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1ÀÏ 5mgÀ» 7Àϰ£ Åõ¿©ÇÑ´Ù. |
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1ÀÏ 10mgÀ» 7Àϰ£ Åõ¿©ÇÑ´Ù. |
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ÀÓ»óÀÚ·á¿¡ ±âÃÊÇÏ¿©, 65¼¼ ÀÌ»óÀÇ ³ëÀΠȯÀÚ¿¡¼ ±ÇÀåµÇ´Â ¿ë·®Àº 1ÀÏ 20mgÀÌ´Ù.
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4. °£Àå¾Ö ȯÀÚ :
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ÀÌ ¾àÀÇ ¸ðÀ¯·ÎÀÇ ÀÌÇà ¿©ºÎ´Â ¹àÇôÁöÁö ¾Ê¾ÒÀ¸³ª ÀÌ ¾àÀÇ Áö¿ë¼ºÀ» °í·ÁÇÏ¸é °¡´É¼ºÀÌ ÀÖ´Ù. µû¶ó¼ ÀÌ ¾àÀ» Åõ¿©ÇÏ´Â °æ¿ì, ¼öÀ¯¸¦ Áß´ÜÇØ¾ß ÇÑ´Ù.
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ÀÓ»ó½ÃÇèÀ̳ª ½ÃÆÇÈÄ °æÇè¿¡¼ °ú·® Åõ¿©¿¡ ´ëÇÑ °æÇèÀº ¸Å¿ì Á¦ÇÑÀûÀÌ´Ù.
1) Áõ»ó:
ºñ±³Àû °ú·® (200mg/ÀÏ, 105mg/ÀÏ, °¢°¢ 3Àϰ£) º¹¿ë ½Ã ÇǷΰ¨, ¹«·Â°¨ ±×¸®°í/¶Ç´Â ¼³»ç µîÀÇ Áõ»ó ¶Ç´Â ¹«Áõ»óÀÌ ³ªÅ¸³µ´Ù. 140mg ÀÌÇÏ ¶Ç´Â ¾Ë·ÁÁöÁö ¾ÊÀº ¿ë·®ÀÇ °ú·®¿¡¼´Â ÁßÃ߽Űæ°è Áõ»ó (È¥µ·, Á¹À½, Á¹¸², ¾îÁö·¯¿ò (Vertigo), ÃÊÁ¶, °ø°Ý¼º, ȯ°¢, °ÉÀ½Àå¾Ö) ±×¸®°í/¶Ç´Â ¼Òȱâ°è Áõ»ó(±¸Åä, ¼³»ç)ÀÌ ³ªÅ¸³µ´Ù.
°¡Àå ½ÉÇÑ °ú·® Åõ¿© ¿¹·Î´Â, ÀÌ ¾àÀ» 2,000mg±îÁö °ú·® º¹¿ëÇÑ È¯ÀÚ¿¡¼ ÁßÃ߽Űæ°è Áõ»ó (10Àϰ£ È¥¼ö»óÅÂ, ÀÌÈÄ¿¡ °ãº¸ÀÓ ¹× ÃÊÁ¶)ÀÌ ³ªÅ¸³µ´Ù. ÀÌ È¯ÀÚ´Â ´ëÁõ¿ä¹ý°ú Ç÷ÀåºÐ¸®¹ÝÃâ¼ú Ä¡·á ÈÄ ¿µ±¸ÀûÀÎ ÈÄÀ¯Áõ ¾øÀÌ È¸º¹µÇ¾ú´Ù.
´Ù¸¥ °ú·® Åõ¿© ¿¹·Î, ÀÌ ¾àÀ» 400mg±îÁö °ú·® º¹¿ëÇÑ ÇÑ È¯ÀÚ¿¡¼ ¾ÈÀýºÎÀý, Á¤½Åº´, ȯ½Ã, °æ·Ã, Á¹¸², È¥¹Ì, ¹«Àǽİú °°Àº ÁßÃ߽Űæ°è Áõ»óÀÌ ³ªÅ¸³µÀ¸¸ç, ÀÌ È¯ÀÚ ¶ÇÇÑ È¸º¹µÇ¾ú´Ù.
