普瑞巴林:修订间差异

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== 药理学 ==
== 药理学 ==
普瑞巴林是[[神经递质]][[γ-氨基丁酸]]的衍生物,<ref name="pmid10189176">{{cite journal | vauthors = Bryans JS, Wustrow DJ | title = 3-substituted GABA analogs with central nervous system activity: a review | url = https://archive.org/details/sim_medicinal-research-reviews_1999-03_19_2/page/149 | journal = Medicinal Research Reviews | volume = 19 | issue = 2 | pages = 149–177 | date = March 1999 | pmid = 10189176 | doi = 10.1002/(SICI)1098-1128(199903)19:2<149::AID-MED3>3.0.CO;2-B | s2cid = 38496241 }}</ref> 也是種強效的[[加巴丁]]類化合物,但它并不与任何γ-氨基丁酸受体结合,而是通过抑制[[钙通道]]发挥作用。<ref name="Cal2016">{{cite journal | vauthors = Calandre EP, Rico-Villademoros F, Slim M | title = Alpha<sub>2</sub>delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use | journal = Expert Review of Neurotherapeutics | volume = 16 | issue = 11 | pages = 1263–1277 | date = November 2016 | pmid = 27345098 | doi = 10.1080/14737175.2016.1202764 | s2cid = 33200190 }}</ref><ref name="Uch2010">{{cite journal | vauthors = Uchitel OD, Di Guilmi MN, Urbano FJ, Gonzalez-Inchauspe C | title = Acute modulation of calcium currents and synaptic transmission by gabapentinoids | journal = Channels | volume = 4 | issue = 6 | pages = 490–496 | year = 2010 | pmid = 21150315 | doi = 10.4161/chan.4.6.12864 | title-link = doi | doi-access = free }}</ref>它是某些[[电压依赖性钙通道]](VDCCs)的辅助[[CACNA2D|α<sub>2</sub>δ]]亚基位点的[[配體_(生物化學)|配体]],从而作为含α<sub>2</sub>δ亚基的电压依赖性钙通道的抑制剂。<ref name="Cal2016" />
普瑞巴林是[[神经递质]][[γ-氨基丁酸]]的衍生物,<ref name="pmid10189176">{{cite journal | vauthors = Bryans JS, Wustrow DJ | title = 3-substituted GABA analogs with central nervous system activity: a review | url = https://archive.org/details/sim_medicinal-research-reviews_1999-03_19_2/page/149 | journal = Medicinal Research Reviews | volume = 19 | issue = 2 | pages = 149–177 | date = March 1999 | pmid = 10189176 | doi = 10.1002/(SICI)1098-1128(199903)19:2<149::AID-MED3>3.0.CO;2-B | s2cid = 38496241 }}</ref> 也是一种强效的[[加巴丁]],但它并不与任何γ-氨基丁酸受体结合,而是通过抑制[[钙通道]]发挥作用。<ref name="Cal2016">{{cite journal | vauthors = Calandre EP, Rico-Villademoros F, Slim M | title = Alpha<sub>2</sub>delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use | journal = Expert Review of Neurotherapeutics | volume = 16 | issue = 11 | pages = 1263–1277 | date = November 2016 | pmid = 27345098 | doi = 10.1080/14737175.2016.1202764 | s2cid = 33200190 }}</ref><ref name="Uch2010">{{cite journal | vauthors = Uchitel OD, Di Guilmi MN, Urbano FJ, Gonzalez-Inchauspe C | title = Acute modulation of calcium currents and synaptic transmission by gabapentinoids | journal = Channels | volume = 4 | issue = 6 | pages = 490–496 | year = 2010 | pmid = 21150315 | doi = 10.4161/chan.4.6.12864 | title-link = doi | doi-access = free }}</ref>它是某些[[电压依赖性钙通道]](VDCCs)的辅助[[CACNA2D|α<sub>2</sub>δ]]亚基位点的[[配體_(生物化學)|配体]],从而作为含α<sub>2</sub>δ亚基的电压依赖性钙通道的抑制剂。<ref name="Cal2016" />
<ref name="pmid16376147">{{cite journal | vauthors = Sills GJ | title = The mechanisms of action of gabapentin and pregabalin | journal = Current Opinion in Pharmacology | volume = 6 | issue = 1 | pages = 108–113 | date = February 2006 | pmid = 16376147 | doi = 10.1016/j.coph.2005.11.003 }}</ref>它与[[CACNA2D1|α<sub>2</sub>δ1]]以及[[CACNA2D2|α<sub>2</sub>δ2]]这两个亚基结合,并在这两个位点上表现出了相似的[[亲和力]],因此普瑞巴林缺乏α<sub>2</sub>δ亚基的选择性,<ref name="Cal2016" />但具有电压依赖性钙通道的α<sub>2</sub>δ亚基选择性。<ref name="pmid16376147" />
<ref name="pmid16376147">{{cite journal | vauthors = Sills GJ | title = The mechanisms of action of gabapentin and pregabalin | journal = Current Opinion in Pharmacology | volume = 6 | issue = 1 | pages = 108–113 | date = February 2006 | pmid = 16376147 | doi = 10.1016/j.coph.2005.11.003 }}</ref>它与[[CACNA2D1|α<sub>2</sub>δ1]]以及[[CACNA2D2|α<sub>2</sub>δ2]]这两个亚基结合,并在这两个位点上表现出了相似的[[亲和力]],因此普瑞巴林缺乏α<sub>2</sub>δ亚基的选择性,<ref name="Cal2016" />但具有电压依赖性钙通道的α<sub>2</sub>δ亚基选择性。<ref name="pmid16376147" />
