO-NR

9 Ro, -O-CO-NH-R 2 , -O-CO-RI 3 or -CO-0-RI 4 , or R 4 is C3-Clo-alkynyl optionally substituted by a C3-C1s-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; Rs is hydrogen or Ci-Ce-alkyl;

R

6 is Ci-Cs-alkyl, C-Cio-alkynyl or Ci-Co-alkoxy in each case optionally substituted by a C 3 Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R' is a C3-C1s-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

7 is a C3-Cis-carbocyclic group; R' is a C 3 -Cis-carbocyclic group; R9 is hydrogen or Cl-Cs-alkyl; WO 2004/096800 PCT/EP2004/004605 8

RI

0 is C-Ca-alkyl optionally substituted by cyano, Ci-Cs-alkoxy, a C3-Cis-carbocyclic group or by a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or RI 0 is a C-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R1z is a C3-Cis-carbocyclic group;

R

1 3 is Ci-Cs-alkyl; and

R

14 is hydrogen, a C3-Cis-carbocyclic group, C-Cg-alkenyl, or C-Cs-alkyl optionally substituted by a C-Cis-carbocyclic group. Preferred compounds include those of formula I in salt or zwitterionic form, where

R

1 and R 3 are each independently a C3-Circarbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroarom selected from nitrogen, oxygen and sulphur;

R

2 is halo or hydroxy;

R

4 is Ci-Cs-alkyl substituted by -NHR 5 , -NR 5 -CO-R', -NR 5

-CO-NH-R

7 , -NRs-SOz-R 8 , -CO-NR'R'o, -O-CO-NH-R 2 , -O-CO-R1 3 or -CO-O-R 14 , or R 4 is C-Cio-alkynyl optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

5 is hydrogen or CI-C8-alkyl; R' is Ci-Cs-alkyl, C-Cio-alkynyl or Ci-Cs-alkoxy in each case optionally substituted by a C 3 Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-CIs-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

7 is a C-Cis-carbocyclic group;

R

8 is a C-Cis-carbocyclic group;

R

9 is hydrogen or Ci-Co-alkyl; RIO is Ci-CR-alkyl optionally substituted by cyano, Ci-CO-alkoxy, a C3-Cis-carbocyclic group or by a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or RIO is a C3-Cls-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R12 is a C-Cis-carbocyclic group;

R

1 3 is Ci-C8-alkyl; and WO 2004/096800 PCT/EP2004/004605 9 R1 4 is hydrogen, a C3-Cls-carbocyclic group or Ci-Ca-alkyl optionally substituted by a C 3 -Cis carbocyclic group. Preferred compounds also include those of formula I in salt or zwitterionic form, where RI and R 3 are each independently a C3-Cis-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

2 is halo or hydroxy;

R

4 is CI-Cs-alkyl substituted by -NHRs, -NRs-CO-R', -NRs-CO-NH-R 7 , -NR 5 -S0 2

-R

8 , -CO-NR9R 10 , -O-CO-NH-R1 2 , -O-CO-R 13 or -CO-O-R 1 4 , or R 4 is C3-Cio-alkynyl optionally substituted by a C3-Cis-carbocyclic group or a 5- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R5 is hydrogen;

R

6 is Cl-Cg-alkyl or Ci-Cs-alkoxy in either case optionally substituted by a C3-Cis-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-Cls-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroarom selected from nitrogen, oxygen and sulphur;

R

7 is a C3-C1s-carbocyclic group;

R

8 is a C3-Cis-carbocyclic group; R' is hydrogen or CI-Cs-alkyl;

R

1 O is Ci-C-alkyl optionally substituted by cyano, Ci-Cs-alkoxy, a C3-C1s-carbocyclic group or by a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 1 0 is a C3-Cls-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R'

2 is a C3-Cis-carbocyclic group;

R

1 3 is Ci-C8-alkyl; and R1 4 is hydrogen, Ci-Ca-alkyl or a C3-Cls-carbocyclic group. Especially preferred compounds include those of formula I in salt or zwitterionic form where

R

1 and R 3 are each independently a C6-Clo-carbocyclic aromatic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

2 is halo or hydroxy; WO 2004/096800 PCTIEP2004/004605 10

R

4 is Ci-Cs-alkyl substituted by -NHR 5 , -NR 5 -CO-R', -NR 5

-CO-NI--R

7 , -NR 5 -S02-R8, -CO-NR9R 10 , -O-CO-NH-Riz, -O-CO-R 13 or -CO-O-R14, or R 4 is C 3 -Cs-alkynyl optionally substituted by a C3-Cio-carbocyclic group or a 4- to 10 membered heterocyclic group having at least one ring heteroarom selected from nitrogen, oxygen and sulphur; R5 is hydrogen or CI-C 4 -alkyl;

R

6 is Cl-C 4 -alkyl, C2-CS-alkynyl or CI-C 4 -alkoxy in each case optionally substituted by a C 3 Cio-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R' is a C 3 -Cio-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R7 is a C3-Cio-carbocyclic group; RI is a C3-Clo-carbocyclic group; R9 is hydrogen or CI-C 4 -alkyl; RIO is CI-C 4 -alkyl optionally substituted by cyano, CI-C4-alkoxy, a C3-Cio-carbocyclic group or by a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 10 is a C3-Clo-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R1 2 is a C3-Clo-carbocyclic group; R1 3 is C-C 4 -alkyl; and R1 4 is hydrogen, a C3-C1o-carbocyclic group, CI.C 4 -alkenyl, or CI-C4-alkyl optionally substituted by a C3-Clo-carbocyclic group. Especially preferred compounds include those of formula I in salt or zwitterionic form where

R

1 and R 3 are each independently a C6-Cio-carbocyclic aromatic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

2 is halo or hydroxy;

R

4 is Ci-Cs-alkyl substituted by -NHRs, -NR5-CO-R', -NR 5

-CO-NH-R

7 , -NRs-SO 2 -R8, -CO-NR9R 0 , -O-CO-NH-R 1 2 , -O-CO-R 13 or -CO-0-R 4 , or R 4 is C3-CS-alkynyl optionally substituted by a C3-Cio-carbocyclic group or a 4- to 10 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

5 is hydrogen or CI-C 4 -alkyl; WO 2004/096800 PCTIEP2004/004605 11 R' is CI-C4-alkyl, C2-C-alkynyl or C1-C 4 -alkoxy in each case optionally substituted by a C 3 CIO-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-C1o-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

7 is a C3-Cio-carbocyclic group;

R

8 is a C3-C1o-carbocyclic group;

R

9 is hydrogen or CI-C 4 -alkyl; RIO is C1-C 4 -alkyl optionally substituted by cyano, C1-C4-alkoxy, a C3-Cio-carbocyclic group or by a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or RIO is a C3-Clo-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

12 is a C3-Cio-carbocyclic group; R1 3 is C1-C4-alkyl; and R1 4 is hydrogen, a C3-Cio-carbocyclic group or Ci-C4-alkyl optionally substituted by a C 3

-C

10 carbocyclic group. Especially preferred compounds also include those of formula I in salt or zwitterionic form where RI and R 3 are each independently a C6-Cio-carbocyclic aromatic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

2 is halo or hydroxy;

R

4 is Ci-C8-alkyl substituted by -NHR 5 , -NR 5 -CO-R', -NR 5 -CO-NH-R7, -NR 5

-SO

2 -R', -CO-NR9R1 0 , -O-CO-NH-R1 2 , -O-CO-R1 3 or -CO-0-RI 4 , or R 4 is C3-Cs-alkynyl optionally substituted by a C3-C1o-carbocyclic group or a 5- to 10 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R5 is hydrogen;

R

6 is C1-C4-alkyl or Cl-C4-alkoxy in either case optionally substituted by a C3-C1-carbocyclic group or a 5- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R6 is a C3-Cio-carbocyclic group or a 5- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

7 is a C3-Clo-carbocyclic group; WO 2004/096800 PCTEP2004/004605 12 R' is a C 3 -Cio-carbocyclic group;

R

9 is hydrogen or CI-C4-alkyl; RIO is CI-C4-alkyl optionally substituted by cyano, CI-C 4 -alkoxy, a C 3 -C1o-carbocyclic group or by a 5- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 1 0 is a C3-CIo-carbocyclic group or a 5- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

12 is a C3-Clo-carbocyclic group;

R

1 3 is C 1

-C

4 -alkyl; and R1 4 is hydrogen, C1-C 4 -alkyl or a C3-Cio-carbocyclic group. The compounds of formula I are quaternary ammonium salts. Suitable counter ions are pharmaceutically acceptable counter ions including, for example, fluoride, chloride, bromide, iodide, nitrate, sulfate, phosphate, formate, acetate, trifluoroacetate, propionate, butyrate, lactate, citrate, tartrate, malate, maleate, succinate, benzoate, p-chlorobenzoare, diphenyl acetate or triphenylacetate, o-hydroxybenzoate, p-hydroxybenzoare, 1-hydroxynaphthalene-2 carboxylate, 3-hydroxynaphthalene-2-carboxylate, methanesulfonate and benzenesulfonate. Compounds of formula I that contain a basic centre are capable of forming acid addition salts, particularly pharmaceutically acceptable acid addition salts. Pharmaceutically acceptable acid addition salts of the compound of formula I include those of inorganic acids, for example, hydrohalic acids such as hydrofluoric acid, hydrochloric acid, hydrobromic acid or hydroiodic acid, nitric acid, sulfuric acid, phosphoric acid; and organic acids, for example aliphatic monocarboxylic acids such as formic acid, acetic acid, trifluoroacetic acid, propionic acid and butyric acid, aliphatic hydroxy acids such as lactic acid, citric acid, tartaric acid or malic acid, dicarboxylic acids such as maleic acid or succinic acid, aromatic carboxylic acids such as benzoic acid, p-chlorobenzoic acid, diphenylacetic acid or triphenylacetic acid, aromatic hydroxy acids such as o-hydroxybenzoic acid, p-hydroxybenzoic acid, 1-hydroxynaphthalene 2-carboxylic acid or 3-hydroxynaphthalene-2-carboxylic acid, and sulfonic acids such as methanesulfonic acid or benzenesulfonic acid. These salts may be prepared from compounds of formula I by known salt-forming procedures. Compounds of formula I which contain acidic, e.g. carboxyl, groups, are also capable of forming salts with bases, in particular pharmaceutically acceptable bases such as those well known in the art; suitable such salts include metal salts, particularly alkali metal or alkaline earth metal salts such as sodium, potassium, magnesium or calcium salts, or salts with WO 2004/096800 PCTIEP2004/004605 13 ammonia or pharmaceutically acceptable organic amines or heterocyclic bases such as ethanolamines, benzylamines or pyridine. These salts may be prepared from compounds of formula I by known salt-forming procedures. Compounds of formula I that contain acidic, e.g. carboxyl, groups may also exist as zwitterions with the quaternary ammonium centre. The compounds of the invention contain at least one asymmetric carbon atom and thus they exist in individual optically active isomeric forms or as mixtures thereof, e.g. as racemic mixtures. In cases where additional asymmetric centres exist the present invention also embraces both individual optically active isomers as well as mixtures, e.g. diastereomeric mixtures, thereof. Specific especially preferred compounds of the invention are those described hereinafter in the Examples. These have R stereochemistry at the 3 position of the quinuclidine. The invention also provides a process for the preparation of compounds of formula I which comprises (i) (A) reacting a compound of compound of formula II RI | R2 0 N or a protected form thereof where R1, R 2 and R 3 are as hereinbefore defined, with a compound of formula III R--X III where R 4 is as hereinbefore defined and X is chloro, bromo or iodo; (B) for the preparation of compounds of formula I where R 4 is Cl-Ca-alkyl substituted by -NR 5 -CO-R' where Rs and R' are as hereinbefore defined, reacting a compound of formula IV WO 2004/096800 14 PCT/EP2004/004605 R 14 R 0 N IV N-R H or a protected form thereof where R 1 , R 2 , R 3 and R 5 are as hereinbefore defined, optionally in the presence of a coupling agent, and T denotes Ci-Ca-alkylene, with a compound of formula V 0 I 1 HO-C-R V where R 6 is as hereinbefore defined or an amide-forming derivative thereof such as an acid halide; (C) for the preparation of compounds of formula I where R 4 is C1-C8-alkyl substituted by -NR 5

-CO-NH-R

7 where R5 and R7 are as hereinbefore defined, reacting a compound of formula IV or a protected form thereof where R', RZ, R 3 and R 3 are as hereinbefore defined and T denotes Ci-Cs-alkylene, with a compound of formula VI O=C=N-R' VI where R 7 is as hereinbefore defined; (D) for the preparation of compounds of formula I where R 4 is Ci-Ca-alkyl substituted by -NR 5 -S02-R 8 where R 5 and R 8 are as hereinbefore defined, reacting a compound of formula IV or a protected form thereof where R 1 , R 2 , and R 3 are as hereinbefore defined and T denotes Ci-Cg-alkylene, with a compound of formula VII 0 X-S-R VII 0 where R$ is as hereinbefore defined and X is halo; or (E) for the preparation of compounds of formula I where R 4 is C-Ca-alkyl substituted by -CO-NR 9 RIO where R 9 and RIO are as hereinbefore defined, reacting a compound of formula VIII WO 2004/096800 PCT/EP2004/004605 15 R | R2 O C R 3 0 N Vill II T OH 0 or a protected form thereof where R 1 , R 2 , and R 3 are as hereinbefore defined and T denotes Ci-Ca-alkylene, optionally in the presence of a coupling agent, or an amide forming derivative thereof such as an acid halide, with a compound of formula IX R9 HN IX where R 9 and RIO are as hereinbefore defined; and (ii) recovering the product in salt or zwirterionic form. Process variant (A) may be effected using known procedures for reacting quinuclidinol esters with halogenides or analogously as hereinafter described in the Examples. The reaction is conveniently carried out in water or an organic solvent, for example acetonitrile, dimethylformamide (DMF), dimethylsulphoxide (DMSO), ethyl acetate or chloroform. The reaction is carried out at a temperature between 200 C to 120* C, conveniently between room temperature and 80* C. Process variant (B) may be effected using known procedures for reacting amines with carboxylic acids or amide-forming derivatives thereof such as acid halides to give amides or analogously as hereinafter described in the Examples. The reaction between the carboxylic acid and the amine is conveniently carried out in an organic solvent, for example dimethylformamide (DMF), optionally in the presence of a coupling agent, for example O-(7 azabenzotriazol-1-yl)-N, N,-N', N'-tetramethyl-uronium hexafluorophophate (HATU), and a base, for example diisopropyl-ethylamine (DIPEA) or triethylamine. Suitable reaction temperatures are from 0* C to 50* C, conveniently room temperature. Process variant (C) may be effected using known procedures for reacting amines with isocyanates to give ureas or analogously as hereinafter described in the Examples. The reaction is conveniently carried out in an organic solvent, for example dimethylformamide (DMF), and WO 2004/096800 PCTIEP2004/004605 16 preferably in the presence of a base, for example DIPEA. Suitable reaction temperatures are from -780 C to 40* C, conveniently room temperature. Process variant (D) may be effected using known procedures for reacting amines with sulfonylhalides to give sulfonamides or analogously as hereinafter described in the Examples. The reaction is conveniently carried out in an organic solvent, for example dimethylformamide (DMF), and preferably in the presence of a base, for example DIPEA. Suitable reaction temperatures are from 0* C to 50* C, conveniently room temperature. Process variant (E) may be effected using known procedures for reacting carboxylic acids or amide-forming derivatives thereof such as acid halides with amines to give amides or analogously as hereinafter described in the Examples. The reaction between the carboxylic acid and the amine is conveniently carried out in an organic solvent, for example dimethylsulfoxide (DMSO) or dimethylformamide (DMF), optionally in the presence of a coupling agent, for example HATU, and preferably in the presence of a base, for example DIPEA. Suitable reaction temperatures are from 00 C to 50 C, conveniently room temperature. Compounds of formula II are known or may be prepared by known procedures such as those disclosed in W. J. Rzeszotarski et al, J. Med. Chem. 1988, 31, 1463, international patent publication WO 01/04118 and United States patent specification US 3,833,592. Compounds of formula M are known or may be prepared by known procedures. Compounds of formula IV may be prepared by deprotecting a compound of formula X Rx O C R2 N T N - -Q NNQ R S where RI, R 2 , R 3 and R 3 are as hereinbefore defined, Q is an amine protecting group and T denotes CI-Cs-alkylene, e.g. when Q is t-butyloxycarbonyl by treatment with a strong acid, e.g. hydrochloric acid or hydrobromic acid, which is conveniently carried out in an organic solvent, WO 2004/096800 PCTIEP2004/004605 17 for example dioxan (1,4-dioxycyclohexane), and suitable reaction temperatures are from 00 C to 60* C, conveniently room temperature. Compounds of formula V, VI and VII are known or may be prepared by known procedures. Compounds of formula VIII may be prepared by cleavage of a corresponding ester of formula XI R K~~oN

KR

2 X 1 C R2 C 0 where R 1 , R 2 , and R 3 are as hereinbefore defined, T denotes Ci-C8-alkylene and W denotes a group that is readily replaceable by hydrogen. For example when W is t-butyl the compound may be reacted with an anhydrous strong acid, e.g. hydrochloric acid, hydrobromic acid or trifluoroacetic acid, which is conveniently carried out in an organic solvent, for example dioxane, and suitable reaction temperatures are from -20* C to 40* C, conveniently room temperature. Compounds of formula IX are known or may be prepared by known procedures. Compounds of formula X may be prepared by reacting a compound of formula II where R', R2 and R 3 are as hereinbefore defined, with a compound of formula XII X'--T-N -Q XII 1 6 R where R 5 is as hereinbefore defined, Q is an amine protecting group e.g. t-butyloxycarbonyl, XI is chloro, bromo or iodo and T denotes Ci-C8-alkylene. The reaction is conveniently carried out in an organic solvent, for example DMF. Suitable reaction temperatures are from 40* C to 120* C, conveniently between room temperature and 800 C. Compounds of formula XI may be prepared by reacting a compound of formula II where RI,