2) Ä¡·á:
°ú·® º¹¿ë ½ÃÀÇ Ã³Ä¡´Â ´ëÁõ¿ä¹ýÀ» ½Ç½ÃÇÑ´Ù. Ưº°ÇÑ ÇØµ¶Á¦´Â ¾øÀ¸¸ç, Ȱ¼º¼ººÐ ¾à¹°À» Á¦°ÅÇϱâ À§ÇÏ¿© À§¼¼Ã´, ¾à¿ëź Åõ¿© (ÀáÀçÀûÀÎ Àå-°£ Àç¼øÈ¯ ¹æÁö), ¿ä»ê¼ºÈ, °Á¦ÀÌ´¢ µîÀÇ ÀϹÝÀûÀÎ ¹æ¹ýÀ» ÀûÀýÇÏ°Ô »ç¿ëÇÑ´Ù.
ÀϹÝÀûÀÎ ÁßÃ߽Űæ°è °ú´ÙÀÚ±Ø(overstimulation) Áõ»ó°ú ¡Èĸ¦ º¸ÀÌ´Â °æ¿ì¿¡´Â ÁÖÀÇ ±íÀº ´ëÁõ ÀÓ»ó Ä¡·á¸¦ °í·ÁÇØ¾ß ÇÑ´Ù.
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1) ¾î¸°ÀÌÀÇ ¼ÕÀÌ ´êÁö ¾Ê´Â °÷¿¡ º¸°üÇÑ´Ù.
2) ´Ù¸¥ ¿ë±â¿¡ ¹Ù²Ù¾î ³Ö´Â °ÍÀº »ç°í¿øÀÎÀÌ µÇ°Å³ª ǰÁúÀ¯Áö ¸é¿¡¼ ¹Ù¶÷Á÷ÇÏÁö ¾ÊÀ¸¹Ç·Î À̸¦ ÁÖÀÇÇÑ´Ù.
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¿îÀü ¹× ±â°è Á¶ÀÛ´É¿¡ ´ëÇÑ ¿µÇâ
ÀÌ ¾àÀÇ Åõ¿© ´ë»óÀÎ Áߵ¿¡¼ ÁßÁõÀÇ ¾ËÃ÷ÇÏÀ̸Ӻ´ ȯÀÚ´Â ÀϹÝÀûÀ¸·Î ¿îÀü ¹× ±â°è Á¶ÀÛ´É Àå¾Ö »óÅÂÀÌ´Ù. ´õ¿íÀÌ ÀÌ ¾àÀº ȯÀÚÀÇ ¹ÝÀÀ¼º¿¡ ¿µÇâÀ» ¹ÌÄ¥ ¼ö ÀÖÀ¸¹Ç·Î ÀÌ·¯ÇÑ ¿Ü·¡ ȯÀÚÀÇ °æ¿ì ¿îÀü ¹× ±â°è Á¶À۽à Ưº°È÷ ÁÖÀÇÇϵµ·Ï °æ°íÇØ¾ß ÇÑ´Ù.
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1) ¾à·ÂÇÐÀû Ư¼º
¾à¹°Ä¡·á±º: ±âŸ Ä¡¸ÅÄ¡·áÁ¦, ATC code: N06DX01.
NMDA(N-methyl-D-aspartate) ¼ö¿ëü¿¡¼ ±Û·çŸ¸ÞÀÌÆ®¼º(glutamergic) ½Å°æÀü´ÞÀÇ ±â´ÉÀå¾Ö°¡ ½Å°æÅðÇ༺ Ä¡¸ÅÀÇ Áõ»ó ¹ßÇö ¹× Áúº´ ÁøÇà¿¡ °ü¿©ÇÑ´Ù´Â Áõ°Å°¡ Áõ°¡Çϰí ÀÖ´Ù.