<ref name="BenzonRathmell2013">{{Cite book | vauthors = Benzon HM, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW |url=https://books.google.com/books?id=kfcDAQAAQBAJ&pg=PA1006 |title=Practical Management of Pain |date=September 11, 2013 |publisher=Elsevier Health Sciences |isbn=978-0-323-17080-2 |page=1006}}</ref> 虽然普瑞巴林不与任何γ-氨基丁酸受体结合,也不会转换为γ-氨基丁酸或其他γ-氨基丁酸受体激动剂,也不直接调节γ-氨基丁酸的[[转运]]或代谢,<ref name="Uch2010" /><ref name="pmid16376147" />但它会增加[[L-谷氨酸脱羧酶]](GAD)在大脑中的[[基因表达|表达]],<ref>{{Cite book|veditors=Lin GQ, You QD, Cheng JF|url=https://books.google.com/books?id=Zgx13oMZaYUC&pg=PA88|title=Chiral Drugs: Chemistry and Biological Action|date=August 8, 2011|publisher=John Wiley & Sons|isbn=9781118075630|page=88|via=Google Books|access-date=August 17, 2016|archive-date=April 25, 2022|archive-url=https://web.archive.org/web/20220425105353/https://books.google.com/books?id=Zgx13oMZaYUC&pg=PA88|url-status=live}}</ref><ref>{{cite journal | vauthors = Li Z, Taylor CP, Weber M, Piechan J, Prior F, Bian F, Cui M, Hoffman D, Donevan S | display-authors = 6 | title = Pregabalin is a potent and selective ligand for α(2)δ-1 and α(2)δ-2 calcium channel subunits | journal = European Journal of Pharmacology | volume = 667 | issue = 1–3 | pages = 80–90 | date = September 2011 | pmid = 21651903 | doi = 10.1016/j.ejphar.2011.05.054 | url = https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Pregabalin+is+a+potent+and+selective+ligand+for+alpha%282%29delta-1+and+alpha%282%29delta-2+calcium+channel+subunits&btnG= | access-date = October 20, 2020 | url-status = live | archive-url = https://web.archive.org/web/20201021030744/https://scholar.google.com/scholar?hl=en&as_sdt=0,5&q=Pregabalin+is+a+potent+and+selective+ligand+for+alpha(2)delta-1+and+alpha(2)delta-2+calcium+channel+subunits&btnG= | archive-date = October 21, 2020 }}</ref>
<ref name="BenzonRathmell2013">{{Cite book | vauthors = Benzon HM, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW |url=https://books.google.com/books?id=kfcDAQAAQBAJ&pg=PA1006 |title=Practical Management of Pain |date=September 11, 2013 |publisher=Elsevier Health Sciences |isbn=978-0-323-17080-2 |page=1006}}</ref> 虽然普瑞巴林不与任何γ-氨基丁酸受体结合,也不会转换为γ-氨基丁酸或其他γ-氨基丁酸受体激动剂,也不直接调节γ-氨基丁酸的[[转运]]或代谢,<ref name="Uch2010" /><ref name="pmid16376147" />但它会增加[[L-谷氨酸脱羧酶]](GAD)在大脑中的[[基因表达|表达]],<ref>{{Cite book|veditors=Lin GQ, You QD, Cheng JF|url=https://books.google.com/books?id=Zgx13oMZaYUC&pg=PA88|title=Chiral Drugs: Chemistry and Biological Action|date=August 8, 2011|publisher=John Wiley & Sons|isbn=9781118075630|page=88|via=Google Books|access-date=August 17, 2016|archive-date=April 25, 2022|archive-url=https://web.archive.org/web/20220425105353/https://books.google.com/books?id=Zgx13oMZaYUC&pg=PA88|url-status=live}}</ref><ref>{{cite journal | vauthors = Li Z, Taylor CP, Weber M, Piechan J, Prior F, Bian F, Cui M, Hoffman D, Donevan S | display-authors = 6 | title = Pregabalin is a potent and selective ligand for α(2)δ-1 and α(2)δ-2 calcium channel subunits | journal = European Journal of Pharmacology | volume = 667 | issue = 1–3 | pages = 80–90 | date = September 2011 | pmid = 21651903 | doi = 10.1016/j.ejphar.2011.05.054 | url = https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Pregabalin+is+a+potent+and+selective+ligand+for+alpha%282%29delta-1+and+alpha%282%29delta-2+calcium+channel+subunits&btnG= | access-date = October 20, 2020 | url-status = live | archive-url = https://web.archive.org/web/20201021030744/https://scholar.google.com/scholar?hl=en&as_sdt=0,5&q=Pregabalin+is+a+potent+and+selective+ligand+for+alpha(2)delta-1+and+alpha(2)delta-2+calcium+channel+subunits&btnG= | archive-date = October 21, 2020 }}</ref>
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== 滥用 ==
== 滥用 ==
普瑞巴林因其中枢抑制的特性时常被滥用,通常会使用至少一次300mg或更高的剂量。
普瑞巴林因其中枢抑制的特性时常被滥用,通常会使用至少一次300mg或更高的剂量。普瑞巴林在过量时可能具有成瘾性和戒断反应