R

2 and R 3 are as hereinbefore defined, with a compound of formula XIII 18 X--T-C 1-0 W Xill where T denotes Ci-Ca-alkylene, X 2 is chloro, bromo or iodo and W is a group that is readily replaceable by hydrogen. For example when W is t-butyl the reaction is conveniently carried out in an organic solvent, for example DMF. Suitable reaction temperatures are from 00 C to 120* C, conveniently between room temperature and 60* C. Compounds of formula XII and XIII are known or may be prepared by known procedures. Where reference is made herein to protected functional groups or to protecting groups, the protecting groups may be chosen in accordance with the nature of the functional group, for example as described in Protective Groups in Organic Synthesis, T.W. Greene and P.G.M. Wuts, John Wiley & Sons Inc, Third Edition, 1999, which reference also describes procedures suitable for replacement of the protecting groups by hydrogen. Compounds of formula I are quaternary ammonium salts and may be converted between different salt forms using ion exchange chromatography. The compounds can be obtained in the form of hydrates or solvates containing a solvent used for crystallization. Compounds of formula I can be recovered from reaction mixtures and purified using known methods. Isomers, such as enantiomers, may be obtained in a conventional manner, e.g. by fractional crystallization, chiral phase chromatography or asymmetric synthesis from correspondingly asymmetrically substituted, e.g. optically active, starting materials. Compounds of formula I in pharmaceutically acceptable salt or zwitterionic form, hereinafter referred to alternatively as agents of the invention, are useful as pharmaceuticals. Accordingly the invention also provides a compound of formula I in pharmaceutically acceptable salt or zwitterionic form for use as a pharmaceutical. The agents of the invention act as muscarinic antagonists, particularly muscarinic M3 receptor antagonists, thereby inhibiting acetylcholine induced contraction of smooth muscle in e.g. respiratory tract, digestive tract and urinary systems. In another aspect the invention provides a medicament comprising a compound of formula I C:\NRPoIb\DlCCKZL\2611I DOC.17/12/2009 - 18A 0 % C R ' 3 11 N I 14 R' in salt or zwitterionic form wherein RI and R3 are each independently a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or -CRIR 2

R

3 together form a group of formula R where R is a bond, -0-, -S- , -CH2-, -CH=CH-, -CH2-CH2-, amino or -N(CH3)-;

R

2 is hydrogen, halo, hydroxy, Ci-Co-alkoxy or Ci-Ce-alkyl optionally substituted by hydroxy;

R

4 is Ci-Cs-alkyl substituted by -NHR 5 , -NR-CO-R', -NRs-CO-NH-R, -NRI-SO2-R 8 , -CO-NR'RIO, -OR" 1 , -O-CO-NHR 12 , -O-CO-RI 3 or -CO-O-R 4 , or R 4 is C3-Cio-alkynyl optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; RI is hydrogen or Ci-Cs-alkyl; R6 is Ci-Cs-alkyl, C2-Cs-alkenyl, C2-Cio-alkynyl or Ci-Ca-alkoxy in each case optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R' is a C3-C-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur;

R

7 is a C3-Ci-carbocyclic group; RI is a C3-C-carbocyclic group; C RPortbl\DCC\ZL\615R81_IDOC-17/12/20) - 18B R 9 is hydrogen or Ci-Cs-alkyl; RIO is hydrogen, Ci-Cs-alkyl optionally substituted by cyano, amino, nitro, carboxy, Ci-Ca-alkoxy, a C3-CI5-carbocyclic group, or by a 4- to 12-membered heterocyclic group having at least one ring 5 heteroatom selected from nitrogen, oxygen and sulphur, or RIO is a C 3 -Cis-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R" is hydrogen, Ci-Cs-alkyl, Ci-Cs-alkyl-CI-Cs-alkoxy or Ci-Cs-alkyl-O-R' 5 ; R1 is a C3-CIs-carbocyclic group; 10 R 1 3 is Ci-Cs-alkyl or a C3-Cis-carbocyclic group;

R

1 4 is hydrogen, a C3-Cis-carbocyclic group, Ci-Cs-alkenyl, or Ci-Cs-alkyl optionally substituted by a C3-C5-carbocyclic group; and R" is a C3-C15-carbocyclic group; 15 in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid. In a further aspect the invention provides a use of a medicament of the invention for the manufacture of a medicament for the treatment of a condition mediated by the muscarinic 20 M3 receptor. In another aspect the invention provides a use of a medicament of the invention for the manufacture of a medicament for the treatment of an inflammatory or allergic condition. 25 In a further aspect the invention provides a use of a medicament of the invention for the manufacture of a medicament for the treatment of chronic obstructive pulmonary disease. In another aspect the invention provides a method of treating a condition mediated by the muscarinic M3 receptor comprising administering to a subject in need thereof a compound 30 of formula I in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid.

C:\NRPorb1\DCC\DAH\2635983 1.DOC-21/12/2(X19 - 18C In a further aspect the invention provides a method of treating an inflammatory or allergic condition comprising administering to a subject in need thereof a compound of formula I in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid. 5 In another aspect, the invention provides a method of treating chronic obstructive pulmonary disease comprising administering to a subject in need thereof a compound of formula I in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid. The affinity of (Ki) of agents of the invention at the human muscarinic acetylcholine M3 10 receptor can be determined in a competitive filtration binding assay with the radio-labelled antagonist [ 3 H] n-methyl scopolamine methyl chloride (NMS): WO 2004/096800 PCT/EP2004/004605 19 Membranes prepared from CHO cells stably transfected with human M3 receptor at 10 pg protein/ well are incubated with serial dilutions of the agents of the invention, [3H]NMS (0.25 nM) and assay buffer (20 mM HEPES, 1 mM MgC 2 at pH 7.4) for 17 hours at room temperature. The assay is carried out in a 250 jpL final volume, in the presence of a final dimethyl sulfoxide concentration of 1%. Total binding of [ 3 H]NMS is determined in the absence of the agents of the invention with a corresponding substituted volume of assay buffer. Non-specific binding of [3H] NMS is determined in the presence of 300 nM ipratropium bromide. Following the incubation period, the membranes are harvested onto a Unifilternm GF/B filter plate containing 0.05 % polyethyleneimine, using a BrandelTM filtration harvester 9600. Filter plates are dried for two hours at 350C before the addition of MicroscintTM '0' cocktail, and read on a Packard Topcount TM scintillator using a 3 H-Scintillation protocol. All ICSOs are calculated with the aid of XL-Fit graph package and Ki values derived using the Cheng-Prusoff correction (Cheng Y., Prusoff W. H. (1973) Biochem. Pharmacol 22 3099 3109). The compounds of the Examples herein below generally have Ki values below 1 pM in the above assay. For instance, the compounds of Examples 17, 34, 52, 54, 71, 76, 96, 114, 138, 159, 170, 190, 209, 221, 242 and 244 have M3 Ki values of 0.0144, 0.0023, 0.0019, 0.0001, 0.0005, 0.0011, 0.0046, 0.0002, 0.0022. 0.0007, 0.0007, 0.0007, 0.0010, 0.0013, 0.0003 and 0.0003 pM respectively. Having regard to their inhibition of acetyl choline binding to M3 muscarinic receptors, agents of the invention are useful in the treatment of conditions mediated by the muscarinic M3 receptor, particularly those associated with increased parasympathetic tone leading to, for example, excessive glandular secretion or smooth muscle contraction. Treatment in accordance with the invention may be symptomatic or prophylactic. Having regard to their antimuscarinic activity, the agents of the invention are useful in the relaxation of bronchial smooth muscle and the relief of bronchoconstriction. Relief of bronchoconstriction can be measured in models such as the in vivo plethysmography models of Chong et al, J. Pharmacol. Toxicol. Methods 1998, 39, 163, Hammelmann et al, Am. J. Respir. Crit. Care Med., 1997, 156, 766 and analogous models. The agents of the invention are therefore useful in the treatment of obstructive or inflammatory airways diseases. In view of their long duration of action, it is possible to administer the agents of the invention once-a day in the treatment of such diseases. In another aspect, agents of the invention commonly exhibit characteristics indicating a low incidence of side effects commonly encountered with 02 WO 2004/096800 PCT/EP2004/004605 20 agonists such as tachycardia, tremor and restlessness, such agents accordingly being suitable for use in on demand (rescue) treatment as well as prophylactic treatment of obstructive or inflammatory airways diseases. Inflammatory or obstructive airways diseases to which the present invention is applicable include asthma of whatever type or genesis including both intrinsic (non-allergic) asthma and extrinsic (allergic) asthma. Treatment of asthma is also to be understood as embracing treatment of subjects, e.g. of less than 4 or S years of age, exhibiting wheezing symptoms and diagnosed or diagnosable as "wheezy infants", an established patient category of major medical concern and now often identified as incipient or early-phase asthmatics. (For convenience this particular asthmatic condition is referred to as "wheezy-infant syndrome".) Prophylactic efficacy in the treatment of asthma will be evidenced by reduced frequency or severity of symptomatic attack, e.g. of acute asthmatic or bronchoconstrictor attack, improvement in lung function or improved airways hyperreactivity. It may further be evidenced by reduced requirement for other, symptomatic therapy, i.e. therapy for or intended to restrict or abort symptomatic attack when it occurs, for example anti-inflammatory (e.g. corticosteroid) or bronchodilatory. Prophylactic benefit in asthma may in particular be apparent in subjects prone to "morning dipping". "Morning dipping" is a recognised asthmatic syndrome, common to a substantial percentage of asthmatics and characterised by asthma attack, e.g. between the hours of about 4 to 6 am, i.e. at a time normally substantially distant from any previously administered symptomatic asthma therapy. Other inflammatory or obstructive airways diseases and conditions to which the present invention is applicable include adult/acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary or airways disease (COPD or COAD), including chronic bronchitis, or dyspnea associated therewith, emphysema, as well as exacerbation of airways hyperreactivity consequent to other drug therapy, in particular other inhaled drug therapy. The invention is also applicable to the treatment of bronchitis of whatever type or genesis including, e.g., acute, arachidic, catarrhal, croupus, chronic or phthinoid bronchitis. Further inflammatory or obstructive airways diseases to which the present invention is applicable include pneumoconiosis (an inflammatory, commonly occupational, disease of the lungs, frequently accompanied by airways obstruction, whether chronic or acute, and occasioned by repeated inhalation of dusts) of whatever type or genesis, including, for example, aluminosis, anthracosis, asbestosis, chalicosis, ptilosis, siderosis, silicosis, tabacosis and byssinosis.

WO 2004/096800 PCT/EP2004/004605 21 Having regard to their antimuscarinic activity, the agents of the invention are also useful in the treatment of a condition requiring relaxation of smooth muscle of the uterus, bladder or vascular system. They are thus useful for the prevention or alleviation of premature labour pains in pregnancy. They are also useful in the treatment of chronic and acute urticaria, psoriasis, allergic conjunctivitis, actinitis, rhinitis including allergic rhinitis, mastocyrosis, urinary disorders such as urinary incontinence (particularly that caused by overactive bladder), pollakiuria, neurogenic or unstable bladder, cytospasm and chronic cystitis; gastrointestinal disorders such as irritable bowel syndrome, spastic colitis, diverticulitis and peptic ulceration; and cardiovascular disorders such as vagally induced sinus bradycardia, as well as in ophthalmic interventions. The agents of the invention are also useful as co-therapeutic agents for use in combination with other drug substances such as anti-inflammatory, bronchodilatory, antihistamine, decongestant or anti-tussive drug substances, particularly in the treatment of obstructive or inflammatory airways diseases such as those mentioned hereinbefore, for example as potentiators of therapeutic activity of such drugs or as a means of reducing required dosaging or potential side effects of such drugs. An agent of the invention may be mixed with one or more other drug substances in a fixed pharmaceutical composition or it may be administered separately, before, simultaneously with or after the other drug substance(s). Accordingly the invention includes a combination of an agent of the invention as hereinbefore described with an anti-inflammatory, bronchodilatory, antihistamine, decongestant or anti-tussive drug substance, said agent of the invention and said drug substance being in the same or different pharmaceutical composition. Such anti-inflammatory drugs include steroids, for example glucocorticosteroids such as budesonide, beclamethasone, fluticasone, ciclesonide or mometasone, or steroids described in WO 02/88167, WO 02/12266, WO 02/100879 or WO 02/00679, especially those of Examples 3, 11, 14, 17, 19, 26, 34, 37, 39, 51, 60, 67, 72, 73, 90, 99 and 101, and non-steroidal steroid agonists such as those described in WO 00/00531, WO 02/10143, WO 03/082280, WO 03/082787, WO 03/104195, WO 04/005229; LTB4 antagonists such as those described in US 5451700; LTD4 antagonists such as montelukast and zafirlukast; PDE4 inhibitors such as cilomilast (Ariflo@ GlaxoSmithKline), Roflumilast (Byk Gulden),V-11294A (Napp), BAY19 8004 (Bayer), SCH-351591 (Schering-Plough), Arofylline (Almirall Prodesfarma), PD189659 (Parke-Davis), AWD-12-281 (Asta Medica), CDC-801 (Celgene), SelCID(TM) CC-10004 (Celgene), KW-4490 (Kyowa Hakko Kogyo), WO 03/104204, WO 03/104205, WO 04/000814, WO 04/000839 and WO 04005258 (Merck), as well as those described in WO 98/18796 and WO 03/39544; A2a agonists such as those described in EP 1052264, EP 1241176, EP 409595A2, WO 94/17090, WO 96/02543, WO 96/02553, WO 98/28319, WO WO 2004/096800 PCT/EP2004/004605 22 99/24449, WO 99/24450, WO 99/24451, WO 99/38877, WO 99/41267, WO 99/67263, WO 99/67264, WO 99/67265, WO 99/67266, WO 00/23457, WO 00/77018, WO 00/78774, WO 01/23399, WO 01/27130, WO 01/27131, WO 01/60835, WO 01/94368, WO 02/00676, WO 02122630, WO 02/96462, and WO 03/086408; and A2b antagonists such as those described in WO 02/42298. The agents of the invention are useful in combination therapy with chemokine receptor antagonists, calcium channel blockers, alpha-adrenoceptor antagonists, dopamine agonists, endothelin antagonists, substance-P antagonists, S-LO inhibitors, VLA-4 antagonists and theophylline. The agents of the invention are also particularly useful as co-therapeutic agents for use in combination with beta-2 adrenoceptor agonists or corticosteroids. Suitable beta-2 adrenoceptor agonists include salbutamol, terbutaline, salmeterol and, especially, formoterol and pharmaceutically acceptable salts thereof, and compounds (in free or salt or solvate form) of formula I of WO 0075114, which document is incorporated herein by reference, preferably compounds of the Examples thereof, especially a compound of formula 0 HN

CH

3 HO

CH

3 HH OH and pharmaceutically acceptable salts thereof, as well as compounds (in free or salt or solvate form) of formula I of WO 04/16601. Co-therapeutic antihistamine drug substances include cetirizine hydrochloride, acetaminophen, clemastine fumarate, promethazine, loratidine, desloratidine, diphenhydramine and fexofenadine hydrochloride. Combinations of agents of the invention and one or more of beta-2 adrenoceptor agonists, steroids, PDE4 inhibitors, A2a agonists, A2b agonists and LTD4 antagonists may be used, for example, in the treatment of asthma but particularly COPD. In accordance with the foregoing, the present invention also provides a method for the treatment of an obstructive or inflammatory airways disease which comprises administering to WO 2004/096800 PCT/EP2004/004605 23 a subject, particularly a human subject, in need thereof a compound of formula I, or a pharmaceutically acceptable salt or solvate thereof, as hereinbefore described. In another aspect, the invention provides a compound of formula I, or a pharmaceutically acceptable salt or solvate thereof, as hereinbefore described for use in the preparation of a medicament for the treatment of an obstructive or inflammatory airways disease. The agents of the invention may be administered by any appropriate route, e.g. orally, for example in the form of a tablet or capsule; parenterally, for example intravenously; topically to the skin, for example in the treatment of psoriasis; intranasally, for example in the treatment of hay fever; or, preferably, by inhalation, particularly in the treatment of obstructive or inflammatory airways diseases. In particular, the agents of the invention may be delivered as an inhalable formulation for the treatment of COPD and asthma. In a further aspect, the invention also provides a pharmaceutical composition comprising a compound of formula I in free form or in the form of a pharmaceutically acceptable salt or solvate thereof, optionally together with a pharmaceutically acceptable diluent or carrier thereof. Such compositions may be prepared using conventional diluents or excipients and techniques known in the galenic art. Thus oral dosage forms may include tablets and capsules. Formulations for topical administration may take the form of creams, ointments, gels or transdermal delivery systems, e.g. patches. Compositions for inhalation may comprise aerosol or other atomizable formulations or dry powder formulations. When the composition comprises an aerosol formulation, it preferably contains, for example, a hydro-fluoro-alkane (HFA) propellant such as HFA134a or HFA227 or a mixture of these, and may contain one or more co-solvents known in the art such as ethanol (up to 20% by weight), and/or one or more surfactants such as oleic acid or sorbitan trioleate, and/or one or more bulking agents such as lactose. When the composition comprises a dry powder formulation, it preferably contains, for example, the compound of formula I having a particle diameter up to 10 microns, optionally together with a diluent or carrier, such as lactose, of the desired particle size distribution and a compound that helps to protect against product performance deterioration due to moisture. When the composition comprises a nebulised formulation, it preferably contains, for example, the compound of formula I either dissolved, or suspended, in a vehicle containing water, a co-solvent such as ethanol or propylene glycol and a stabiliser, which may be a surfactant.