¸Þ¸¸Æ¾Àº Àü¾Ð ÀÇÁ¸¼º(voltage-dependent), Áߵ ģȷÂ(moderate-affinity)ÀÇ ºñ°æÀïÀû NMDA ¼ö¿ëü ±æÇ×Á¦ÀÌ´Ù. º´¸®ÇÐÀûÀ¸·Î »ó½ÂµÈ ±Û·çŸ¸ÞÀÌÆ®(glutamate)¿¡ ÀÇÇÏ¿© ½Å°æÀå¾Ö¸¦ ÀÏÀ¸Å³ ¼ö ÀÖ´Â ¼öÄ¡ÀÇ ¿µÇâÀ» Á¶ÀýÇÑ´Ù.
ÀÓ»ó ½ÃÇè
Áߵ¿¡¼ ÁßÁõÀÇ ¾ËÃ÷ÇÏÀ̸Ӻ´ ȯÀÚ(Åõ¿© Àü º£À̽º¶óÀÎ °£ÀÌÁ¤½Å»óŰ˻ç(Mini-mental State Examination, MMSE) ÃÑÁ¡ 3-14)¸¦ ´ë»óÀ¸·Î ÇÑ ´ÜÀÏ¿ä¹ý Áß¿ä Àӻ󿬱¸(pivotal study)¿¡¼ ÃÑ 252¸íÀÇ ¿Ü·¡ ȯÀÚ°¡ Æ÷ÇԵǾú´Ù. ÀÌ ¿¬±¸¿¡¼ ¸Þ¸¸Æ¾ Ä¡·á 6°³¿ù ÈÄ À§¾à´ëºñ À¯ÀÇÇÑ È¿°ú¸¦ º¸¿´´Ù. (observed cases analysis for the clinician¢¥s interview based impression of change (CIBIC-plus): p=0.025; Alzheimer¢¥s disease cooperative study – activities of daily living (ADCS-ADLsev): p=0.003; severe impairment battery (SIB): p=0.002).
°æµµ¿¡¼ ÁߵÀÇ ¾ËÃ÷ÇÏÀ̸Ӻ´(Åõ¿© Àü º£À̽º¶óÀÎ MMSE ÃÑÁ¡ 10-22) Ä¡·á¿¡ ´ëÇÑ ¸Þ¸¸Æ¾ ´ÜÀÏ¿ä¹ý Áß¿ä Àӻ󿬱¸¿¡´Â ÃÑ 403¸íÀÇ È¯ÀÚ°¡ Æ÷ÇԵǾú´Ù. ¸Þ¸¸Æ¾Ä¡·á ȯÀÚ±º¿¡¼ ÀÏÂ÷ À¯È¿¼º Æò°¡ÁöÇ¥¿¡ ´ëÇÏ¿© À§¾à´ëºñ Åë°èÀûÀ¸·Î À¯ÀÇÇÑ °³¼± È¿°ú¸¦ º¸¿´´Ù. (Æò°¡ 24ÁÖÂ÷¿¡ ¾ËÃ÷ÇÏÀ̸Ӻ´ Æò°¡ÁöÇ¥(ADAS-cog) (p=0.003) ¹× CIBIC-plus (p=0.004) (last observation carried forward (LOCF)). °æµµ¿¡¼ ÁߵÀÇ ¾ËÃ÷ÇÏÀ̸Ӻ´¿¡ ´ëÇÑ ¶Ç ´Ù¸¥ ´ÜÀÏ¿ä¹ý ¿¬±¸¿¡¼´Â ÃÑ 470¸íÀÇ È¯ÀÚ(Åõ¿© Àü º£À̽º¶óÀÎ MMSE ÃÑÁ¡ 11-23)°¡ ¹«ÀÛÀ§ ¹èÁ¤µÇ¾ú´Ù. ÀüÇâÀûÀ¸·Î Á¤ÀÇµÈ Ãʱ⠺м® °á°ú 24ÁÖÂ÷¿¡ ÀÏÂ÷À¯È¿¼º Æò°¡¿¡¼ Åë°èÀû À¯ÀǼºÀ» È®º¸ÇÏÁö ¸øÇÏ¿´´Ù.