== 參考文献 ==
== 參考文献 ==
{{reflist|}}
{{reflist}}

2024年6月26日 (三) 06:16的版本

普瑞巴林Pregabalin),是一種治療癲癇神經痛纖維肌痛廣泛性焦慮症[1][2]的藥物。

藥理學

普瑞巴林是神經遞質γ-氨基丁酸的衍生物,[3] 也是一種強效的加巴噴丁類物質,但它並不與任何γ-氨基丁酸受體結合,而是通過抑制鈣通道發揮作用。[4][5]它是某些電壓依賴性鈣通道(VDCCs)的輔助α2δ亞基位點的配體,從而作為含α2δ亞基的電壓依賴性鈣通道的抑制劑。[4] [6]它與α2δ1以及α2δ2這兩個亞基結合,並在這兩個位點上表現出了相似的親和力,因此普瑞巴林缺乏α2δ亞基的選擇性,[4]但具有電壓依賴性鈣通道的α2δ亞基選擇性。[6] [7] 雖然普瑞巴林不與任何γ-氨基丁酸受體結合,也不會轉換為γ-氨基丁酸或其他γ-氨基丁酸受體激動劑,也不直接調節γ-氨基丁酸的轉運或代謝,[5][6]但它會增加L-穀氨酸脫羧酶(GAD)在大腦中的表達[8][9] [10] 而此酶是用於合成γ-氨基丁酸的酶,因此可能由於大腦內γ氨基丁酸水平升高造成一些γ-氨基丁酸能的作用。但目前沒有證據可以說明普瑞巴林的作用是除了抑制含α2δ亞基的電壓依賴性鈣通道介導的。[6] [11] 因此,普瑞巴林對其的抑制作用似乎是它抗驚厥鎮痛抗焦慮效果的原因。[6][11]


在一項研究中發現,普瑞巴林對含α2δ亞基的電壓依賴性鈣通具有比加巴噴丁高6倍的親和力,[12][13]而在另一項研究中發現,普瑞巴林和加巴噴丁對人類重組α2δ1亞基具有差不多的親和力(Ki分別為32 nM和40 nM)。[14]在任何情況下,普瑞巴林作為鎮痛藥的效力是加巴噴丁的2~4倍,[3][15]在動物身上作為抗驚厥藥時的效力似乎是加巴噴丁的3~10倍。[3][15]