WO 2004/096800 PCT/EP2004/004605 24 The invention also includes (A) a compound of formula I as hereinbefore described in free form, or a pharmaceutically acceptable salt or solvate thereof, in inhalable form; (B) an inhalable medicament comprising such a compound in inhalable form together with a pharmaceutically acceptable carrier in inhalable form; (C) a pharmaceutical product comprising such a compound in inhalable form in association with an inhalation device; and (D) an inhalation device containing such a compound in inhalable form. Dosages of agents of the invention employed in practising the present invention will of course vary depending, for example, on the particular condition to be treated, the effect desired and the mode of administration. In general, suitable daily dosages for administration by inhalation are of the order of 0.0001 to 30 mg/kg, typically 0.01 to 10 mg per patient, while for oral administration suitable daily doses are of the order of 0.01 to 100 mg/kg. The invention is illustrated by the following Examples. EXAMPLES Especially preferred compounds of formula I include compounds of formula XIV RI I R2 0 '- 1 I C R N XV R' where R', R 2 , R 3 , and R 4 are as shown in Table 1 below, the method of preparation being described hereinafter. All compounds are quaternary ammonium salts. The table also shows mass spectrometry data. TABLE 1 Ex. R 1 and R 3 R4 R2 M/s M+ 1 NHZ OH 395.4 WO 2004/096800 PCTIEP2004/004605 25 Ex. R 1 and R 3 R4 R 2 M/s M+ 2 OH 499.4 3 OH 549.5 H- NO2 H OH 524.5 H 6 0 OH 575.5 70 OH 564.5 0 OH 577.5 9 OH 500.4 99H "O.K 10 0 OH 533.4 9 0 OH 559.4 I O

H

2

C

WO 2004/096800 PCT/EP2004/004605 26 Ex. RI and R3 R4 R2 M/s M+ 12OH 533.4 HI 13 OH 527.4 N H H 14 0 F OH 567.4 N' F 1o OH 567.4 H FF 16 F F OH 567.4 OF HI 17 OH 559.5 18 OH 529.4

CH

3 19 p0 OH 529.4 _ _ _ _ CH __ _ 20 OH 557.5

H

3 C CH, WO 2004/096800 PCT/IEP2004/004605 27 Ex. R 1 and R 3 R R 2 M/s M+ 21 OH 559.5 H ___________CH3 CH, 22 0 OH 559.5 N ' H CNa O CH3 23 OH 524.4 24 OH 547.4 25 0 OH 524.4 N N H 26 OH 529.5 7 N ' H k

H

,

C_ 27 0 OH 500.4 H NJ 28 N0 OH 500.4 N 'N I~HI 29 0 OH 504.4 CH 3 WO 2004/096800 PCTIEP2004/004605 28 Ex. R 1 and R 3 R4 R 2 M/s 30 01H 505.7 H 31 014 519.7 H 32 0OH 491.7 H N OH 493.7 H CH, 34 0 OH 513.7 H 35 OH 527.7 36 OH 548.7 37 OH 505.7 379 H 38 OH 501.6 39 OH 539.7 40 0 OH 514.7 WO 2004/096800 PCTIEP2004/004605 29 Ex. R 1 and R 3 R4 R 2 M/s M+ 41 NO H1 N OH 514.7 H. _ _ H N 42 o . o- OH 544.6 H 43 OH 533.2 T H 44 C ~ OH 577.2 [I] ~CH, 45 N0 ~ OH 527.7 H " H,' H 46 0 OH 465.6 47 OH 514.4 48cH OH 584.3 49 OH 535.4 CH3 50 OH 485.4 H 51 OH 546.3 0F 52 OH 471.4 529

_

WO 2004/096800 PCT/EP2004/004605 30 Ex. R 1 and R 3 R4 R 2 M/s I M+ 53 OH 485.4 H 0 54 OH 376.3 CCH 55 OH 535.0 56 OH 390.3 CH, 57 OH 418.2 C C CH3 58 OH 452.2 9 OH 495.4 H,C CH, 60 OH 452

H

3 C

CH

3 61 OH 481 H CH,

H

3 C Ci 62 OH OH 396 63 C OH 567 N 0 ICHa

CH,

WO 2004/096800 PCT/EP2004/004605 31 Ex. R 1 and R 3 R4 R 2 M/s M+ 64 9HOH 404.2 65 CH 3 OH 535.2 0 66 OH 507.4 67 OH 500.4 68 OH 506.5 y _ _ 69 C CH OH 404.3 70

COH

3 OH 507.3 71 K OH 416.3 'clz--c CH 3 72 OH 519.4 73 OH 512.3 74 C OH 388.2 75 OH 497.1 0 WO 2004/096800 PCTIEP2004/004605 32 Ex. RI and R 3 R4 R2 M/s M+ 76 s H OH 483.3 77 s H H OH 518.4 0\ / N y N ,, 78 N OH 558.3 0 S F 79 C C OH 464.7 80 OH 475.2 81 OH 505.2 82 ci OH 539.2 83 9 OH 501.3 0 0 84 a OH 505.2 85 OH 449.3 N 86 N.-, OH 516.3 87 H OH 485.3 90 __ WO 2004/096800 PCT/EP2004/004605 33 Ex. R 1 and R 3 R4 R 2 M/s M+ 88 Cl OH 519.2 0 89 -. HOH 499.3 90 OH 511.3 91 OH 519.2 ",, H 0 92 cI OH 519.2 0 93 OH 535.3 0I 94 OH 520.3 0 95 Cl OH 553.2 N I ci 96 H OH 505.3 N 0 97 OH 491.3 0 98 CH3 OH 437.3 0 CH 99 CH3 OH 423.2 WO 2004/096800 PCT/EP2004/004605 34 Ex. R and R 3 R4 R2 M/s M+ 100 OH 449.2 101 H OH 437.3 -"Y N CH, 0 102 OH 477.3 103 OH 491.2 H 104 H OH 453.3 0

CH

3 105 CH 3 OH 499.3 106 OH 448.3 107 OH 578.3 ________________ ~H 2 Ng _______ _____ 108 OH 495.3 OHsC O CH, 109 0 F 474.3 110 C F 378.2 111 0 F 426.3 -, O)

CH,

WO 2004/096800 PCTIEP2004/004605 35 Ex RI and R3 R 4

R

2 M/s M+ 112 H OH 500.4 N No 113 C OH 402.3 114 c OH 430 115 OH 535.2 y1C1N OH 510.2 0c 117 Hc OH 513.3 118 OH 561.3 119 -N - OH 550.2 N 0 120 OH 563.2 o H~co ____ 121 OH 486.2 N 122 9 OH 519.2 WO 2004/096800 PCT/EP2004/004605 36 Ex. R 1 and R 3 R4 R 2 MIs I M+ 123 - CH, OH 545.2 '.CH: ___ __ ___ _A 0 _ _ _ _ _ 0 124 OH 519.2 I ~ N..Ci O 125

CH

3 OH 513.2 0 126 OH 553.2 F o F F 127 F OH 553.2 F O 128 OH 553.2 OF F 129 H0 CH, OH 545.2 H N o CH 3 130 0," OsCH3 OH 515.2 0 131 OH 515.2 OH3C' 1312 OH 545.2 132 9 OCH OH 543.2 N CH, WO 2004/096800 PCT/EP2004/004605 37 Ex. RI and R 3 R4 R2 M/s M+ 133 OH 545.2 OH3C O_ _ 134 OH 511.2 135 OH 515.3 o CH_ 136 OH 513.2 137 OH 491.3 138 OH 487.2 H T N 139 OH 525.2 140 OH 475.3 0 141 0- OH 520.2 142)0 O5. 142 N-0 ~ OH 525.3 0 - WO 2004/096800 PCT/EP2004/004605 38 Ex. RI and R 3 R4 R2 M/S M+ 143 sOH 491.3 0 144 H~NOH 488.3 N 145 H)C NC-N OH 503.3 0CH 3 146 OH 566.3 NN o CH, 147 S-N OH 507.2 N o CHS 148 N- OH 490.3 0 149 0 OH 489.3 o CH, 150 s OH 521.3 o ,0

H

3 C 151 s OH 535.3 0 CHa _ _ _ _ _ _ _ _ _ 2 CH OH 533.2 -0 WO 2004/096800 PCT/EP2004/004605 39 Ex. RI and R 3

R

4 R2 M/s M+ 153 S OH 525.2 o ci 154 S OH 569.2 o aBr 155 HC OH 503.3 0 / CH, 156 OH 555.2 III 0 H 0 157 CHS OH 503.3 N-N I / CH 3 158 9 OH 485.2 Preparation of Specific Examples Abbreviations used are as follows: DAST is diethylaminosulfur trifluoride, DCE is dichloro ethane, DCM is dichloromethane, DIPEA is diisopropylethylamine, DME is dimethoxyerhane, HATU is 0-(7-azabenzotriazol-1-yl)-N, N,-N', N'-tetramethyl-uronium hexafluorophophate, HPLC is High Performance Liquid Chromatography, Isolute CBA is propylcarboxylic acid, NBS is N-bromosuccinimide, PyBOP is benzorriazol-1-yloxytripyrrolidinophosphonium hexafluorophosphate and THF is retrahydrofuran. BEMP: 2-tert-Butylimin o-2-dierhylamino 1,3-dimethyl-perhydro-1,3,2-diazaphosphorine, polymer bound. In cases where purification is performed by C18 reverse phase column chromatography utilising trifluoroacetic acid as a component of the eluent, the composition of the resulting counter ion was not confirmed spectroscopically, and may indeed be a variable mixture of trifluoroacetate and the halide resulting from the quaternarisation reaction. Where HATU is used as a coupling agent the counter ion may also be hexa fluorophosphate.

WO 2004/096800 PCTIEP2004/004605 40 Example 1 (R)-1-(3-Amino-propyl)-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia-bicyclof2.2.2loctane (i) Bromide: To a stirred solution of hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-y) ester (Sg, 14.82 mmol) in DMF (40 ml) is added 3-aminopropyl bromide (pre-neutralised from 3 aminopropyl bromide hydrobromide using polymer supported diethyl amine) (6.47 g, 29.54 mmol). The reaction mixture is heated to 40 OC overnight and then concentrated in vacuo. The crude residue is diluted with acetonitrile and the resulting precipitate is filtered and redissolved in DMF (20 ml). Merrifield resin is added to this solution followed by potassium carbonate (20 mg, catalytic amount) and the reaction is stirred at 40 OC for 24 hours. The reaction mixture is filtered and acetonitrile is added to the filtrate. The resulting precipitate is filtered and dried in vacuo to yield the titled compound. (ii) Chloride: (a) (R)-1-(3-tert-Butoxycarbonylamino-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane bromide: Hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (1 g, 2.97 mmol) and 3 (BOC-amino) propylbromide (1.06 g, 4.73 mmol) are dissolved in DMF (10 ml) and stirred to 60 OC for 4 hours. The solvent is removed in vacuo and purification of the crude residue by chromatography on C1 8 silica, eluting with water: acetonitrile affords the title compound as a colourless foam. (b) (R)-1-(3-Amino-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane chloride hydrochloride: To a stirred solution of (R)-1-(3-tert-Butoxycarbonylamino-propyl)-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide [Example 1(ii)(a)] (1 g, 2.02 mmol) in dioxane (10 ml) at room temperature is added hydrochloric acid (1.5 ml, 4M aqueous solution). The reaction mixture is stirred for 16 hours and the solvent is removed in vacuo to yield the titled compound as a white solid. Example 2 (R)-1-(3-Benzoylamino-propyl)-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia-bicyclo(2.2.21 octane trifluoroacetare To a stirred solution of benzoic acid (0.012 g, 0.1 mmol) and HATU (0.038 g, 0.1 mmol) in DMF (0.5 ml) is added DIPEA (0.05 ml). The reaction mixture is left to stand at room WO 2004/096800 PCT/EP2004/004605 41 temperature for 15 minutes after which time, a solution comprising (R)-1-(3-amino-propyl)-3 (2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane chloride hydrochloride [Example 1(ii)] (0.047 g, 0.1 mmol) in DMF (0.5 ml) is added. The reaction mixture is stirred at room temperature for 30 minutes and the solvent is removed in vacuo. Purification by mass directed preparative HPLC eluding with acetonitrile: water: trifluoroacetic acid yields the titled compound as a colourless oil. Examples 3 to 46 These compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{3-[(naphthalene-2 carbonyl)-amino]-propylj- 1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[3-(4-Cyano benzoylamino)-propyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[3-(2,6-Dimethyl-benzoylamino)-propyl]-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-azonia-bicyclo-[2.2.2]octane trifluoroacetate, (R)-1-(3-[(Biphenyl-4-carbonyl) amino]-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoro acetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-(4-pyrrol-1-yl-benzoylamino)-propyl]-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-(3 methanesulfonyl-benzoyl-amino)-propyl]-1-azonia-bicyclo[2.2.2] octane trifluoroacetate, (R)-3 (2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-[(pyridine-3-carbonyl)-amino]-propyl)-1-azonia bicyclo-[2.2.2]octane trifluoro-acetate, (R)-1-[3-(4-Chloro-benzoylamino)-propyl]-3-(2 hydroxy-2,2-diphenyl-aceroxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[3-(3,S Dimethoxy-benzoylamino)-propyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2]octane trifluoroacetate, (R)-1-[3-(3-Chloro-benzoylamino)-propyl]-3-(2-hydroxy-2,2 diphenyl-aceroxy)-1-azonia-bicyclo[2.2.2]-octane trifluoroacetate, (R)-1-[3-(4-Ethyl-benzoyl amino)-propyl]-3 -(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo [2.2.2]octane trifluoro acetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-(3-trifluoromethyl-benzoylamino) propyl]-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1-[3-(4-trifluoromethyl-benzoyl-amino)-propyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-(2-trifluoromethyl-benzoyl amino)-propyl] -1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[3-(3,4-Dimethoxy benzoylamino)-propyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-aceroxy)-1-[3-(4-methoxy-benzoylamino) propyl]-1-azonia-bicyclo-[2.2.2]octane-trifluoro-acetate, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1-[3-(2-methoxy-benzoylamino)-propyl]-1-azonia-bicyclo[2.2.2]octane trifluoro acetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-(4-isopropoxy-benzoylamino)-propyl]-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[3-(2,4-Dimethoxy-benzoylamino)-propyl] 3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo-[2.2.2]octane trifluoroacetare, (R)-1-[3- WO 2004/096800 PCT/EP2004/004605 42 (2,3 -Di methoxy-benzoyl-ami no)-propyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo [2.2.2locrane trifluoro-acerare, (R) -1 -[3-(2-Cya no-benzoyl amino)- propyll.-3 -(2 -hydroxy-2,2 di phenyl-acetoxy)- 1-azonia- bicyclo[2.2.2] octane trifluoroacetate, (R)-1-[3-(3-Fluoro-4 methoxy-benzoylamino)-propylJ -3 -(2-hydroxy-2,2-diphenyl-acetoxy)-l1-azonia-bicyclo[2.2. 2] octane trifluoroacetate, (R)-1 -[3-(3-Cyano-benzoyl-amino)-propyll-3-(2-hydroxy-2,2-diphenyl aceroxy)- 1 -azoni a -bicyclo [2. 2. 2]octane trifluoroacerate, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)- 1 -[3- (3 -meth oxy-benzoylami no) -propyl ] -1 -azonia-bicyclo[12.2.21]octane trifluoro acetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 -(3-[(pyridine-2-carbonyI)-amino]-propyll.1 azonia-bicyclo[2.2.2]octane-trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-aceroxy)-1 -3 [ (pyridi ne-4-carbon yl)-a mino] -propyl) -1 -a zonia-bicyclo- [2.2.2] octane trifluoroacetate, (R)-3 (2-Hyd roxy-2,2-di phenyl-acetoxy)-1 -f 3-[(S-methyl-isoxazole- 3-carbon yl)-ami no] -propyl-l azonia-bicyclo[2.2.2l octane trifluoroacetate, (R)-l-[3-(Cyclohexanecarbonyl-amaino)-propyl].3 (2-h ydroxy-2,2- di phenyl-aceroxy) -1 -azonia-bicyclo- [2.2.2] octane trifluoroacetate, (R)-1 -[3 (Cycloheptanecarbonyl-ami no)-propyl] -3-(2-Iiydroxy-2,2-diphenyl-aceroxy)-l1-azonia-bicyclo [2.2.2]octane trifluoroacetate, (R)-l-[3-(Cyclopentane-carbonyl-amino)-propyl]-3-(2-hydroxy 2,2 -di pbenyl-acetoxy) -1 -azonia-bicyclo[12.2.21]octane trifluoroacetate, (R)-1-[3-(3,3-Dimethyl bu tyryl amino)-p ropyl] -3-(2-hydroxy-2,2-diphen yl-acetoxy)-l -azon ia-bicyclo [2 .2.2] octane trifl uoro acetate, (R) -3 -(2-Hydroxy-2,2-di phenyl-acetoxy)- 1 -(3 -phenylacetyl amino- propyl)- 1 azonia-bicyclo [2.2.21Joctane trifluoroacerare, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[3-(3 phenyl-propionylamino)-propyll-azonia-bicyclo-[2.2.2loctane trifluoroacetate, (R)-1 -(3-[( 1 Acetyl -pi peri dine-4-ca rbonyl) -amino] -propyl) -3-(2-hydroxy-2,2-di phenyl-acetoxy) -1 -azoni a bicyclo[2.2.2J octane trifluoroacetate, (R)-l-[3-(2-Cyclopenryl-acetylamino)-propyl]-3-(2 hydroxy-2,2-diphenyl-aceroxy)-1 -azonia-bicyclo[2.2.2]-octane trifluoroacetate, (R)-3-(2 Hydroxy-2,2-diphenyl-acetoxy)-1 -13-[(pyrazine-2-carbonyl)-aminol-propyl)-1 -azonia-bicyclo [2.2.2]octane trifluoroacerate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 -(3-[(indane-2 carbonyl)-ami no] -prop yl)- 1 -azoni a-bicyclo [2.2.2]ocrane trifluoroacerare, (R)-3-(2-Hydroxy 2,2-diphenyl-acetoxy)-1 -[3-(2-pyridin-2-yl-acerylamino)-propyl] -1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 -( 3-[(2-methyl-pyridi ne-3-carbonyl) amino]-propyl) -1-azoni a-bicyclo [2.2.2] octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy) -1-[3-(2-nirro-benzoylamino)-propyl] -1-azonia-bicyclo[2.2.2]octane rri fluoroacerate, (R)-1 -[3-(2-Chloro-benzoylamino)-propyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-l1-azonia bicyclo [2.2.21Joctane trifluoroacerare, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-l1-[3-(2 merhanesul fonyl- benzoylami no) -propyl ]-1 -azonia-bicyclo [2.2.21]-octane tnfluoroacerate, (R)-1. [3 -( 3 ,5-Dimerhyl-benzoylamino)-propyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)- -azoni a-bicyclo 12.2.2loctane trifluoroacetate and (R)-3-(2-Hydroxy-2,2-diphenyl-aceroxy)-1 -(3-isoburyryl amino-propyl)- 1-azonia-bicyclo[2.2.21 octane trifluoroacerate respectively, are all prepared by WO 2004/096800 PCT/EP2004/004605 43 the procedure of Example 2 from (R)-1-(3-Amino-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy) 1-azonia-bicyclo[2.2.2]octane chloride [Example 1(ii)] and the appropriate acid. Example 47 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-[3-(3-phenyl-ureido)-propyll-1-azonia-bicyclo 12.2.2]octane trifluoroacetate To a solution comprising (R)-1-(3-amino-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2]octane chloride [Example 1(ii)] (0.023 g, 0.05 mmol) and DIPEA (0.025 ml) in DMF (0.25 ml) is added phenyl isocyanate (0.006 ml). The reaction mixture is left to stand at room temperature overnight. Purification using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid affords the titled compound. Example 48 (R)-1-3-[3-(4-Butyl-2-methyl-phenyl)-ureidol-propyll-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1 azonia-bicyclof2.2.2]octane trifluoroacetate This compound is made via an analogous procedure to (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1 -[3-(3-phenyl-ureido)-propyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate (Example 47) by replacing phenyl isocyanate with 4-butyl-1-isocyanato-2-methyl-benzene. Example 49 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-[2-(toluene-4-sulfonylamino)-ethyll-1-azonia bicyclo[2.2.2loctane trifluoroacetate (i) (R)-1-(2-tert-Butoxycarbonylamino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicydo[2.2.2]octane bromide: To a stirred suspension of hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (2.5 g, 7.42 mmol) in DMF (SO ml) under an atmosphere of argon is added (2-Bromo-ethyl) carbamic acid tert-butyl ester (2.5 g, 11.16 mmol). The reaction mixture is heated to 60 oC overnight and then the solvent is removed in vacuo to yield a brown oil which is used crude in the next step. (ii) (R)-1-(2-Amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide hydrobromide: To a stirred suspension of (R)-1-(2-tert-butoxycarbonylamino-ethyl)-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide (0.5 g, 1.04 mmol) in dioxane (25 WO 2004/096800 PCTIEP2004/004605 44 ml) is added hydrogen bromide solution in dioxane (1 ml, prepared by bubbling HBr gas through dry, cooled dioxane). The reaction mixture is stirred at room temperature overnight. The solvent is removed in vacuo and purification of the crude residue by chromatography on C1 8 silica, eluting with water: acetonitrile affords the title compound as a brown solid. (iii) (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[2-(toluene-4-sulfonylamino)-ethyl]-1-azonia bicyclo[2.2.2]octane trifluoroacetate: A solution comprising (R)-1-(2-amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane bromide hydrobromide [Example 50(ii)] (0.032 g, 0.059 mmol) p toluenesulfonyl chloride (0.011 g, 0.059 mmol) and DIPEA (0.041 ml, 0.236 mmol) in DMF (0.5 ml) is allowed to stir at room temperature for 66 hours. Purification using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroaceric acid affords the titled compound. Example 50 (R)-1-(2-Benzoylamino-ethyl)-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2,21 octane bromide (i) (R)-1-(2-tert-Butoxycarbonylamino-ethyl)-3-(2-hydroxy-2,2-dipheny-acetoxy)-1-azonia bicyclo[2.2.2]octane bromide: To a stirred suspension of hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (2.5 g, 7.42 mmol) in DMF (50 ml) under an atmosphere of argon is added (2-Bromo-ethyl) carbamic acid tert-butyl ester (2.5 g, 11.16 mmol). The reaction mixture is heated to 60 OC overnight and then the solvent is removed in vacuo to yield a brown oil which is used crude in the next step. (ii) (R)-1 -(2-Amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide hydrobromide: To a stirred suspension of (R)-1-(2-tert-butoxycarbonylamino-ethyl)-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide (0.5 g, 1.04 mmol) in dioxane (25 ml) is added hydrogen bromide solution in dioxane (1 ml, prepared by bubbling HBr gas through dry, cooled dioxane). The reaction mixture is stirred at room temperature overnight. The solvent is removed in vacuo and purification of the crude residue by chromatography on C18 silica, eluting with water: acetonitrile affords the title compound as a brown solid.