ÃÑ 6°ÇÀÇ 3»ó, À§¾à-´ëÁ¶, 6°³¿ù Àӻ󿬱¸(´ÜÀÏ¿ä¹ý ¿¬±¸¿Í ¾ÈÁ¤ ¿ë·®ÀÇ ¾Æ¼¼Æ¿Äݸ° ºÐÇØ È¿¼Ò ¾ïÁ¦Á¦(acetylcholinesterase inhibitors) º´¿ëÅõ¿© ¿¬±¸ Æ÷ÇÔ)¿¡ Æ÷ÇÔµÈ Áߵ¿¡¼ ÁßÁõÀÇ ¾ËÃ÷ÇÏÀ̸Ӻ´ ȯÀÚ¿¡ ´ëÇÑ ¸ÞŸºÐ¼® °á°ú, ¸Þ¸¸Æ¾ Ä¡·á½Ã ÀÎÁö±â´É, Àü¹ÝÀûÀÎ Æò°¡ ¹× ±â´É ¿µ¿ª¿¡¼ Åë°èÀûÀ¸·Î À¯ÀÇÇÑ °³¼± È¿°ú°¡ ³ªÅ¸³ª´Â °ÍÀ¸·Î È®ÀεǾú´Ù. ºÐ¼® °á°ú¿¡¼, ȯÀÚ°¡ 3°¡Áö µµ¸ÞÀÎ ¸ðµÎ¿¡¼ µ¿½Ã¿¡ Áõ»ó ¾ÇȰ¡ ³ªÅ¸³¯ ¶§, À§¾à±º¿¡¼ 2¹è ´õ ¸¹Àº ȯÀÚ¿¡¼ ¾Çȸ¦ º¸¿´À¸¸ç(21% vs. 11%, p¡æ0.0001), ¸Þ¸¸Æ¾Àº À§¾à ´ëºñ Åë°èÀûÀ¸·Î À¯ÀÇÇÏ°Ô Áõ»ó ¾ÇÈ ¿¹¹æ È¿°ú¸¦ ³ªÅ¸³Â´Ù.
ÀϺ»¿¡¼ ¼öÇàµÈ Áߵ¿¡¼ ÁßÁõ ¾ËÃ÷ÇÏÀ̸ÓÇü Ä¡¸Å ȯÀÚ (MMSE Á¡¼ö : 5 Á¡ ÀÌ»ó 14 Á¡ ÀÌÇÏ, FAST ´Ü°è : 6a ÀÌ»ó 7a ÀÌÇÏ) ÃÑ 432 ¸íÀ» ´ë»óÀ¸·Î ¸Þ¸¸Æ¾¿°»ê¿° 20mg (5mg/ÀÏ, 10mg/ÀÏ ¹× 15mg/ÀÏ °¢°¢ Â÷·Ê·Î 1 ÁÖ°£ Åõ¿© ÈÄ 20mg/ÀÏÀ» 21 ÁÖ°£ Åõ¿© : ÃÑ 24 ÁÖ°£ Åõ¿©) ¶Ç´Â À§¾àÀ» 24 ÁÖ°£ Åõ¿©ÇÏ´Â ÀÌÁß ¸Í°Ë 3»ó ÀÓ»ó½ÃÇè¿¡¼ ÀÏÂ÷ À¯È¿¼ºÀÎ Åõ¿© 24ÁÖ ÈÄ À§¾à±º°ú ¸Þ¸¸Æ¾¿°»ê¿° 20mg/ÀÏ ±º °£ SIB-J Á¡¼ö º¯È·® Â÷ÀÌ´Â 4.53Á¡À¸·Î, µÎ ±º °£¿¡ Åë°èÀûÀ¸·Î À¯ÀÇÇÑ Â÷À̰¡ ³ªÅ¸³µ´Ù (ºÐ¼® ´ë»ó: 368¸í, p=0.0001, Wilcoxon °ËÁ¤). Àü¹ÝÀûÀÎ ÀÓ»ó Áõ»óÀ» Æò°¡ÇÏ´Â Modified CIBIC plus-J Åõ¿© 24 ÁÖ ÈÄ Æò±ÕÄ¡¿¡¼ µÎ ±º°£ÀÇ Â÷ÀÌ´Â 0.11À̸ç, À¯ÀÇÇÑ Â÷À̰¡ ³ªÅ¸³ªÁö ¾Ê¾Ò´Ù (ºÐ¼® ´ë»ó: 367 ¸í, p = 0.3189, Mantel °ËÁ¤).
