Old reliable amides

Some of the trickiest organic chemistry is total synthesis of natural products, and it brings out all sorts of unusual reactions. But medicinal chemistry is (rather famously) not quite like natural product synthesis. There’s the same any-weapon-to-hand attitude, but the weapons we use in the biopharma labs are mostly variations on just a few classic general reactions, and the med-chem literature is full of calls for new chemistry and warnings about how overreliance on a few transformations leads to too many similar compounds. But is that really right?