WO 2004/096800 PCT/EP2004/004605 45 (iii) (R)-1-(2-Benzoylamino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyco[2.2.2] octane bromide: To a stirred suspension of (R)-1-(2-Amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane bromide hydrobromide [50(ii)] (0.28 g, 0.517 mmol) in DCM at 0 0 C is added triethylamine (0.216 ml, 1.552 mmol) followed by benzoyl bromide (0.122 ml, 1.03 mmol). The reaction mixture is stirred at 0 0 C for 1.5 hours and the solvent was removed in vacuo. Purification of the crude residue by chromatography on C18 silica, eluting with water: acetonitrile affords the title compound. Example 51 (R)-1-[(S-Fluoro-benzothiazol-2-vlcarbamoyl)-methyll-3-(2-hydroxy-2,2-diphenl-acetoxy)-1 azonia-bicyclo[2.2.2loctane trifluoroacetate Hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.050 g, 0.148 mmol), 2 Bromo-N-(5-fluoro-benzothiazol-2-yl)-acetamide (0.064 g, 0.222 mmol) and potassium carbonate (0.01 g, catalytic quantity) are added to DMSO (0.5 ml) and stirred together at 40 OC overnight. Purification using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid affords the titled compound. Example 52 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-phenylcarbamoylmethyl-1-azonia bicyclo[2.2.2loctane (i) Trifluoroacetate: To a sealed vial containing hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.020 g, 0.059 mmol in DMSO) is added 2-chloro-N-phenyl-acetamide (0.030 g, 0.177 mmol in methylene chloride. The reaction mixture is stirred at room temperature overnight and purification using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid affords the titled compound. (ii) Chloride: Hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.2 g, 0.593 mmol) and 2-chloro-N-phenyl-acetamide (0.12 g, 0.89 mmol) are added to DMSO (2 ml) and stirred at 400C overnight. The solvent in removed in vacuo and purification by chromatography on C18 silica eluding with water: acetonitrile yields the titled compound as a chloride salt. Example 53 WO 2004/096800 PCTIEP2004/004605 46 (R)-1 -(Benzylcarbamoyl-methyl)-3-(2-hydroxy-2.2-diphenyl-aceroxy)-1 -azonia-bicyclo[2.2.21 octane trifluoroacetate The title compound is made via an analogous procedure to(R)-3-(2-Hydroxy-2,2-diphenyl acetoxy) -1 -phenylcarbamoyl methyl-1-azonia-bicyclo[2.2.21 octane chloride [Example 52 (ii)] by replacing 2-chloro-N-phenyl-acetamide with 3-chloro-N-phenyl-propionamide. Examples 54 to 58 These compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-prop-2-ynyl-1-azonia bicyclo[2.2.2]octane trifluoroacetate, (R)-1-(3-Benzenesulfonylamino-propyl)-3-(2-hydroxy 2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-But-2-ynyl-3-(2 hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-Hex-2 ynyl-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2] octane trifluoroacetate, and (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(3-phenyl-prop-2-ynyl)-1-azonia-bicyclo[2.2.2] octane trifluoroacerate are prepared made via an analogous procedure to (R)-3-(2-Hydroxy 2,2-diphenyl-acetoxy)- 1 -phenylcarbamoylmethyl-1 -azonia-bicydo[2.2.2]octane trifluoroacetate [Example 52 (i)] by replacing 2-chloro-N-phenyl-acetamide with the appropriate alkyl halide. Example 59 (R)-1-(3-tert-Butoxycarbonylamino-propyl)-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2loctane bromide Preparation of this compound is described in Example 1(ii)(a). Example 60 (R)-1-tert-Butoxycarbonylmethyl-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia-bicyclo(2.2.21 octane bromide To a solution comprising hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.2 g, 0.593 mmol) in dry chloroform (5 ml) is added t-butylbromoacetate (0.438 ml, 2.96 mmol). The reaction mixture is left to stand at room temperature overnight. The solvent is removed in vacuo and purification of the crude residue by chromatography on C18 silica, eluting with water : acetonitrile affords the title compound as a white solid. Example 61 (R)-1-(2-tert-Buroxycarbonylamino-erhyl)-3-(2-hydroxy-2.2-diphenyl-aceroxy)-1-azonia bicyclo[2.2.2]octane bromide WO 2004/096800 PCT/EP2004/004605 47 The title compound is made via an analogous procedure to (R)-1-tert-buroxycarbonylmethyl-3 (2-hydroxy-2,2-diphenyl-aceroxy)-1-azonia-bicyclo[2.2.2]octane bromide (Example 60) by replacing t-butylbromoacetate with (2-bromo-ethyl)-carbamic acid tert-butyl ester. Example 62 (R)-1-Carboxymethyl-3-(2-hydroxy-2. 2-diphenyl-acetoxyI-1 -azonia-bicyclo[2.2.21-octane trifluoroacetate To a stirred solution of (R)-1-tert-Butoxycarbonylmethyl-3-(2-hydroxy-2,2-diphenyl-acetoxy) 1-azonia-bicyclo[2.2.2]octane bromide (Example 60) (0.14 g, 0.264 mmol) in chloroform (5 ml) is added trifluoroacetic acid (1 ml). The reaction mixture is left to stir at room temperature overnight. The solvent is removed in vacuo and purification of the residue by chromatography on C18 silica, eluting with water: acetonitrile affords the titled compound as a white solid. Example 63 (R)-1-[(5.6-Diethyl-indan-2-ylcarbamoyl)-methyll-3-(2-hydroxy-2.2-diphenvl-acetoxy)-1 azonia-bicyclo[2.2.2loctane trifluoroacetate To a stirred suspension of (R)-1-carboxymethyl-3-(2-hydroxy-2, 2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane trifluoroacetate [Ex. 62] (0.052 g, 0.102 mmol) in dry DMF (5 ml) is added DIPEA (0.070 ml, 0.408 mmol), HATU (0.097 g, 0.255 mmol) and 5,6-Diethyl-indan-2 ylamine hydrochloride (0.058 g, 0.255 mmol). The mixture is left to stir at room temperature overnight. The solvent is removed in vacuo and purification by mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid yields the titled compound. Alternatively, to a stirred suspension of (R)-1-carboxymethyl-3-(2-hydroxy-2, 2-diphenyl acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate [Ex. 62] (0.052 g, 0.102 mmol) in dry DMF (5 ml) is added DIPEA (0.053 ml, 0.306 mmol), HATU (0.058 g, 0.153 mmol) and 5,6 Diethyl-indan-2-ylamine hydrochloride (0.035 g, 0.153 mmol). The mixture is left to stir at room temperature overnight. The solvent is removed in vacuo and purification by mass directed preparative HPLC eluring with acetonitrile: water: trifluoroacetic acid yields the titled compound. Example 64 (RI-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-pent-4-ynyl-1-azonia-bicyclo[2.2.2]octane trifluoroacetate Hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.02 g, 0.059 mmol), 5 chloro-pent-1-yne (0.0073 g, 0.071 mmol), sodium iodide (0.009 g, catalytic amount) and WO 2004/096800 PCT/EP2004/004605 48 potassium carbonate (0.009 g, catalytic amount) are added to acetonitrile (0.5 ml) and stirred together at 9 hours. Purification is carried out using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid. Further purification is carried out by heating the resulting product in Merrifield resin in acetonitrile at 80 OC for 6 hours. The mixture is allowed to cool to room temperature and then filtered. The filtrate is concentrated in vacuo to yield the titled product as an oil. Example 65 (R)-1-[3-(1.3-Dioxo-1.3-dihydro-isoindol-2-yl)-prop-2-ynyll-3-(2-hydroxy-2.2-diphenyl acetoxyl-1-azonia-bicyclo[2.2.2]octane trifluoroacetate The title compound is made via an analogous procedure to(R)-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-pent-4-ynyl- 1 -azonia-bicyclo[2.2.2] octane trifluoroacetate (Example 64) by replacing 5-chloro-pent-1-yne with 2-(3-Chloro-prop-1-ynyl)-isoindole-1,3-dione, acetonitrile with DMSO and not adding poptassium carbonate. Examples 66 to 69 These compounds, namely (R)-1-(2-Cyclohexylcarbamoyloxy-ethyl)-3-(2-hydroxy-2,2 diphenyl-acetoxy)- 1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-[2-(3-phenyl-ureido)-ethyl]-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[2-(3-Cyclohexyl-ureido)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2]octane trifluoroacetate and (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-pent-2-ynyl-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, are all prepared made via an analogous procedure to (R)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-pent-4-ynyl-1-azonia-bicyclo[2.2.2]-octane trifluoroacetate (Example 64) by replacing acetonitrile with DMSO and S-chloro-pent-1-yne with the appropriate alkyl halide. Example 70 (R)-1-(3-tert-Butoxycarbonylamino-propyl)-3-(2-hydroxy-2.2-di-thiophen-2-YI-aceoxv)-1 azonia-bicyclof2.2.2loctane bromide (i) Hydroxy-di-thiophen-2-yl-acetic acid methyl ester: Potassium hydroxide (100 ml, 1.25 M solution) is added to 2,2'-thenil (Ubichem) at room temperature and the reaction mixture is heated to reflux for 4 hours and then cooled to room temperature. The solution is acidified to pH2 and extracted with ethyl acetate (3 x 100 ml). The combined organic portions are washed with water (100 ml), dried over Na2SO 4 and cooled to 0OC. TMS-diazomerhane (20 ml of a 2M solution in hexanes) is added dropwise and the WO 2004/096800 PCTIEP2004/004605 49 mixture is allowed to warm to room temperature. Acetic acid (4 ml) is added and the reaction mixture is left at room temperature overnight. The solvent is removed in vacuo and the crude product is dried and triturated with hexane to yield the titled compound as a brown amorphous solid. (ii) Hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester: To a flask containing sodium metal (0.018 g, 0.786 mmol) under an atmosphere of argon was added a suspension comprising hydroxy-di-thiophen-2-yl-acetic acid methyl ester [Example 70 (i)](0.2 g, 0.786 mmol) and (R)-1-Aza-bicyclo[2.2.2]octan-3-ol (0.149 g, 1.179 mmol) in toluene (3 ml). The reaction mixture was stirred under the inert atmosphere at 85 OC for 4 hours and the solvent was removed in vacuo. The resulting crude residue was dissolved in DCM and washed with saturated sodium bicarbonate solution. The organic portion was dried over MgSO4 and concentrated in vacuo to yield a brown oil. Trituration with acetonitrile affords the titled compound. (iii) (R)-1-(3-tert-Butoxycarbonylamino-propyl)-3-(2-hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1 azonia-bicyclo[2.2.2]octane bromide: Hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.758 g, 2.17 mmol) and 3(BOC-amino) propylbromide (0.775 g, 3.25 mmol) are dissolved in DMF (7 ml) and heated at 60 OC for 2.5 hours. The solvent is removed in vacuo and purification of the crude residue by chromatography on C18 silica, eluting with water: acetonitrile affords the titled compound as an oil. Examples 71 to 75 These compounds, namely (R)-3-(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-pent-2-ynyl-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-(2-Cyclohexylcarbamoyloxy-ethyl)-3-(2 hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-di-thiophen-2-y-acetoxy)-1-[2-(3-pheny-ureido)-ethyl]-1-azonia bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1 -prop 2-ynyl-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate and (R)-1-(Benzylcarbamoyl-methyl)-3 (2-hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate are all made via an analogous procedure to(R)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-pent-4-ynyl-1 azonia-bicyclo[2.2.2]-octane trifluoro-acetate (Example 64) by replacing hydroxy-diphenyl acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yI) ester with hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo-[2.2.2]oct-3-yl) ester (Example 70(ii)), by replacing acetonitrile with DMSO and by replacing 5-chloro-pent-1-yne with the appropriate alkyl halide.