ÀÌ»ó¹ÝÀÀ ¹ßÇö ºóµµ´Â ¸Þ¸¸Æ¾¿°»ê¿° ±º¿¡¼ 28.5 % (63/221 ¸í)À̸ç, ÁÖ¿ä ÀÌ»ó¹ÝÀÀÀº º¯ºñ 3.2 % (7/221 ¸í), Ç÷¾Ð »ó½Â 2.3 % (5/221 ¸í), °íÇ÷¾Ð 1.8 % (4/221 ·Ê), Ç÷Áß Å©·¹¾ÆÆ¾Æ÷½ºÆ÷Ű³ªÁ¦ Áõ°¡, ¾ËÃ÷ÇÏÀ̸ÓÇü Ä¡¸Å °¢ 1.4 % (3/221 ¸í)¿´´Ù.
2) ¾àµ¿ÇÐÀû Ư¼º
Èí¼ö (Absorption)
¸Þ¸¸Æ¾Àº ¾à 100%ÀÇ Àý´ë »ýüÀÌ¿ë·üÀ» º¸ÀδÙ. Tmax´Â 3 - 8½Ã°£ÀÌ´Ù. À½½ÄÀÌ ¸Þ¸¸Æ¾ Èí¼ö¿¡ ¿µÇâÀ» ¹ÌÄ£´Ù´Â ¡ÈÄ´Â ¹ß°ßµÇÁö ¾Ê¾Ò´Ù.
ºÐÆ÷ (Distribution)
¸Þ¸¸Æ¾ 1ÀÏ 20mg ¿ë·®À» Åõ¿©½Ã 70~150 ng/ml (0.5~1 µmol) ¹üÀ§ÀÇ Ç×Á¤»óÅÂ(steady-state) Ç÷Àå ³óµµ¸¦ º¸À̸ç, °³ÀÎ Â÷À̰¡ Å©´Ù. 1ÀÏ 5~30 mg Åõ¿© ½Ã, Æò±Õ ³úô¼ö¾×(CSF)/Ç÷û ºñÀ²Àº 0.52·Î °è»êµÇ¾ú´Ù. ºÐÆ÷·®Àº ¾à 10 l/kgÀÌ´Ù. ¸Þ¸¸Æ¾ÀÇ ¾à 45%´Â Ç÷Àå ´Ü¹éÁú°ú °áÇյȴÙ.
´ë»ç (Biotransformation)
»ç¶÷ÀÇ °æ¿ì ¼øÈ¯ÇÏ´Â ¸Þ¸¸Æ¾ °ü·Ã ¹°ÁúÀÇ ¾à 80%°¡ ¹Ì´ë»çü(parent compound)·Î Á¸ÀçÇÑ´Ù. »ç¶÷¿¡¼ ÁÖ¿ä ´ë»çü´Â N-3,5-µð¸ÞÆ¿-±Û·ç´Üź°ú À̼ºÁúü È¥ÇÕ¹°ÀÎ 4- ¹× 6-ÇÏÀ̵å·Ï½Ã ¸Þ¸¸Æ¾°ú 1-´ÏÆ®·Î¼Ò-3,5-µð¸ÞÆ¿-¾Æ´Ù¸¸ÅºÀÌ´Ù. ÀÌµé ´ë»çü´Â NMDA ±æÇ× È°¼ºÀ» ³ªÅ¸³»Áö ¾Ê´Â´Ù. ½ÃÇè°ü ³»¿¡¼ »çÀÌÅäÅ©·Ò P 450 Ã˸Š´ë»ç´Â °ËÃâµÇÁö ¾Ê¾Ò´Ù.
14C-¸Þ¸¸Æ¾ °æ±¸Åõ¿© ¿¬±¸¿¡¼ Æò±Õ 84%ÀÇ ¿ë·®ÀÌ 20ÀÏ À̳»¿¡ ȸº¹µÇ¾úÀ¸¸ç 99% ÀÌ»óÀÌ ½ÅÀåÀ¸·Î ¹è¼³µÇ¾ú´Ù.