濫用

普瑞巴林因其中樞抑制的特性時常被濫用,通常會使用至少一次300mg或更高的劑量。普瑞巴林在過量時可能具有成癮性和戒斷反應。

參考文獻

  1. Frampton, JE (September 2014). "Pregabalin: a review of its use in adults with generalized anxiety disorder". CNS Drugs. 28 (9): 835–54. doi:10.1007/s40263-014-0192-0. PMID 25149863.
  2. "Pregabalin". The American Society of Health-System Pharmacists. Archived from the original on 2020-08-09. Retrieved 2015-10-23. {{cite web}}: Unknown parameter |dead-url= ignored (|url-status= suggested) (help)
  3. 3.0 3.1 3.2 Bryans JS, Wustrow DJ (March 1999). "3-substituted GABA analogs with central nervous system activity: a review". Medicinal Research Reviews. 19 (2): 149–177. doi:10.1002/(SICI)1098-1128(199903)19:2<149::AID-MED3>3.0.CO;2-B. PMID 10189176. S2CID 38496241.
  4. 4.0 4.1 4.2 Calandre EP, Rico-Villademoros F, Slim M (November 2016). "Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use". Expert Review of Neurotherapeutics. 16 (11): 1263–1277. doi:10.1080/14737175.2016.1202764. PMID 27345098. S2CID 33200190.
  5. 5.0 5.1 Uchitel OD, Di Guilmi MN, Urbano FJ, Gonzalez-Inchauspe C (2010). "Acute modulation of calcium currents and synaptic transmission by gabapentinoids". Channels. 4 (6): 490–496. doi:10.4161/chan.4.6.12864. PMID 21150315.
  6. 6.0 6.1 6.2 6.3 6.4 Sills GJ (February 2006). "The mechanisms of action of gabapentin and pregabalin". Current Opinion in Pharmacology. 6 (1): 108–113. doi:10.1016/j.coph.2005.11.003. PMID 16376147.
  7. Benzon HM, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW (September 11, 2013). Practical Management of Pain. Elsevier Health Sciences. p. 1006. ISBN 978-0-323-17080-2.
  8. Lin GQ, You QD, Cheng JF, eds. (August 8, 2011). Chiral Drugs: Chemistry and Biological Action. John Wiley & Sons. p. 88. ISBN 9781118075630. Archived from the original on April 25, 2022. Retrieved August 17, 2016 – via Google Books.
  9. Li Z, Taylor CP, Weber M, Piechan J, Prior F, Bian F, et al. (September 2011). "Pregabalin is a potent and selective ligand for α(2)δ-1 and α(2)δ-2 calcium channel subunits". European Journal of Pharmacology. 667 (1–3): 80–90. doi:10.1016/j.ejphar.2011.05.054. PMID 21651903. Archived from the original on October 21, 2020. Retrieved October 20, 2020.
  10. Sze PY (1979). "L-Glutamate Decarboxylase". GABA—Biochemistry and CNS Functions. Advances in Experimental Medicine and Biology. Vol. 123. pp. 59–78. doi:10.1007/978-1-4899-5199-1_4. ISBN 978-1-4899-5201-1. PMID 390996.
  11. 11.0 11.1 Stahl SM, Porreca F, Taylor CP, Cheung R, Thorpe AJ, Clair A (June 2013). "The diverse therapeutic actions of pregabalin: is a single mechanism responsible for several pharmacological activities?". Trends in Pharmacological Sciences. 34 (6): 332–339. doi:10.1016/j.tips.2013.04.001. PMID 23642658.
  12. Baidya DK, Agarwal A, Khanna P, Arora MK (July 2011). "Pregabalin in acute and chronic pain". Journal of Anaesthesiology Clinical Pharmacology. 27 (3): 307–314. doi:10.4103/0970-9185.83672. PMC 3161452. PMID 21897498.
  13. McMahon SB (2013). Wall and Melzack's textbook of pain (6th ed.). Philadelphia, PA: Elsevier/Saunders. p. 515. ISBN 9780702040597.
  14. Taylor CP, Angelotti T, Fauman E (February 2007). "Pharmacology and mechanism of action of pregabalin: the calcium channel alpha2-delta (alpha2-delta) subunit as a target for antiepileptic drug discovery". Epilepsy Research. 73 (2): 137–150. doi:10.1016/j.eplepsyres.2006.09.008. PMID 17126531. S2CID 54254671. Archived from the original on October 23, 2020. Retrieved October 19, 2020.
  15. 15.0 15.1 Lauria-Horner BA, Pohl RB (April 2003). "Pregabalin: a new anxiolytic". Expert Opinion on Investigational Drugs. 12 (4): 663–672. doi:10.1517/13543784.12.4.663. PMID 12665421. S2CID 36137322.