WO 2004/096800 PCT/EP2004/004605 50 Alternative preparation of the compound of Example 71 as a bromide salt: A solution of 1-bromo-2-pentyne (0.51 g, 3.44 mmol) in chloroform (2 ml) is treated with polymer supported TEA resin. After a few minutes this solution is added to a solution of hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo-[2.2.2]oct-3-y) ester (Example 70(ii)) (1.0 g, 2.87 mmol) in chloroform (2ml). The resulting mixture is heated to 500C for 18h and the mixture allowed to cool to room temperature. A white solid is isolated by filtration, washed with chloroform and dried. Recrystallisation from chloroform-acetonitrile, washing the resultant solid with cold acetonitrile, and drying under vacuum gives (R)-3-(2-Hydroxy 2,2-di-thiophen-2-yl-acetoxy)- 1-pent-2-ynyl-1 -azonia-bicyclo[2.2.2] octane bromide. Example 76 (R)-3-(2-Hydroxy-2.2-di-thiophen-2-vl-acetoxy)-1-phenylcarbamoylmethyl-1-azonia bicyclo[2.2.21octane trifluoroacetate Hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (Example 70(ii)) (0.03 g, 0.0857 mmol), 2-chloro-N-phenyl-acetamide (0.0218 g, 0.129 mmol), sodium iodide (0.0026 g, catalytic amount) and potassium carbonate (0.0026 g, catalytic amount) are added to DMSO (1 ml) and heated to 40 OC overnight. The solvent is then removed in vacuo and purification is carried out using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid. Further purification is required and is carried by chromatography on C18 silica, eluting with water: acetonitrile to afford the titled compound. Examples 77 to 79 These compounds, namely (R)-1 -[2-(3-Cyclohexyl-urei do)-ethyl] -3-(2-hydroxy-2,2-di thiophen-2-yl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(5-Fluoro benzothiazol-2-ylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-azonia bicyclo[2.2.2]octane trifluoroacetate and (R)-3-(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-(3 phenyl-prop-2-ynyl)- 1 -azoni a- bicyclo[2.2.2]octane trifluoroacetate are all prepared by an analogous procedure to (R)-3-(2-hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-phenylcarbamoyl methyl-I-azonia-bicyclo[2.2.2]octane trifluoroacetate (Example 76) by replacing 2-chloro-N phenyl-acetamide with the appropriate alkyl halide. Example 80 (R)-1-{ [(Furan-2-ylmethyl)-carbamoylI-methyl)-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.21octane trifluoroacetate To a solution of (R)-1-carboxymethyl-3-(2-hydroxy-2, 2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2]octane trifluoroacetate [Example 62] (0.04 g, 0.078 mmol) in DCM (0.5 ml) is added WO 2004/096800 PCT/EP2004/004605 51 DIPEA (0.056 ml) and C-furan-2-yl-methylamine (0.056 ml, 0.634 mmol) followed by PyBOP (0.055 g, 0.106 mmol) in DMF (1 ml). The reaction mixture is left to stir at room temperature over 48 hours. Initial purification is carried out using Solid Phase Extraction with a pH 8 pre conditioned column (pH adjusted using Isolute CBA) . Further purification is carried out using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid to afford the titled compound. Alterbatively, to a solution of (R)-1-carboxymethyl-3-(2-hydroxy-2, 2-diphenyl-acetoxy)-1 azonia-bicyclo-[2.2.2]octane trifluoroacetate [Example 62] (0.04 g, 0.078 mmol) in DCM (0.5 ml) is added DIPEA (0.056 ml) and C-furan-2-yl-methylamine (0.021 ml, 0.234 mmol) followed by PyBroP (0.055 g, 0.118 mmol) in DMF (1 ml). The reaction mixture is left to stir at room temperature over 48 hours. Initial purification is carried out using Solid Phase Extraction with a pH 8 pre-conditioned column (pH adjusted using Isolute CBA) . Further purification is carried out using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid to afford the titled compound. Examples 81 to 108 These compounds, namely (R)-1-[(4-Chloro-phenylcarbamoyl)-methyl]-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(3,4-Dichloro-phenyl carbamoyl)-methyl]-3 -(2-hydroxy-2,2-diphenyl-aceroxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(4-methoxy-phenylcarbamoyl) methyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(3-Chloro-phenylcarbamoyl) methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(2-Chloro-phenylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane trifluoroacerate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(4-nitro phenylcarbamoyl)-methyl] -1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy 2,2-diphenyl-acetoxy) -1 -(o-tolylcarbamoyl-methyl)-1 -azonia-bicyclo[2.2.2]octane trifluoro acetate, (R)-1-[(4-Chloro-benzylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 (phenethylcarbamoyl-methyl)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2 Hydroxy-2,2-diphenyl-acetoxy)-1 -(indan-2-ylcarbamoylmethyl)-1 -azonia-bicyclo[2.2.2] octane trifluoroacetate, (R)-1-[(3-Chloro-benzylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(2-Chloro-benzylcarbamoyl) methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate,(R) 3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-([(naphthalen-1-ylmethyl)-carbamoyl]-methyll-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{[3-(2- WO 2004/096800 PCT/EP2004/004605 52 oxo-pyrrolidin- 1-yl)-propylcarbamoyl]-methyl}- 1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1 -[(3,4-Dichloro-benzylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(2-thiophen 2-yl-ethylcarbamoyl)-methyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(Cyclo hexylmethyl-carbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2] octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(isopropylcarbamoyl methyl)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-Ethylcarbamoylmethyl-3-(2 hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(Cyclo propylmethyl-carbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2] octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-propylcarbamoylmeth yl-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-Cyclohexylcarbamoylmethyl-3-(2-hydroxy 2,2-diphenyl-acetoxy)-1 -azonia-bicyclo [2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-{[(thiophen-2-ylmethyl)-carbamoyl]-methyl}-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(2-methoxy-ethylcarbamoyl) methyl]-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1 -[(4-methyl-benzylcarbamoyl)-methyl]-1-azonia-bicyclo[2.2.2] octane trifluoro acetate, (R)-1-[(2-Cyano-ethylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2] octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{[2-(4 sulfamoyl -phenyl)-ethylcarbamoyl] -methyl) -1 -azonia-bicyclo[2.2.2]octane trifluoroacetate and (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(3-isopropoxy-propylcarbamoyl)-methyl]-1-azonia bicyclo[2.2.2] octane trifluoroacetate are all prepared by an analogous procedure to (R)-1 ([(furan-2-ylmethyl)-carbamoyl]-methyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]-octane trifluoroacetate (Example 80) ) by replacing C-furan-2-yl-methylamine with the appropriate amine. Example 109 (R)-3-(2-Fluoro-2,2-diphenyl-acetoxy)-1-phenoxycarbonylmerhyl-1-azonia-bicyclo[2.2.21 octane bromide (i) Fluoro-diphenyl-aceric acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester: To a cooled (0 OC), stirred solution of DAST (0.101 ml, 0.826 mmol) in DCM (0.5 ml) under an atmosphere of argon is added, dropwise over 10 minutes, a suspension of hydroxydiphenyl acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.209 g, 0.62 mmol) in DCM (10 ml). The reaction mixture is stirred at 0 OC for 1 hour after which time water (5 ml) is added dropwise followed by sodium hydrogen carbonate solution (3 ml, 10%w/w NaHCO 3 ) to adjust the pH of the solution to pH8. The reaction mixture is diluted with DCM (10 ml) and the organic WO 2004/096800 PCTEP2004/004605 53 portion is separated. The aqueous layer is extracted with DCM (10 ml) and the organic portions are combined, dried over MgSO 4 and concentrated in vacuo. Purification of the crude residue is carried by chromatography on silica, eluting with DCM: methanol to yield the titled compound as a brown oil. (ii) (R)-3-(2-Fluoro-2,2-diphenyl-acetoxy)-1-phenoxycarbonylmethyl-1-azonia-bicyclo[2.2.2] octane bromide: To a solution of fluoro-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester [Example 109(i)] (0.034 g, 0.1 mmol) in DMSO (0.25 ml) is added bromo-acetic acid phenyl ester (0.071 ml, 0.5 mmol). The reaction mixture is left standing at room temperature overnight. Purification is carried out by chromatography on C18 silica, eluding with water: acetonitrile to yield the titled compound as a colourless oil. Examples 110 and 111 These compounds, namely (R)-3-(2-Fluoro-2,2-diphenyl-acetoxy)-1-prop-2-ynyl-1-azonia bicyclo [2.2.2]octane bromide and (R)-1-(2-Acetoxy-ethyl)-3-(2-fluoro-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2]octane bromide are prepared by an analogous method to (R)-3-(2-fluoro 2,2-diphenyl-acetoxy)-1-phenoxycarbonylmethyl-I-azonia-bicyclo[2.2.2]octane bromide (Example 109) by replacing bromo-acetic acid phenyl ester with the appropriate alkyl halide. Example 112 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy-1-[2-(3-phenyl-ureido)-ethyll-1-azonia-bicyclor2.2.21 octane trifluoroacetate This compound is made analogously to (R)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-[2-(toluene 4-sulfonylamino)-ethyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate (Example 49) by replacing p-toluenesulfonyl chloride with phenyl isocyanate. Example 113 (R)- 1 -But-2-ynyl-3-(2-hydroxy-2.2-di-thiophen-2-yl-acetoxy)-1 -azonia-bicyclo[2.2.2] octane trifluoroacetate This compound is made analogously to (R)-3-(2-hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1 phenylcarbamoylmethyl-1-azonia-bicyclo[2.2.2]octane trifluoroacetate (Example 76) by replacing 2-chloro-N-phenyl-acetamide with the appropriate alkyl halide. Example 114 WO 2004/096800 PCT/EP2004/004605 54 (R)-1 -Hex-2-ynyl-3 -(2-hydroxy-2,2-di-thiochen-2-yl-acetoxy)-1 -azonia-bicycloi2.2.21octane trifluoroacetate A stirred solution comprising hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2] oct-3-yl) ester (Example 70(ii)) (0.03 g, 0.086 mmol), 1-bromo-2-hexyne (0.021 g, 0.0129 mmol), potassium carbonate (0.002 g, catalytic amount) in acetonitrile (0.5 ml) is heated to 500 C overnight. The solvent is removed in vacuo and purification by mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid yields the titled compound. Example 115 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-{2-[(naphthalene-2-carbonl)-aminol-erhyll-1 azonia-bicyclor2.2.21octane trifluoroacetate To a solution of naphthalene-2-carboxylic acid (0.019 g, 0.113 mmol) in DMF (0.28 ml) is added diisopropylethylamine (0.02 ml, 0.113 mmol) in DMF (1 ml) followed by HATU (0.043 g, 0.113 mmol) in DMF (0.28 ml). The reaction mixture is allowed to stand for 20 minutes after which time a solution comprising (R)-1-(2-amino-ethyl)-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide hydrobromide [Example 49(ii)] (0.051 g, 0.113 mmol) and diisopropylethylamine (0.02 ml, 0.113 mmol) in DMF (0.57 ml) is added. The reaction mixture is allowed to stand at room temperature over night. Initial purification is carried out using Solid Phase Extraction with a 1 g Isolute ALB cartridge. Further purification is carried out using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid to afford the titled compound. Examples 116 to 157 These compounds, namely (R)-1-[2-(4-Cyano-benzoylamino)-ethyl]-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[2-(2,6-Dimethyl benzoylamino)-ethyl]-3-(2- hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-(2-[(Biphenyl-4-carbonyl)-aminol-ethyl)-3-(2-hydroxy-2,2-diphenyl acetoxy)-1 -azonia-bicyclo[2.2.2] octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1-[2-(4-pyrrol-1-yl-benzoylamino)-erhyl]-1 -azonia-bicyclo[2.2.2]octane trifluoro acetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 -[2-(3-methanesulfonyl-benzoylamino) ethyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy) 1-(2-[(pyridine-3-carbonyl)-amino]-ethyl)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1 [2-(4-Chloro-benzoylamino)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo [2.2.2]octane trifluoroacetate, (R)-1-[2-(3,S-Dimethoxy-benzoylamino)-ethyl]-3-(2-hydroxy 2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[2-(3-Chloro- WO 2004/096800 PCTJEP2004/004605 55 benzoylamino)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-l-azonia-bicyclo(2.2.2] octane trifluoroacetate, (R)-1- [2-(4-Ethyl-benzoylami no)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy). 1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-l-[2-(3 trifi uoromethyl-benzoylamino)-ethyl]-1-azonia-bicyclo[2.2.2joctane trifluoroacetare, (R)-3-(2 Hydroxy-2,2-diphenyl- acetoxy)-1 -[2-(4-trifluoromerhyl-benzoyl amino) -ethyl]- 1-azoni a-b icyclo I 2.2.2joctane trifi uoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-l1-[2-(2-trif] uoro methyl-b~enzoylamino)-ethyl]-1 -azonia-bicyclo[2.2.2]octane trifluoroacerate, (R)- t-12-(3,4 Dimerhoxy-benzoylamiino)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-l1-azonia-bicyclo[2.2.21. octane trifluoroacetate, (R)-3 -(2-Hydroxy-2,2-di phenyl-acetoxy)- 1 -[2-(4-methoxy- ben zoyl ami no)-ethyl j- 1 -azon ia-bicyclo[2.2.2] octane trifluoro acetate, (R)-3-(2-Hydroxy-2,2-diphenyl aceroxy)-l1-[2-(2-methoxy-benzoylamino)-ethyl] -1-azonia-bicyclo[2.2.2loctane trifluoroacerate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 -[2-(4-isopropoxy-benzoylamino)-ethyl]l--azonia bicyclo[2.2.2]ocrane trifluoroacetate, (R)-1-[2-(2,4-Dimethoxy-benzoylamino)-erhylj-3-(2 hydroxy-2,2-d iphenyl -aceroxy)- 1 -azoni a-bicyclo[2.2 .2] octane trifluoroacerate, (R) -1 -f2-(2 Cyan o-benzoyl amino) -ethyl] -3-(2 -hydroxy-2,2-diphenyl -acetoxy)- 1 -azonia- bicycl o[2.2.2 ] octane trifluoroacetare, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-l-[2-(3-methoxy-benzoyl amino) -ethyl ]- 1 -azonia-bicyclo[2.2.2l octane trifluoro acetate, (R)-3 -(2-Hydroxy-2,2-diphenyl acetoxy)- 1-[2-( 3-phenyl-propionylamino)-ethyl] -1-azonia-bicyclo [2.2.2]octane trifluoroacerate, (R)-1 -[2-(2-Cyclopentyl-acerylamino)-ethyl]-3 -(2-hydroxy-2,2-diphenyl-acetoxy)- 1-azonia bicyclo[2.2.21 octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1{2-[(pyrazi ne 2-carbonyl)-amino]-ethyl)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy 2,2-diphenyl-acetoxy)-l -f2 - [(in dane-2-carbonyl)-amino]-etbyl )-1 -azonia-bicyclol[2.2.21]octane tri fl uoro acetate, (R)-I -[2-(2-Carbamoyl-benzoylamino)-erhyl]-3-(2-hydroxy-2,2-dipheny acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetare and (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy) -1 -[2-(2- ni tro- benzoyla mi no) -ethyl] -1 -azonia-bicyclo[2.2.2 ]octane trifluoroacerare, (R)-3 -(2-Hydroxy-2,2 -di phenyl-acetoxy)-1 -[2-(2-pyridin-3 -yI-acetylami no) -ethyl] -1 -azon ia bicyclo[2.2.21 octane trifluoroacetate, (R)- 1 -2- [(Furan-3 -carbon yI)-ami no] -ethyl 1-3 -(2- hyd roxy 2,2-dip henyl-acetoxy)-l -azoniabicycl o[2.2.2] octane trifluoroacetare, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-12-[(S-nitro-furan-2-carbonyl)-amino-ethyl I- -azonia-bicyclo[2.2.2]octane tri fluoro acetate, (R)-3-(2-Hydroxy-2,2-dipbenyl-acetoxy)-l1 -2-[(11--indazole-3-carbonyl) amino]-erhyl }-1-azonia-bicyclo[2.2.2]ocrane trifluoroacerare, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1-{2-[(thiophene-3-carbonyl)-amino]-.ethyl)-1-azonia-bicyclo[2.2.2]ocrane trifluoroacetare, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-[(1 -merhyl-IH-pyrrole-2 carbonyl) -amino]-erhyl)- 1-azonia-bicyclo[2.2.2] octane trifluoroacerare, (R)-1 -12-[(2,S Dimethyl-2H-py razole- 3 -carbonyl) -a mino] -ethyl1-3 -(2-hyd roxy-2,2-diphenyl-acetoxy)- 1 -azon ia WO 2004/096800 PCTIEP2004/004605 56 -bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{2-[(5 methyl-2-phenyl-2H- [1,2,3]triazole-4-carbonyl)-amino]-ethylI-1 -azonia-bicyclo[2.2.

2 ]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-[(4-methyl-[1,2,3]thiadiazole- 5 carbonyl)-amino]-ethyl)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1 -(2- [(5-methyl-isoxazole-3-carbonyl)-amino] -ethyl)-1 -azonia-bicyclo [2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-[(3-methyl-furan 2-carbonyl)-amino]-ethyl)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy 2,2-diphen yl-acetoxy)-1 -{2- [(4-methoxy-thiophene-3 -carbonyl) -amino] -ethyl)- 1 -azonia-bicyclo [2.2.2joctane trifluoroacetate, (R)-1-(2-[(3-Ethoxy-thiophene-2-carbonyl)-amino-ethyl}-3-(2 hydroxy-2,2-diphenyl-acetoxy)- 1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-{2-[(5 Aceryl-thiophene-2-carbonyl)-amino]-ethyl) -3-(2-hydroxy-2,2-diphenyl-acetoxy)- 1 -azonia bicyclo[2.2.2]octane (R)-1 -(2-[(3-Chloro-thiophene-2-carbonyl)-amino]-ethyl)-3-(2-hydroxy 2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-(2-[(3-Bromo thiophene-2-carbonyl)-amino]-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2]octane trifluoroacetate, (R)-1-(2-[(2,5-Dimethyl-furan-3-carbonyl)-amino]-ethyl)-3-(2 hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-{2-[(5 Bromo-furan-2-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia bicyclo[2.2.2]octane trifluoroacetate, (R)-1-(2-[(1,5-Dimethyl-1H-pyrazole-3-carbonyl) amino]-ethyl }-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate are all prepared by an analogous procedure to (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1-(2-[(naphthalene-2-carbonyl)-amino]-ethyl)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate (Example 115) by replacing naphthalene-2-carboxylic acid with the appropriate acid. Example 158 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-[(methyl-phenyl-carbamoyl)-methyll-1-azonia bicyclo[2.2.21octane Hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.03 g, 0.09 mmol) and 2-Chloro-N-methyl-N-phenyl-acetamide (0.025 g, 0.136 mmol), are dissolved in acetonitrile DMSO (3:2, 5 ml) and stirred together at 18 hours at 500C. Chloromethyl polystyrene resin (Merrifield resin) is added and the reaction stirred for an additional 4 hours at room temperature. Filtration and purification using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid followed by treatment with polymer bound Hunig's base then dissolution in ethyl acetate and washing with water, drying and concentration in vacuo gives the titled product as a solid.

WO 2004/096800 PCTIEP2004/004605 57 Other especially preferred compounds of formula I include compounds of formula XTV where R1, R 2 , R 3 , and R 4 are as shown in Table 2 below, the method of preparation being described hereinafter. All compounds are quaternary ammonium salts. The table also shows mass spectrometry data. TABLE 2 Ex. RI and R 3 R4 R2 M/s 159 SM+ 159 OH 485.1 O N 160 OH 473.1 o N ,, N 161 OH OH 487.2 162 OH 487.3 aOH _ 163 OH 480.25 H3C CH, 164 0 OH 495.3 H CH, H3C CH, 165 OH 417.2 C 166 S OH 428.1 C"-C 167 OH 433.3 CC CH3 CH3

CH

WO 2004/096800 PCT/EP2004/004605 58 Ex. RI and R 3 R4 R 2 M/s M+ 168 s OH 452.2 C, c CH 3 "I-CH 3

CH

3 169 OH 419.9 - CH CH3 170 OH 431.9 ""\ CH3 CH3 171 9 OH 405.2 172 0 OH 424.2 173 OH 499.3 174 0 OH 513.35 _____________ ~CH 1 ______ 175 OH 513.3 176 H 3 OH 395.3 ___ ~"XNH____ 177 H3 0 OH 499.3 ,,N 178 H 3 OH 509.3 CH3

?ZCH

3 _ WO 2004/096800 PCT/EP2004/004605 59 Ex. RI and R 3 R4 R2 M/s I M+ 179 O 501.3 180 O OH 501.3 181 0 OH 486.2 182 CH OH 395.2 183 0 OH 499.3 H3 184 Br OH 551.2 185H OH 490.3 N 0 N 0H 3 C / C H 3 186 H OH 493.3 N s N O N CH, 187 N OH 580

H

3 C Br _______________ H 3 ________ 188 H OH 489 0 N CH, ______ 189 9 CH 3 OH 489.6

NN

WO 2004/096800 PCTIEP2004/004605 60 Ex. R2 and R 3

R

4

R

2 M/s M+ 190 0 OH 475.3 H J1/ 191 OH 464 NH 192 OH 478 H 19 9 0 OH 492 195 OH 464 N 196 OH 472 197 N OH 487 CHH 198 OH 500.4 199 F F F OH 540.6 N 200 OH 488 201 H OH 473 0 N: WO 2004/096800 PCT/EP2004/004605 61 Ex. R 1 and R 3 R4 R 2 M/s M+ 202 OH 476 CH, 203 OH 472 204 9 OH 492 205 9 OH 492 ____ ~~CH~ ______ 206 H OH 472 207 OH 491.3 s 208 OH 209 0 OH 539.2 S 1/ CHI 210 0 OH 589.2 HaC ) Is CI 211 OH 516.3 IqN CH, OH 212 0 OH 547.2 H 1 _________________ ~S ________ _______ WO 2004/096800 PCTIEP2004/004605 62 Ex. RI and R 3 R4 R2 M/s M+ 213 OH 561.3 N N H F 214 0 OH 571.2 Br 215 CHS OH 543.3 216 0 OH 549.3 CI 217 0 OH 486.3 H "'N 218 0 CH 3 OH 549.3 HC O H3CN0 219 0 OH 566.2 Sr 220 0 CH3 OH 504.3 H >N HC 0 221 OH 465.3 H 222 OH 605.3 N r

F

WO 2004/096800 PCTIEP2004/004605 63 Ex. R and R 3

R

4 R2 M/s M+ 223 0 OH I N CH3 224 0 OH 449.3 225 0 0 OH 598.2 N H 226 OH 545.3 ' N S H 227 0 CH3 OH 553.3 ____ CH 3 228 OH 603.2 CH. 229 0 OH 525.2 / C 230 0 OH 537.2 cI 231 0 OH 555.3

H

3 C 232 0 CH OH 558.3 F 0 F

F

WO 2004/096800 PCT/EP2004/004605 64 Ex. RI and R 3 R4 R2 M/s M+ 233 0 OH 447.3 CH, 234 OH 516.3 Hc 235 6> OH 596.3 iii 0 CM 3 HC 0 CH 3 236 OH 509.3 237 0 OH 555.2 s