¹è¼³ (Elimination)
¸Þ¸¸Æ¾Àº ´ÜÀÏÁö¼ö ¹æ½ÄÀ¸·Î ¼Ò½ÇµÇ¸ç ¸»´Ü ¹è¼³ ¹Ý°¨±â(t¨ö)´Â 60-100½Ã°£ÀÌ´Ù. Á¤»óÀûÀÎ ½ÅÀå±â´ÉÀ» °¡Áø Áö¿øÀÚ¿¡¼ ÃÑ Ã»¼ÒÀ²(Cltot)Àº 170 ml/min/1.73m©÷ À̸ç, Àüü ½ÅÀå û¼ÒÀ²ÀÇ ÀϺδ ¼¼´¢°ü ºÐºñ¿¡ ÀÇÇØ ÀÌ·ç¾îÁø´Ù.
½ÅÀå¿¡¼ ¼¼´¢°ü ÀçÈí¼öµµ ¼ö¹ÝµÇ¸ç, ¾çÀ̿ ¼ö¼Û ´Ü¹éÁú¿¡ ÀÇÇØ ¸Å°³µÇ´Â °ÍÀ¸·Î ÃßÁ¤µÈ´Ù. ¾ËÄ®¸®¼º ¼Òº¯¿¡¼ ¸Þ¸¸Æ¾ÀÇ ½ÅÀå Á¦°ÅÀ²Àº 7~9¹è °¨¼ÒÇÒ ¼ö ÀÖ´Ù. ¼Òº¯ÀÇ ¾ËÄ®¸®È´Â ½Ä´ÜÀÇ ±Þ°ÝÇÑ º¯È(¿¹: À°·ù À§ÁÖÀÇ ½Ä´Ü¿¡¼ ä½Ä À§ÁÖÀÇ ½Ä´ÜÀ¸·ÎÀÇ º¯È ¶Ç´Â ¾ËÄ®¸®¼º À§ ¿ÏÃæÁ¦ÀÇ ´Ù·® ¼·Ãë)·Î ÀÎÇØ ¹ß»ýÇÒ ¼ö ÀÖ´Ù.
¼±Çü¼º (Linearity)
Áö¿øÀÚ¸¦ ´ë»óÀ¸·Î ÇÑ ¿¬±¸¿¡¼ 10~40mgÀÇ ¿ë·®¹üÀ§¿¡¼ ¼±Çü ¾àµ¿ÇÐÀÌ ÀÔÁõµÇ¾ú´Ù.
¾àµ¿ÇÐ/¾à·ÂÇÐ °ü°è
¸Þ¸¸Æ¾ 1ÀÏ 20mg ¿ë·®¿¡¼ ³úô¼ö¾×(CSF) ¼öÄ¡´Â Àΰ£ ÀüµÎ¿± ÇÇÁú¿¡¼ 0.5 µmolÀÎ ¸Þ¸¸Æ¾ÀÇ ki°ª(ki=¾ïÁ¦»ó¼ö)°ú ÀÏÄ¡ÇÑ´Ù.
3) ºñÀÓ»ó ¾ÈÀü¼º ÀÚ·á
·§µå¸¦ ´ë»óÀ¸·Î ÇÑ ´Ü±â°£ ½ÃÇè¿¡¼ ´Ù¸¥ NMDA ±æÇ×Á¦¿Í ¸¶Âù°¡Áö·Î ¸Þ¸¸Æ¾ÀÇ ÃÖ°í Ç÷û ³óµµ¸¦ ¸Å¿ì ³ôÀº ¿ë·®À¸·Î À¯µµÇÏ¿´À» ¶§¿¡¸¸ ½Å°æ °øÆ÷È ¹× ±«»ç¸¦ À¯¹ßÇß´Ù. ¿îµ¿½ÇÁ¶ ¹× ´Ù¸¥ ºñÀÓ»ó ¡Èİ¡ °øÆ÷È ¹× ±«»çº¸´Ù ¸ÕÀú ³ªÅ¸³µ´Ù. ¼³Ä¡·ù ¶Ç´Â ºñ¼³Ä¡·ù¿¡ ´ëÇÑ Àå±â°£ ½ÃÇè¿¡¼´Â ¿µÇâÀÌ °üÂûµÇÁö ¾Ê¾Ò±â ¶§¹®¿¡ ÀÌ·¯ÇÑ ¹ß°ßÀÇ ÀÓ»óÀû °ü·Ã¼ºÀº ¾Ë·ÁÁ® ÀÖÁö ¾Ê´Ù.