H

3 C ____ ~~CI _ _ _ _ _ _ _ 238 0 OH 479.4 239 0 OH 493.35 0 240 0 OH 522 241 0 OH 551.2 -"---N s /CH, 9 0 242 OH 462.2 243 s O~ rioOH 474.1 0 244 s OH 485.1 0 N N WO 2004/096800 PCT/EP2004/004605 65 Ex. RI and R 3 R4 R 2 MIs M+ 245 N OH 473.2 N N 0 N, Preparation of Specific Examples Example 159 A) Bromide salt of (R)- 3 -(2-Hydroxy-2.2-di-thiophen-2-yl-acetoxy)-1-(pyrazin-2-ylcarbamoyl methyl)-1-azonia-bicyclo[2.2.21octane i) 2-Bromo-N-pyrazin-2-yI-acetamide: To a solution of 2-aminopyrazine (5.0 g, 52.6 mmol) in chloroform (250 ml) under an argon atmosphere is added triethylamine (8.79 ml, 63.1 mmol) and the temperature of the resulting mixture reduced to -40oC. To this solution is added a solution of bromoacetylbromide (4.57 ml, 52.6 mmol) in chloroform dropwise over 20 minutes, and stirring continued at-200C to 400C for 1 hour. The reaction mixture is then quenched by addition to saturated aqueous sodium bicarbonate solution. The chloroform later is separated and washed sequentially with saturated aqueous sodium bicarbonate solution, 0.5 M citric acid and brine. Concentration followed by purification by flash silica column chromatography ( gradient elution : ethyl acetate/ hexane 4:6 to 4:1) gives the title compound. ii) (R)-3-(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-(pyrazin-2-ylcarbamoylmeth yl)-1-azonia bicyclo[2.2.2]octane bromide: A solution of 2 -bromo-N-pyrazin-2-y-acetamide (0.77 g, 3.56 mmol) and hydroxy-di thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (Example 70(ii)) (1.12 g, 3.23 mmol) in dry chloroform are heated at 50oC for 2 hours. The mixture is then cooled to room temperature and extracted with water. The aqueous layer is concentrated under reduced pressure then redissolved in a small volume of acetonitrile containing a few drops of water. The mixture is allowed to stand at room temperature for several hours, the resulting solid is filtered and dried then redissolved in a small volume of water containing a few drops of acetonitrile. After several hours a solid is formed which is filtered and dried to give the title compound as a white solid. B) Chloride salt of (R)3-(2-Hydrox-2.2-di-thiophen-2-yl-aceroxy)-1-(pyrazin-2-vlcarbamoyl methyl)-1-azonia-bicyclo[2.2.2loctane WO 2004/096800 PCT/EP2004/004605 66 Pyrazin-2-yl-amine (400 1 , 0.5 M solution in DMF) and triethylamine (500 I, 0.5 M solution in DMF) are combined and cooled in an ice bath. Chloroacetyl chloride (500 i, 0.5 M solution in DMF) is added dropwise and stirred at O'C for 1 hour. To the crude 2-Chloro-N pyrazin-2-yl-acetamide and hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct 3-yl) ester (Example 70(ii)) (800 pl, 0.25 M solution in DMF) is added triethylamine (30 pl, 1 equivalent) and the mixture stirred at room temperature overnight. PS-Bromoacetamidomethyl NovaGel 2.3 mmol/g (0.3 g) and triethylamine (30 pl, 1 equivalent) are added to the reaction mixture and shaken at room temperature for 2 hours. The reaction mixture is filtered and PS bromoacetic acid 1.2 mmol/g (0.2 g) is added to the filtrate and shaken at 30'C for 1 hour. The reaction mixture is passed through a 1 g Isolute SPE (Al-B) cartridge. The solvent is removed in vacuo and purification of the crude residue by mass directed preparative HPLC eluting with water:acetonitrile:trifluoroacetic acid yield the compound as a yellow oil. Examples 160 to 171 These compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 -(pyrimidin-4-yl carbamoylmethyl)-1-azonia-bicyclo[2.2.2]octane bromide, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1-[(3-hydroxy-phenylcarbamoyl)-methyl]-1-azonia-bicyclo[2.2.2]octane bromide, (R) 3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(4-hydroxy-phenylcarbamoyl)-methyl]-1-azonia bicyclo[2.2.2]octane bromide, (R)-1-(3-tert-Buroxycarbonyl-propyl)-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane bromide, (R)-1-((R/S)-2-tert-Butoxycarbonyl amino-propyl)-3-(2-hydroxy-2,2-diphenyl-aceroxy)-1-azonia-bicyclo[2.2.2]octane bromide, (R)-1-(3-Cyclopropyl-prop-2-ynyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)--azonia-bicyclo [2.2.2]octane bromide, (R)-1-(3-Cyclopropyl-prop-2-ynyl)-3-(2-hydroxy-2,2-di-thiophen-2-yl acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide, (R)-1 -(4,4-Dimethyl-pent-2-ynyl)-3-(2 hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide, (R)-1-(4,4-Dimethyl pent-2-ynyl)- 3- (2-hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1 -azon ia-bicyclo[2.2.2]octane bromide, (R)-3-(2-Hydroxy-2,2-dipheny-acetoxy)-1-(4-merhyl-pent-2-ynyl)-1-azonia-bicyclo [2.2.2]octane bromide, (R)-3 -(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1 -(4-methyl-pent-2 ynyl)- 1 -azonia-bicyclo[2.2.2]octane bromide, and (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 pent-3-ynyl-1-azonia-bicyclo[2.2.2]octane bromide, are all prepared analogously to (R)-1-tert Butoxy-carbonylmethyl-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]-octane bromide (Example 60) by replacing t-butylbromoacetate with the appropriate organic halide and heating the mixture at 500C for 2 to 21 hours. The compounds are purified either by trituration with organic solvents, C1 8 chromatography (as for Example 60) or recrystalisation from acetonitrile, water or chloroform. The required halides for quaternarisation are either commercially available or readily synthesised by methods well known in the art.

WO 2004/096800 PCTIEP2004/004605 67 Example 172 (R)-1-(3-Carboxy-propyl)-3-(2-hydroxy-2.2-diphenvl-acetoxy)-1-azonia bicyclof2.2.210crane bromide To a stirred solution of (R)-1-(3-tert-Butoxycarbonyl-propyl)-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide [Example 163] (0.2 g, 0.41 mmol) in methylene chloride (1.5 ml) under an argon atmosphere at room temperature is added hydrobromic acid (33% in acetic acid, 0.36 ml). After stirring at room temperatue for 30 minutes, concentration is followed by dissolution in water / acetonitile and stirring for a further 30 minutes. Concentration then gives the title product. Examples 173 to 175 These compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(3-phenylca rbamoyl propyl)- 1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2-diphenyl-aceto xy)- 1- [3-(merhyl-phenyl-carbamoyl)-propyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacerate and (R)-l-(3-Benzylcarbamoyl-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicycle [2.2.2]octane trifluoroacetate are all prepared analogously to (R)-1-[(5,6-diethyl-indan-2 ylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2joctane trifluoroacetate [Example 63] but by replacing (R)-1-carboxymethyl-3-(2-hydroxy-2, 2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate [Example 62] with (R)-1-(3 carboxy-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2] octane bromide [Example 172] and by replacing 5,6-Diethyl-indan-2-ylamine hydrochloride with the appropriate amine. Example 176 (R)-1-(2-Amino-propyl)-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azoniabicyclo[2.2.21octane chloride hydrochloride This compound is prepared analogously to (R)-1-((R/S)-2-Amino-ethyl)-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide hydrobromide [Example 49ii] but by replacing (R)-1-(2-tert-butoxycarbonylamino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2]octane bromide [Example 49i] with (R)-1-((R/S)-2-tert Butoxycarbonylamino-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane bromide [Example 164] and hydrogen bromide solution in dioxane with hydrogen chloride solution in dioxane. The product is isolated on concentration of the reaction medium, without further purification. Example 177 WO 2004/096800 PCT/EP2004/004605 68 (R)-1-((R/S)-2-Benzolamino-propyl)-3-(2-hydroxy-2.2-diphenyl-aceroxv)--azoni a bicyclof2.2.21 octane trifluoroacerate This compound is prepared analogously to (R)-1-(3-benzoylamino-propyl)-3-(2-hydroxy-2,2. diphenyl-aceroxy)-1-azonia-bicyclo[2.2.2]-octane trifluoroacetate [Example 2] but by replacing (R)-1-(3-amino-propyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo-[2.2.2]octane chloride hydrochloride [Example 1(ii)] with (R)-1-((R/S)-2-amino-propyl)-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azoniabicyclo[2.2.2]octane chloride hydrochloride. Example 178 (R)-1-[3-(tert-Butoxycarbonyl-methyl-amino)-propyll-3-(2-hydroxy-2.2-dipheny-acetox)-1l azonia-bicyclo[2.2.21octane chloride (3-Chloro-propyl)-methyl-carbamic acid tert-butyl ester (2.00 g 9.629 mmol) is solubilised in DMF (20 ml) and polystyrene bound DIPEA added, and after a few minutes removed. This solution is then added to a mixture of hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo [2.2.2]oct-3-yl) ester (2.1634 g 6.419 mmol) and 200 mg of K2CO3, followed by the addition of sodium iodide (10 mg) and heating at 60'C for 2 days. 2.5 g Merrifield resin and 100 mg

K

2

CO

3 is then added to the mixture and heating resumed at 40* C for 12 hours. The resin is then removed, and the mixture purified by gradient C18 column chromatography to give the title product. Example 179 (R)- 1-12-(4-Hydroxy-benzoylamino)-ethyll-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1 -azonia bicyclo[2.2.2]octane bromide i) (R)-1-[2-(4-Benzyloxy-benzoylamino)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane bromide: To a solution of 4-benzyloxybenzoic acid (0.126 mg, 0.55 mmol) in DMF (3 ml) is added diisopropylethylamine (0.3 ml) followed by HATU (0.155 mg, 0.55 mmol). The reaction mixture is stirred for 30 minutes at room temperature after which time a solution comprising (R)-1-(2-amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide hydrobromide [Example 49(ii)] (0.200 g, 0.37 mmol) and the resulting mixture is stirred at room temperature over night. Purification is carried out using preparative C18 column chromatography eluting with acetonitrile: water to afford the titled compound. ii) (R)-1-[2-(4-Hydroxy-benzoylamino)-ethyl]-3-(2-hydroxy-2,2-di phenyl-aceoxy)-1 -azonia bicyclo[2.2.2]octane bromide: WO 2004/096800 PCTIEP2004/004605 69 To a solution of (R)-1-[2-(4-Benzyloxy-benzoylamino)-ethyll-3-(2-hydroxy-2,2-diphenyl acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide (0.075 g, 0.11 mmol) in DMF (1 ml) under an argon atmosphere is added 10% Pd on carbon (40 mg) and the resulting solution hydrogenated for 3 hours. The catalyst is then removed by filtration and concentration in vacuo yields the title compound. Example 180 (R)-1-f2-(3-Hydroxy-benzoylamino)-ethyll-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2loctane chloride i) (R)-1-(2-Amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetyl)-1-azonia-bicyclo[2.2.2]octane chloride hydrochloride: To a solution of (R)-1-(2-tert-butoxycarbonylamino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetyl) 1-azonia-bicyclo[2.2.2]octane bromide [Example 49i] (8.292 g, 14.82 mmol) in dioxane (100 ml) at room temperature is added hydrochloric acid (18.5 ml, 4 M in dioxane). The reaction mixture is stirred for 20 hours. The solvent is removed in vacuo and purification of the crude residue by chromatography on C1 8 silica, eluting with water:acetonitrile affords the titled product as a white solid. ii) (R)-1-[2-(3-Hydroxy-benzoylamino)-ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane chloride: This is prepared analogously to (R)-1-[2-(4-Hydroxy-benzoylamino)-ethyl]-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide [Example 179] but 4-benzyloxy benzoic acid is replaced by 3-benzyloxybenzoic acid and (R)-1-(2-amino-ethyl)-3-(2-hydroxy 2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane bromide hydrobromide is substituted by (R)-1-(2-amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane chloride hydrochloride [Example 180 i]. Example 181 (R)-1-Benzyloxycarbonylmethyl-3-(2-hydroxy-2.2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.21octane bromide A suspension of hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-y) ester (1 g, 2.96 mmol) and bromoacetic acid benzyl ester (0.516 ml, 3.26 mmol) in ethylacetate (20 ml) is heated at 50oC for 2 hours. The reaction mixture is cooled to room temperature and the precipitate removed by filtration. Recrystallisation from acetonitrile (20 ml) gives the title compound.

WO 2004/096800 PCTIEP2004/004605 70 Example 182 (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2-methylamino-ethyl)-1-azonia-bicyclo [2.2.2loctane bromide hydrobromide (2-Bromo-ethyl)-methyl-carbamic acid tert-butyl ester (0.09 g, 0.38 mmol) is added to a solution of hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester (0.265 g, 0.79 mmol) in DMF (10 ml). The resulting mixture is heated at 60oC for 5 hours and concentrated. This procedure is repeated twice giving the title compound as a mixture containing unreacted hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester. Example 183 (R)-1- [2-(Benzoyl-methyl-amino)-ethyll-3-(2-hydroxv-2.2-diphenyl-acetoxy) -1-azonia bicvclo[2.2.2loctane trifluoroacetate The crude product from Example 182 is dissolved in acetonitrile (10 ml) and filtered then cooled over an ice bath, under an argon atmosphere. To this cooled solution is added triethylamine (127 I) followed by benzoyl bromide (64 Vl) and the reaction stirred for 1 hour. Purification is carried out using mass directed preparative HPLC eluting with acetonitrile: water: trifluoroacetic acid to afford the titled compound. Example 184 (R)-1-[(2-Bromo-phenylcarbamoyl)-methyll-3-(2-hydroxy-2.2-diphenyl-aceroxy)1.-azonia bicyclo[2.2.2Ioctane trifluoroacetate (i) N-(2-Bromo-phenyl)-2-chloro-acetamide: 2-Bromoaniline (371 il, 467 mmol) and triethylamine (651 0, 5.84 mmol) are dissolved in DMF (2 ml) and cooled in an ice bath. Chloroacetyl chloride (371 pl, 4.67 mmol) is added dropwise and stirred at O'C for 1 hour. The solvent is removed in vacuo and used crude in the next step. ii) (R)-1-[(2-Bromo-phenylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)]-1-azonia bicyclo[2.2.2] octane trifluoroacetate: N-(2-Bromo-phenyl)-2-chloro-acetamide(155 mg, 0.622 mmol) and hydroxyl-diphenyl-acetic acid(R)-(1-aza-bicyclo[2.2.2]oct-3-yl)ester (210 mg, 0.622 mmol) are dissolved in DMF (4 ml). The reaction mixture is stirred at O'C for 2 hours. PS-Bromoacetamidomethyl-NovaGel 2.3 mmol/g (0.5 g) is added to the reaction mixture and shaken at room temperature for 4 hours. PS-Triphenylphosphine 3 mmol/g (0.5 g) is added to the reaction mixture and shaken at room temperature overnight. The reaction mixture is then passed through a 1 g Isolute SPE (Al-B) WO 2004/096800 PCT/EP2004/004605 71 cartridge. The solvent is removed in vacuo and purification of the crude residue by mass directed preparative HPLC eluting with water:acetonitrile:trifluoroacetic acid yields the titled compound. Example 185 to 189 These compounds, namely (R)-1-[(3,4-Dimethyl-isoxazol-5-ylcarbamoyl)-methyl]-3-(2 hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2 Hydroxy-2,2-diphenyl-acetoxy)-1-[(3-merhyl-[1,2,4]thiadiazol-5-ylcarbamoyl)-methyl]-1 azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(5-Bromo-3,4-dimethyl-pyridin-2- yl carbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-1-[(2,5-Dimethyl-2H-pyrazol-3-ylcarbamoyl)-methyl]-3-(2-hydroxy-2,2 diphenyl-acetoxy)-l-azonia-bicyclo[2.2.2]octane trifluoroacetate, and (R)-1-[(2-Ethyl-2H pyrazol-3-ylcarbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2]octane trifluoroacetate are all prepared analogously to (R)-1-[(2-Bromo-phenyl carbamoyl)-methyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate [Example 184] by replacing 2-Bromoaniline with the appropriate amine. Example 190 (R)-1-f 2 -[(Furan-2-carbonyl)-aminolethyll-3-(2-hydroxy-2.2-diphenyl-acetyl)-1-azonia bicyclo[2.2.2joctane hexafluorophosphate To a stirred solution of 2-furoic acid (91.5 mg, 8.21 mmol) and HATU (284 mg, 7.52 mmol) in DMF (7.5 ml) is added polymer bound morpholine, 2.5 mmol/g (1.36 g, 34.2 mmol). The reaction mixture is left to stand at room temperature for 15 minutes after which time, a solution comprising of (R)-1-(2-amino-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetyl)-1-azonia bicyclo[2.2.2]octane chloride hydrochloride [Example 180 i]] (310 mg, 6.84 mmol) in DMF (7.5 ml) is added. The reaction mixture is stirred at room temperature overnight. The reaction mixture is passed through a 2 g Isolute SPE (Al-B) cartridge. The filtrate is concentrated in vacuo and purification of the crude residue by chromatography on C1 8 silica, eluding with water:acetonitrile affords the title compound as a white solid. Example 191 (R)-1 -{ 2(Azeidinen-3-carbony-)-aminol-ethyl-3-(2-hyroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane trifluoroacetate (i) (R)-1-{2-[1-tert-Butoxycarbonyl-azeridine-3-carbonyl)-amino]ethyl}-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane hexafluorophosphate: WO 2004/096800 PCT/EP2004/004605 72 This compound is prepared analogously to (R)-1-(2-[(Furan-2-carbonyl)-aminolethyl)-3-(2 hydroxy-2,2-diphenyl-acetyl)-1-azonia-bicyclo[2.2.2]octane hexafluorophosphate [Example 190] by replacing 2-furoic acid with 1-BOC-azetidine-3-carboxylic acid. (ii) (R)-1 -2-[(Azetidine-3-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2]octane trifluoroacetate: (R)-1-(2-[(1-tert-butoxycarbonyl-azetidine-3-carbonyl)-amino]erhyl)-3-(2-hydroxy-2,2 diphenyl -acetoxy) 1 -azonia-bicyclo [2.2.2]octane hexafluorophosphate is dissolved in TFA: DCM (1:1) (2 ml) and stirred at room temperature for 1 hour. TFA:DCM (2 ml) is added to the reaction mixture to complete the reaction. The solvent is removed in vacuo and purification of the crude residue by mass directed preparative HPLC eluting with water:acetonitrile: trifluoroacetic acid yields the titled compound. Example 192 to 195 These compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{2-[((S)-pyrrolidine-2 carbonyl)-amino]-ethyl}-1 -azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1 -{2-[((R)-piperidine-2-carbonyl)-amino]-ethyl)- 1 -azonia-bicyclo[2.2.2] octane trifluoroacerate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{2-[((S)-piperidine-2 carbonyl)-amino]-ethyl}-1 -azonia-bicyclo[2.2.2] octane trifluoroacetate and (R)-1-(2-(((S) Azetidine-2-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane trifluoroacerate are prepared analogously to (R)-1-(2-[(Azetidine-3 carbonyl)-am ino]-ethyl }-3 -(2-hyd roxy-2,2-diphenyl-acetoxy)1 -1azoni a-bicyclo[2.2.2]octane trifluoroacetate [Example 191] by replacing 1-BOC-azetidine-3-carboxylic acid with the corresponding BOC protected amino acid. Example 196 (R)-3-(2-Hydroxy-2.2-diphenyl-acetox)--(pyridine-2-ylcarbamoylmethyl)-azonia bicyclo[2.2.21octane trifluoroacetate This compound is prepared analogously to (R)-1-[(2-Bromo-phenylcarbamoyl)-methyl]-3-(2 hydroxy-2,2-diphenyl-acetoxy)]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate [Example 184. However instead of using PS-triphenylphosphine, BEMP 2.3 mmol/g (0.1 g, 1 eqv) is used with the PS-bromoacetamidomethyl-NovaGel 2.3 mmol/g (0.3 g, 1 eqv). Example 197 (RI-3-(2-Hydroxy-2.2-diphenvl-acetoxy)-1-[(4-methyl-pyrimidin-2-ylcarbamoyl)-methyll-1 azonia-bicyclo[2.2.2loctane chloride WO 2004/096800 PCT/EP2004/004605 73 This compound is prepared analogously to (R)3-(2-Hydroxy-2,2-di-thiophen-2-yI-acetoxy)-1 (pyrazin-2-ylcarbamoylmethyl)-1-azonia-bicyclo[2.2.2]octane chloride [Example 159B] by substituting hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester and Pyrazin-2-yl-amine with hydroxy-diphenyl-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester and 4-Methyl-pyrimidin-2-ylamine. Examples 198 to 201 These compounds, namely (R)-1-[(6-Ethyl-pyridin-2-ylcarbamoyl)methyl]-3-(2-hydroxy-2,2 diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-[(3-trifluoromethyl-pyridin-4-ylcarbamoyl)-methyl]-1-azonia-bicyclo [2.2.2]octane trifluoroacetate, R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(3-hydroxy-pyridin 2-ylcarbamoyl)-methyl]-1-azonia-bicyclo[2.2.2]octane trifluoroacetate, and (R)-3-(2-Hydroxy 2,2-diphenyl-acetoxy)-1-(pyrimidin-2-ylcarbamoylmethyl)-1-azoniabicyclo[2.2.2] octane trifluoroacetate are all prepared analogously to (R)-1-[(2-bromo-phenyl-carbamoyl)-methyl]-3 (2-hydroxy-2,2-diphenyl-acetoxy)]-1-azonia-bicyclo[2.2.2]octane chloride [Example 184] by substituting 2-bromoaniline with the corresponding heterocyclic amines, however in these examples PS-triphenylphosphine is not used. Examples 202 to 206 The title compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(4-methyl-oxazol-2 ylcarbamoyl)-methyl]-1-azonia-bicyclo[2.2.2]octane chloride, (R)-3-(2-Hydroxy-2,2-diphenyl acetoxy)-1 -(pyridin-4-ylcarbamoylmerhyl)-1 -azonia-bicyclo[2.2.2]octane chloride, (R)-3-(2 Hydroxy-2,2-diphenyl-acetoxy)-1-[(S-methyl-thiazol-2-ylcarbamoyl)-methyl]-1-azonia bicyclo[2.2.2]octane chloride, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[(4-methyl-thiazol-2 ylcarbamoyl)-methyl]-1-azonia-bicyclo[2.2.2]octane chloride, and (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-(pyridin-3-ylcarbamoylmethyl)-1-azoniabicyclo [2.2.2] octane chloride, are all prepared analogously to (R)-3-(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-(pyrazin-2 ylcarbamoylmethyl)-1-azonia-bicyclo[2.2.2]octane chloride [Example 1S9B] by substituting hydroxy-di-thiophen-2-y-acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-yl) ester with hydroxyl diphenyl-acetic acid(R)-(1-aza-bicyclo[2.2.2]oct-3-yl)ester and replacing Pyrazin-2-yl-a mine with the corresponding heterocyclic amines. Example 207 (R)-3-(2-Hydroxy-2.2-diphenyl-acetyl)-1 -12-[thiophene-2-carbonyl)-amino]-erhyll- 1 -azonia bicyclo[2.2.2]octane hexafluorophosphate WO 2004/096800 PCT/EP2004/004605 74 To a stirred solution of 2-thiophenecarboxylic acid (15.4 mg, 0.12 mmol) and HATU (42 mg, 0.11 mmol) in DMF (0.6 ml) is added triethylamine (42 ltl, 0.3 mmol). The reaction mixture is left to stand for 20 minutes after which time, a solution comprising of (R)-1-(2-amino-ethyl)-3 (2-hydroxy-2,2-diphenyl-acetyl)-1-azonia-bicyclo[2.2.2]octane bromide [Example 49 ii)] (45 mg, 0.1 mmol) in DMF (0.6 ml) is added. The reaction mixture is stirred at room temperature overnight. The reaction mixture is passed through a 1 g Isolute SPE (Al-B) cartridge and the filtrate concentrated in vacuo. Purification by mass directed preparative HPLC eluting with water:acetonitrile:trifluoracetic acid yields the titled compound. Examples 208 to 241 These compounds, namely (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{2-[(3-methyl-thiophene 2-carbonyl)-amino]-ethyl)-1-azonia-bicyclo[2.2.2] octane hexafluoro phosphate, (R)-1-{2-[(3 Chloro-4-methyl-thiophene-2-carbonyl)-amino] -ethyl}1-3-(2-hydroxy-2,2-diphenyl-acetoxy)- 1 azonia-bicyclo[2.2.2]octane hexafluoro phosphate, (R)-1-12-[(5-Chloro-3-methyl-benzo [b]thiophene-2-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo [2.2.2]octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-f2-[(2-hydroxy 6-methyl-pyridine-4-carbonyl)-amino]-ethyl)-1 -azonia-bicyclo[2.2.2]octane hexafluoro phosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-12-[(thieno[3,2-bJthiophene-2-carbonyl) amino] -ethyl)1-1 -azonia-bicyclo[2.2.2] octane hexafluoro-phosphate, (R)-1-{2-[(6-Fluoro-4H benzo[1,3]dioxine-8-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia bicyclo[2.2.2]octane hexafluoro phosphate, (R)-1-[2-[(5-Bromo-thiophene-2-carbonyl)-amino] ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy) -1-azonia-bicyclo[2.2.2]octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[2-(2-propoxy-benzoylamino)-ethyl]-1-azon ia bicyclo[2.2.2]octane hexafluorophosphate, (R)-1-[2-(5-Chloro-2-methoxy-benzoylamino) ethyl] -3-(2-hyd roxy-2,2-diphenyl-acetoxy)-1 -azonia-bicyclo [2.2.2]octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-12-[(pyridine-4-carbonyl)-amino]-ethyl)-1-azonia bicyclo[2.2.2]octane hexafluorophosphate, (R)-1 -[2-(2,6-Dimethoxy-benzoylamino)-ethyl]-3 (2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane hexafluorophosphate, (R)-1 {2-[(S-Bromo-pyridine-3-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl -acetoxy)- 1 azonia-bicyclo[2.2.2]octane hexafluorophosphate, (R)-1-(2-[(3,5-Dimerhyl-isoxazole-4 carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane hexafluoro phosphate, (R)-1 -{2-[(1 -Hydroxy-cyclo-propanecarbonyl)-amino]-ethyl}-3-(2 hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]-octane hexafluorophosphate, (R)-3-(2 Hydroxy-2,2-diphenyl-acetoxy)-1-{2-[(2-trifluoro-methyl-[1,8]naphthyridine-3-carbonyl) amino]-ethyl)-1-azonia-bicyclo[2.2.2]octane hexa-fluorophosphate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)- 1 -{2-[(6-methyl-pyridine-3-carbonyl)-amino] -ethyl}-1-azonia-bicyclo- WO 2004/096800 PCT/EP2004/004605 75 [2.2.2]octane hexafluorophosphate, (R)- 1 -[2-(Cyclopropanecarbonyl-amino)-ethyl]-3-(2 hydroxy-2,2-diphenyl-aceroxy)-1-azonia-bicyclo-[2.2.2]octane hexafluorophosphate, (R)-1-[2 (4-Chloro-3-sulfamoyl-benzoylamino)-ethyl]-3-(2-hydroxy-2,2-diphenyl-aceoxy)-1-azonia bicyclo[2.2.2]octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(2 [(4,5,6,7-terrahydro-benzo[c]thiophene-1 -carbonyl)-amino]-ethyl}-1 -azonia-bicyclo[2.2.2] octane hexafluorophosphate, (R)-1-{2-[(2,7-Dimethyl-imidazo [1,2-a]pyridine-3-carbony) amino]-ethyl)-3-(2-hydroxy-2,2-di phenyl-aceroxy)- 1 -azonia-bicyclo[2.2.2] octane hexa fluorophosphate, (R)-1-12-[(3-Chloro-4-methanesulfonyl-thiophene -2-carbonyl)-amino]-ethyl) 3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo-[2.2.2] octane hexafluorophosphare, (R) 1-(2-[(5-Chloro-thiophene-2-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-aceoxy)-1 azonia-bicyclo[2.2.2]octane hexafluorophosphate, (R)-1-[2-(3-Chloro-4-fluoro-be nzoylamino) ethyl]-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2]octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-{2-[(3-methyl-benzo[b]thiophene-2-carbonyl) amino]-ethyl)-1-azonia-bicyclo[2.2.2]octane hexa-fluorophosphate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-{2-[(3-methyl-S- trifluoromethyl-isoxazole-4-carbonyl)-amino]-ethyl)- 1 azonia-bicyclo[2.2.2]octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 [2-(1-oxo-but-2-ynylamino)-ethyl]-1-azonia-bicyclo-[2.2.2]octane hexafluorophosphate, (R)-3 (2-Hydroxy-2,2-diphenyl-acetoxy)-1 -(2-[(2-methoxy-pyridine-3-carbonyl)-amino]-ethyl}-1 azonia-bicyclo[2.2.2] octane hexafluoro-phosphate, (R)-1-{2-[(S-Dimethylsulfamoyl-2-methyl furan-3-carbonyl)-amino]-ethyl)-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1-azonia-bicyclo[2.2.2] octane hexafluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-[2-(3-phenyl propynoylamino)-ethyl]-1-azonia-bicyclo-[2.2.2]octane hexafluorophosphate, (R)-1-{2-[(5 Chloro-4-methoxy-thiophene-3-carbonyl)-amino]-ethyl}-3-(2-hydroxy-2,2-diphenyl-acetoxy)-1 azonia-bicyclo[2.2.2]octane hexa-fluorophosphate, (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 1 2 -[((R)-tetrahydro-furan-2-carbonyl)-amino]-ethyl}-1-azonia-bicyclo [2.2.2]octane hexafluoro phosphate, (R)- 3

-(

2 -Hydroxy-2,2-diphenyl-acetoxy)-1-(2-[(tetrahydro-pyran-4-car bonyl) amino]-ethyl} -1-azonia-bicyclo[2.2.2]octane hexafluoro phosphate, (R)-3-(2-Hydroxy-2,2 diphenyl-acetoxy)-1-(2-[(3-methoxy-thiophene-2-carbonyl)-amino]-ethyl}-1-azonia-bicyclo [2.2.2]octane hexafluoro-phosphate, and (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-.1-(2-[(5 methoxy-thiophene-2-carbonyl)-amino]-ethyl1-1 -azonia-bicyclo[2.2.2]octane hexafluoro phosphate, are all prepared analogously to (R)-3-(2-Hydroxy-2,2-diphenyl-aceryl)-1-{2 [thiophene-2-carbonyl)-amino]-ethyl }-1 -azon ia-bicyclo[2.2.2]octane hexafluorophosphate [Ex. 207] by substituting 2-thiophenecarboxylic acid with the corresponding carboxylic acid.

WO 2004/096800 PCT/EP2004/004605 76 Example 242 (R)-3-(2-Hydroxy-2.2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-azonia bicyclo[2.2.21octane bromide i) 2-Bromo-N-isoxazol-3-yl-acetamide: To a stirred solution of bromoacetylbromide (5.36 ml, 61.6 mmol) in diethylether (100 ml) at -400C is added, dropwise over 20 minutes, a solution of 3-aminoisoxazol (5.0 ml, 67.0 mmol) and triethylamine (8.5 ml, 61.4 mmol) in diethylether (20 ml). Additional diethylether (50 ml) is added and stirring continued for 3 hours. The reaction mixture is filtered and the solution then washed with 1 M sodium carbonate solution, 1 M hydrochloric acid and brine. Concentration followed by purification by flash silica column chromatography (ethyl acetate/ iso-hexane 4:7) gives the title compound as a white solid. ii) (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoylmethyl)-1-azonia bicyclo[2.2.2]octane bromide: A solution of 2-Bromo-N-isoxazol-3-yl-aceramide (0.82 g, 4.0 mmol) in chloroform/ acetonitrile(1:1) is added to a solution of hydroxyl-diphenyl-acetic acid(R)-(1-aza-bicyclo [2.2.2]oct-3-yl)ester (1.12 g, 3.32 mmol) in dry chloroform(10 ml) and the resulting mixture heated to 55-C under an argon atmosphere for 4 hours. The mixture is then cooled to room temperature and concentrated. The residue is dissolved in acetonitrile and concentration followed by redissolution in hot acetone and cooling gives a jelly like precipitate which is filtered. Recrystallisation of the crude precipitate from acetonitrile containing a few drops of water followed by further crystallisation from acetonitrile gives the title compound as light brown crystals. In an alterntaive method for preparing 2-Bromo-N-isoxazol-3-yl-acetamide, to a stirred solution of bromoacetylbromide (5.36 ml, 61.6 mmol) in diethylether (100 ml) at -400C is added, dropwise over 20 minutes, a solution of 3-aminoisoxazol (5.0 ml, 67.7 mmol) and triethylamine (8.5 ml, 61.4 mmol) in diethylether (20 ml). Additional diethylether (50 ml) is added and stirring continued for 3 hours. The reaction mixture is filtered and the solution then washed with 1 M sodium carbonate solution, 1 M hydrochloric acid and brine. Concentration followed by purification by flash silica column chromatography (ethyl acetate/ iso-hexane 3:7) gives the title compound as a white solid.

WO 2004/096800 PCT/EP2004/004605 77 Example 243 (R)-3-(2-Hydroxy-2,2-di-thioRhen-2-yi-acetoxy)-I-(isoxazol-3-ylcarbamoylmethyl)-1-azonia bicyclo[2.2.21octane bromide A solution of 2 -Bromo-N-isoxazol-3-yI-acetamide [Example 242 i]] (0.70 g, 3.5 rnmol) in chloroform (10 ml) is added to a solution of hydroxy-di-thiophen-2-yl-acetic acid (R)-(1-aza bicyclo[2.2.2]oct-3-yl) ester (1.01 g, 2.9 mmol) acetonitrile (5 ml) and the resulting mixture heated to 55-C under an argon atmosphere for 4 hours. The mixture is then cooled to room temperature and concentrated. The residue is triturated with ethylacetate and then purification by C-18 reverse phase column chromatography (eluent: water-aceronitrile) to give the title compound as a white foam. Example 244 (R)-3-(2-Hydroxy-2,2-di-thiophen-2-vl-acetoxvi-1-(pyrimidin-4-vicarbamovimethyl)-1-azonia bicyclo[2.2.21octane bromide i) 2-Bromo-N-pyrimidin-4-yl-acetamide: To a solution of 4-aminopyrimidine (7.0 g, 73.6 mmol) in chloroform (300 ml) under an argon atmosphere is added triethylamine (12.3 ml, 88.3 mmol) and the temperature of the resulting mixture reduced to -400C. To this solution is added a solution of bromoacetylbromide (6.4 ml, 73.6 mmol) in chloroform (5 ml) dropwise and stirring continued for 1.5 hours. The reaction mixture is then quenched by addition to saturated aqueous sodium bicarbonate solution. The chloroform later is separated and washed with 0.5 M citric acid solution. Concentration followed by purification by flash silica column chromatography ( gradient elution ethyl acetate/ hexane 1:4 to methanol/ ethyl acetate 1:10) gives the title compound. ii) (R)-3-(2-Hydroxy-2,2-di-thiophen-2-yl-acetoxy)-1-(pyrimidin-4-ylcarbamoylmethyl)-1 azonia-bicyclo[2.2.2]octane bromide: A solution of 2 -Bromo-N-pyrimidin-4-yl-acetamide (0.90 g, 4.17 mmol) and hydroxy-di thiophen-2-yl-acetic acid (R)-(1-aza-bicyclo[2.2.2]ocr-3-yl) ester (Example 70(ii)) (1.32 g, 3.79 mmol) in dry chloroform-acetonitrile(20 ml + 4 ml) are heated at 50C for 3 hours. The mixture is then cooled to room temperature and concentrated. Purification by reverse phase C18 column chromatography (gradient elution 100% water to 100% acetonitrile) gives after concentration a light brown solid. The solid was triturated with hot aceronitrile then dissolved in hot acetonitrile containing a few drops of water. After standing at 50C for several hours crystals are formed which are filtered and dried to give the title compound.

WO 2004/096800 PCT/EP2004/004605 78 Example 245 (R)-3-(2-Hydroxy-2.2-diphenyl-aceroxy)-1-(pyrazin-2-ylcarbamoylmethyh-1-azonia bicyclo[2.2.2]octane A solution of 2-bromo-N-pyrazin-2-yl-acetamide (1.50 g, 6.94 mmol) and hydroxyl-diphenyl acetic acid(R)-(1-aza-bicyclo[2.2.2]oct-3-yl)ester (2.13 g, 6.31 mmol) in dry chloroform(10 ml) are heated at SOOC for 2 hours. The mixture is then cooled to room temperature filtered and concentrated. The resulting foam is dissolved in acetonitrile and cooled to -200C, an orange oil is formed from which the acetonitrile layer is decanted. The orange oil is dissolved in water and washed with chloroform before concentration. Redissolution in hot water followed by precipitation by cooling to room temperature gives the title product as a white solid. Firther especially preferred compounds of formula I include compounds of formula XIV where R 1 , R 2 , R 3 , and R 4 are as shown in Table 3 below, the method of preparation being described hereinafter. All compounds are quaternary ammonium salts. The table also shows mass spectrometry data. TABLE 3 Ex. R 1 and R 3 R4 R 2 M/s M+ 246 s OH 448.3 ' O0 CH, 247 S 0 irOH OH 408.3 Preparation of Specific Examples Example 246 1 -Allyloxycarbonylmethyl-3 -(2-hydroxy-2.2-di-thiophen-2-yl-acetoxv- 1 -azonia-bicyclo f2.2.2loctane A solution of bromo-acetic acid allyl ester (0.8 g, 4.46 mmol) and hydroxy-di-thiophen-2-yl acetic acid (R)-(1-aza-bicyclo[2.2.2]oct-3-y) ester (Example 70(ii)) (1.3 g, 3.7 mmol) in dry chloroform are heated at 500C for 2 hours. The contents are then allowed to cool and then concentrated in vacuo. This residue is then taken up in 1% water in acetone at reflux and allowed to cool to room temp. After several hours a solid is formed which is filtered and dried to give the title compound as a brown solid.

79 Example 247 I.Carboxymethyl-3-2-hydroxy-2.2-di-thiophen2-ylcetoxy)-a-zonia-bicyclof 2

.

2

,

2 ocane To a stirred solution of 1-allyloxycarbonylmethyl-3-(2-hydroxy-2,2-di-thiophen-2-yl-acetoxy) 1-azonia-bicyclo[2.2.2]octane (Example 246) (0.79 g, 1.50 mmol) in dry chloroform, under argon, is added terrakis-palladium triphenyl phosphine (0.02 g, 0.017 mmol). The mixture is strirred at room temp., under argon, for 20 minutes before morpholine (0.196 ml, 2.25 mmol) is added. Stirring is continued for a further 4 hrs at room temp. The mixture is concentrated in vacuo and purified by gradient C18 column chromatography to give a pale yellow solid. The solid is then redissolved in a small volume of acetonitrile containing a few drops of water. After several hours a solid is formed which is filtered and dried to give the title compound as a pale yellow solid. The reference in this specification to any prior publication (or information derived from it), or to any matter which is known, is not, and should not be taken as an acknowledgment or admission or any form of suggestion that that prior publication (or information derived from it) or known matter forms part of the common general knowledge in the field of endeavour to which this specification relates.

Claims (22)

1. A medicament comprising a compound of formula I R 0 O1 C N, O R4 in salt or zwitterionic form wherein RI and R 3 are each independently a C3-CI-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or -CRIR 2 R 3 together form a group of formula R 2 R where R is a bond, -0-, -S- , -CH2-, -CH=CH-, -CH2-CH2-, amino or -N(CH3)-; R 2 is hydrogen, halo, hydroxy, C1-Cs-alkoxy or Ci-Cs-alkyl optionally substituted by hydroxy; R 4 is Ci-C8-alkyl substituted by -NHR 5 , -NR 5 -CO-R 6 , -NR 5 -CO-NH-R 7 , -NR 5 -SO2-R 8 , -CO-NR 9 R'O, -OR", -O-CO-NHR1 2 , -O-CO-R 3 or -CO-O-RI 4 , or R 4 is C3-Cio-alkynyl optionally substituted by a C3-Ci-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 5 is hydrogen or Ci-Cs-alkyl; R 6 is Ci-Cs-alkyl, C2-C8-alkenyl, C2-Clo-alkynyl or Ci-Cs-alkoxy in each case optionally substituted by a C3-CI-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-Ci-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 7 is a C3-Ci-carbocyclic group; R 8 is a C3-CIs-carbocyclic group; 81 R 9 is hydrogen or C1-C8-alkyl; RIO is hydrogen, Ci-Cs-alkyl optionally substituted by cyano, amino, nitro, carboxy, Ci-CB-alkoxy, a C3-Ci-carbocyclic group, or by a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or RIO is a C3-Ci-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R" is hydrogen, Ci-Cs-alkyl, C1-Cs-alkyl-C1-C-alkoxy or Ci-Cs-alkyl-O-RIs; R 12 is a C3-CI-carbocyclic group; R1 3 is C1-C8-alkyl or a C3-CI-carbocyclic group; R1 4 is hydrogen, a C3-Ci-carbocyclic group, Ci-C8-alkenyl, or Ci-C8-alkyl optionally substituted by a C3-Ci5-carbocyclic group; and R1 5 is a C3-Ci-carbocyclic group; in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid.

2. A medicament according to claim 1, wherein RI and R 3 are each independently a C3-CI-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 2 is halo or hydroxy; R 4 is Ci-Cs-alkyl substituted by -NHR 5 , -NR 5 -CO-R 6 , -NRS-CO-NH-R 7 , -NR 5 -SO2-R 8 , -CO-NR 9 R 0 , -O-CO-NH-R 2 , -O-CO-RI 3 or -CO-O-RI 4 , or R 4 is C3-Cio-alkynyl optionally substituted by a C3-Cis-carbocyclic group or a 4- to 12 membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; RI is hydrogen or Ci-Cs-alkyl; R 6 is CI-C-alkyl, C2-Cio-alkynyl or Ci-C8-alkoxy in each case optionally substituted by a C3-Cis carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-Ci-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 7 is a C3-CI-carbocyclic group; 82 R 8 is a C3-C1-carbocyclic group; R 9 is hydrogen or CI-Cs-alkyl; RI 0 is Ci-C-alkyl optionally substituted by cyano, Ci-Cs-alkoxy, a C3-Ci-carbocyclic group or by a

4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or RIO is a C3-Ci-carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R1 2 is a C3-Ci-carbocyclic group; R 1 3 is Ci-Cs-alkyl; and R1 4 is hydrogen, a C3-CI-carbocyclic group, C1-C8-alkenyl, or CI-CB-alkyl optionally substituted by a C3-Ci-carbocyclic group. 3. A medicament according to claim 2, wherein RI and R 3 are each independently a C6-Cio-carbocyclic aromatic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 2 is halo or hydroxy; R 4 is C1-Cs-alkyl substituted by -NHR 5 , -NR 5 -CO-R 6 , -NR 5 -CO-NH-R 7 , -NR 5 -S02-R 8 , -CO-NR 9 R'O, -O-CO-NH-R 2 , -O-CO-R 3 or -CO-0-R 4 , or R 4 is C3-C8-alkynyl optionally substituted by a C3-Cio-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 5 is hydrogen or CI-C4-alkyl; R 6 is CI-C4-alkyl, C2-C-alkynyl or Ci-C4-alkoxy in each case optionally substituted by a C3-C1O carbocyclic group or a 4- to 12-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or R 6 is a C3-Cio-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 7 is a C3-Cio-carbocyclic group; R 8 is a C3-Cio-carbocyclic group; R 9 is hydrogen or Ci-C4-alkyl; 83 RIO is CI-C4-alkyl optionally substituted by cyano, CI-C4-alkoxy, a C3-Cio-carbocyclic group or by a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur, or RIO is a C3-Cio-carbocyclic group or a 4- to 10-membered heterocyclic group having at least one ring heteroatom selected from nitrogen, oxygen and sulphur; R 2 is a C3-CIo-carbocyclic group; R1 3 is CI-C4-alkyl; and R1 4 is hydrogen, a C3-Cio-carbocyclic group, CI-C4-alkenyl, or CI-C4-alkyl optionally substituted by a C3-Cio-carbocyclic group. 4. A medicament according to claim 1, in which the compound of formula I is also a compound of formula XIV R |I R 2 O , C R 3 N XIV R' where R1, R 2 , R 3 , and R 4 are as shown in the following table: R 1 and R 3 R 4 R2 NH 2 OH 0 OH H OH 0 OH H 84 RI and R 3 R______________ 4___R___2 0 H 3 OH H H 3 C ) 0 OH No 0 0 OH HI NO N 0 0 OH 0 OHH H N0 OH N OH H N0 FOH - ~-k HI F 85 R and R 3 R4 R2 0F OH H OH F OH N HI ?F 0 OH H 0 C CH 3 0 OH HIaO 0 0 OH CH3 0 OH HCCH3 0 OH H 0 N.0 OH H 0 OH 3 0 H 86 RI and R 3 R4 R2 0 OH -~ N C 0 OH 0 F CH 3 0 OH H C O HO IT, 9 N O 0 OH HIC9 H 3 C N0 OH H O N ~ 0 OH HI "-N N0 OH N\ H 0 ______________CH 3 N0 OH H N0 OH H N0 OH HN 1 - 87 R and R 3 R4 R2 N CH 3 OH N OOH H CHO 3 90 OH N CHOH H 0 OH NN H .0 OH H N0 OH H N0 CH3OH HN Nl -- 0 OH N0 NA- OH 88 RI and R 3 R__ __ _ __4 __ _ R 2 0 CHOH N H N0 OH 7 N CH, H I CH, N0 OH - CH, H CH, N 0 7OH -~ NN N' H H 0 )PI cmi, OH CH3 0I OH H1 7 CH, 0 OH HI H O N NH OH 0 SF HO N OH 0 7 11 OH 0 89 R 1 and R 3 R R2 111 KC C H 3 OH 9 CHOH C COH 9 H CH , O H 9 :NC OH H C CHa O OH H 9 CH3 H 3 C HH 3 C 0 OH H 3 C OH 3 0 OH H 3<H3 H 3 C O H 3 N" OH OH 0 H O N N O 0 - CH 3 OH 3 N OH NH OH 3 O 0 90 RI and R 3 [RI R2_____ OH N H 0N OH NH H N y N , 'N N H H O N y N _o N K OH s 0 C 3 OH 0\/ N 'J OTCH3 K OH S OH H 0N s OH H H S OH H H _,- N OH 0 s OH H H 0\ / N y N ,, 91 RI and R 3 R4R 2 S H O Q/N N OH o sOH S OH "OH OH H N OH N'N H Nci OH H 00 H OH 3 AI o0 'N H OH N 0 A H 'N NH OH 00 92 RI and R 3 R4____________ R 2 H O N OHb 70 N 7 OH H N '-... l NCI OH 7 H, N 0 N -~ OH HI OH H 0 NCI OH K- H 0 N HN OH 0 N OH H 0 NH OH o CH 3 H O N. CH 3 O 0 NH OH 0 NH OH 0 93 RI and R 3 R4__ _ _ __ _ _ _ _ R__ __ _ H O N N O 0 N OH HO 0 N HN- OH o ,-, CH 3 N CH 3 OH 00 NH OH 0F H OH NN N 00 s OH 3 94 RI and R 3 R R 2 s OH OH N 0 H 3 C OH 0 CH 3 ______ N .7 OH H N OH H 1 00 N 7 OH H HO 0 H OH 0 .1 CH3O 95 RI and R 3 R4 R2 OH H I CH 3 OH 0 OH H F O H F F F OH H IF 0 OH H O F F O 3CH, OH H -~ 0 O CH 3 OH 0 OH H 0 0c H O 0, CH 3 OH -H 3 ThH O 96 RI and R 3 R42 N 7 OH o c III N OH H 0 CH3 N. OH 7 ~ NN 0 HO OH 7H 0 H N> OH N 0 HO H - O 0 0 OH 0 97 RI and RI R__ _ _ _ __ _ _ _ _ 4_ _R __2 H 3 C\ OH H N\ 0 H~\N-N OH H I CH 3 0 lp OH H IN 0 CH 3 'N s-N\ OH H N 0 CH 3 N- 0 OH H C N Y / OH 3 0 'N H OH o CH 3 HO o ,0 H 3 C 'NS OH o 0 _ _ _ _ _ _ _CH3 'N0 OH H - CH 3 HO 0 c 98 RI and R 3 R4 R2 s OH o Br H 3 C H OH Br OH H H / CH3 OH N'N H /CHa 0 N cjH 3 OH N

5. A medicament according to claim 1, in which the compound of formula I is also a compound of formula XIV R O C R 3 N XIV R 4 where RI, R 2 , R 3 , and R 4 are as shown in the following table: R 1 and R 3 R4 R2 H OH H NN O N 0 N HOH O N N 99 RI and R 3 R__ __ _ ___4 _ _ _ RI NHO OH OO H O N O 0 ,aOH 0 OH 0 OH HAC 3 H 3 C CH 3 'N OH N 0 OH H 3 H 3 C CH 3 K OH _CHOH C>~H3 OH CH3 s OH O -H 3 H 3 100 R'_and R 3 R4__ _ _ _ __ _ _ _ _ _ R_____2 _ OH CH3 N0 OH 0 OO N 0 OH 0 HO N, ' 7 OH CH 3 O NH 0 OH -N "a H N CH 3 OH N H 3 0 OH NHN HO 0 CH OH0 OH H 0 OH 101 RI and R 3 RI_________R2____ N N~N. ~CH, OH H N0 OH NN B r OH N H N N OH A- I/N HH, H OH N N N o N/ OH 3 H HH N) H 3 C Br OH 3 / H 3 OH N N OH 3 r H KH3 OH N 07,L N0 OH H I1/ N0 OH H NH H H 102 R and R 3 R4 R 2 0 OH H N N H 0 OH H CH OH H'o N H H N N OH H OH N 70 NH OH CH , H Sr> H, OH 0 N FN OH HO 0N HOO N" N O 0 K HO N NY OH N_ N N Y OH N N OH 70 I / CH 3 103 RI and RI R4R H OH N s 0 H O N OH Ho N0 OH H S/ 0 OH H HCH 0 OH CH 3 0 OH H I OHC 0 OH -~ ~ -~~N ~ CH H OH 0. OH H I/ B 104 RI and R 3 R4__ _ _ __ _ _ _ _ R__ __2 _ CH 3 OH HI 0 OH cI HI HC0 0 OH H N 0 0 "CH 3 OH H 3 C 0 0 OH Br NN H / H 3 C 0 0 OH H 0 OH HI F NN F F 0 OH -'- N -" H N CH 3 0 OH H 105 RI and R 3 R4__ _ __ _ _ _ __ _ _ _ R__ __ _ _ 0 0 O N 0 \\,NH, O S\ N0 OH H 1 0 OH 3 OH H) N N _____ _____ ____ H 3 N0 OH H 1 / CI3 0 OH 0 H OH H I/cl N0 OH HI\ FF N0 OH H 3 C3 106 RI and R 3 R4 R2 0 OH H CO -- N N 0 OH SC 0 CH CHOH H 3 C 0 0CH 0 OH 7N HCO H0 OH H s -- N O H 3 C0 cI 0 OH 7 ~ 0 N 0 OH H 0 N0 OH S H 1 N0 OH / OH 3 H OHO N H OH 7 0 S H OH 0\/ 0 0 ,5,N 107 RI and R 3 RI R 2 HOH N HN o N

6. A medicament according to claim 1, in which the compound of formula I is also a compound of formula XIV R | R2 O C R a2 C R3 11 + 0 N+ v N XIV R4 where R1, R 2 , R 3 , and R 4 are as shown in the following table: R and R 3 R4 R 2 S OH / CH 2 0 S , OH OH

7. A medicament according to any one of the claims 1, 2, 3, or 5 wherein the compound of formula I is (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoyl-methyl)-1 azonia-bicyclo- [2.2.2]octane in salt or zwitterionic form.

8. A medicament according to claim 7 wherein the compound of formula I is (R)-3-(2-Hydroxy 2,2-diphenyl-acetoxy)-1-(isoxazol-3-ylcarbamoyl-methyl)-1-azonia-bicyclo- [2.2.2]octane bromide.

9. A medicament according to any one of claims 1 to 8 wherein the beta-2 adrenoceptor agonist is salbutamol, terbutaline, salmeterol or formoterol or a pharmaceutically acceptable salt thereof. 108

10. A medicament according to any one of claims 1 to 8 wherein the beta-2 adrenoceptor agonist is a compound of formula 0 CH 3 HN HO CH 3 HO N H OH or a pharmaceutically acceptable salt thereof.

11. A medicament according to any one of claims 1 to 10 wherein the corticosteroid is budesonide, beclamethasone, fluticasone, ciclesonide or mometasone.

12. A medicament according to claim 11 wherein the corticosteroid is mometasone.

13. A medicament according to claim 1 comprising (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 (isoxazol-3-ylcarbamoyl-methyl)-1-azonia-bicyclo- [2.2.2]octane in salt or zwitterionic form and a compound of formula 0 CH 3 HN HO CH 3 HO N H OH or a pharmaceutically acceptable salt thereof.

14. A medicament according to claim 1 comprising (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 (isoxazol-3-ylcarbamoyl-methyl)-1-azonia-bicyclo- [2.2.2]octane in salt or zwitterionic form and mometasone.

15. A medicament according to claim 1 comprising (R)-3-(2-Hydroxy-2,2-diphenyl-acetoxy)-1 (isoxazol-3-ylcarbamoyl-methyl)-1-azonia-bicyclo- [2.2.2]octane in salt or zwitterionic form, a compound of formula 109 0 CH, HO HN __ CH, .HN HOH * H OH or a pharmaceutically acceptable salt thereof, and mometasone.

16. The use of a medicament according to any one of claims I to 15 for the manufacture of a medicament for the treatment of a condition mediated by the muscarinic M3 receptor.

17. The use of a medicament according to any one of claims 1 to 15 for the manufacture of a medicament for the treatment of an inflammatory or allergic condition.

18. The use according to claim 17 wherein the inflammatory or allergic condition is an inflammatory or obstructive airways disease.

19. The use of a medicament according to any one of claims 1 to 15 for the manufacture of a medicament for the treatment of chronic obstructive pulmonary disease.

20. A method of treating a condition mediated by the muscarinic M3 receptor comprising administering to a subject in need thereof a compound of formula I in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid; wherein the compound of formula I is as defined in any one of claims 1 to 8, the beta-2 adrenoceptor agonist is as defined in any one of claims 1, 9 and 10, and the corticosteroid is as defined in any one of claims 1, 11 and 12.

21. A method of treating an inflammatory or allergic condition comprising administering to a subject in need thereof a compound of formula I in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid; wherein the compound of formula I is as defined in any one of claims 1 to 8, the beta-2 adrenoceptor agonist is as defined in any one of claims 1, 9 and 10, and the corticosteroid is as defined in any one of claims 1, 11 and 12. C:RPorbrlDCC\KZL\2615K83_l DOC-17/12/2009 - 110

22. The method of claim 21, wherein the inflammatory or allergic condition is an inflammatory or obstructive airways disease.

23. A method of treating chronic obstructive pulmonary disease comprising 5 administering to a subject in need thereof a compound of formula I in combination with a beta-2 adrenoceptor agonist and/or a corticosteroid; wherein the compound of formula I is as defined in any one of claims 1 to 8, the beta-2 adrenoceptor agonist is as defined in any one of claims 1, 9 and 10, and the corticosteroid is as defined in any one of claims 1, 11 and 12.