¼³Ä¡·ù¿Í °³¿¡ ´ëÇÑ ¹Ýº¹ Åõ¿© µ¶¼º ½ÃÇè¿¡¼ ¾È±¸ º¯È°¡ ÀϰüµÇÁö ¾Ê°Ô °üÂûµÇ¾úÁö¸¸ ¿ø¼þÀÌ¿¡¼´Â °üÂûµÇÁö ¾Ê¾Ò´Ù. ¸Þ¸¸Æ¾ÀÇ ÀÓ»ó ¿¬±¸¿¡¼ ƯÁ¤ ¾È°ú °Ë»ç ½Ã ¾î¶°ÇÑ ½Ã·Âº¯È´Â ¹ß°ßµÇÁö ¾Ê¾Ò´Ù.
¼³Ä¡·ù¿¡¼ ¸®¼ÒÁ»ÀÇ ¸Þ¸¸Æ¾ ÃàÀûÀ¸·Î ÀÎÇÑ Æó ´ë½Ä¼¼Æ÷ÀÇ ÀÎÁöÁúÁõÀÌ °üÂûµÇ¾ú´Ù. ÀÌ È¿°ú´Â ¾çÀ̿¼º ¾çÄ£¸Å¼º Ư¼ºÀ» °¡Áø ´Ù¸¥ Ȱ¼º¹°Áú·ÎºÎÅÍ ¾Ë·ÁÁ® ÀÖ´Ù. ÀÌ ÃàÀû°ú Æó¿¡¼ °üÂûµÈ °øÆ÷(vacuolisation) »çÀÌ¿¡ Àΰú°ü°è °¡´É¼ºÀÌ ÀÖ´Ù. ÀÌ·¯ÇÑ ¿µÇâÀº ¼³Ä¡·ù¿¡¼ °í¿ë·® Åõ¿© ½Ã¿¡¸¸ °üÂûÀÌ µÇ¾ú´Ù. ÀÌ °á°úµéÀÇ ÀÓ»óÀû °ü·Ã¼ºÀº ¾Ë·ÁÁöÁö ¾Ê¾Ò´Ù.
Ç¥ÁØ ½ÃÇè¿¡¼ ¸Þ¸¸Æ¾ÀÇ À¯Àü µ¶¼ºÀº °üÂûµÇÁö ¾Ê¾Ò´Ù.: ¸¶¿ì½º ¹× ·§µå¸¦ ´ë»óÀ¸·Î ÇÑ Æò»ý ¿¬±¸¿¡¼ ¹ß¾Ï¼º¿¡ ´ëÇÑ Áõ°Å´Â ¾ø¾ú´Ù. ¸Þ¸¸Æ¾Àº ¸ðü µ¶¼º Åõ¿©·®¿¡¼µµ ·§µå¿Í Åä³¢¿¡¼ ÃÖ±âÇüÀ» À¯¹ßÇÏÁö ¾Ê¾ÒÀ¸¸ç, ¸Þ¸¸Æ¾ÀÇ »ý½Ä ´É·Â¿¡ ´ëÇÑ ºÎÀÛ¿ëÀº °üÂûµÇÁö ¾Ê¾Ò´Ù. ·§µå¿¡¼ ÅÂ¾Æ ¼ºÀå °¨¼Ò°¡ ³ëÃâ ¼öÁØ¿¡¼ °üÂûµÇ¾úÀ¸¸ç, ÀÌ´Â »ç¶÷¿¡¼ÀÇ ³ëÃâ°ú µ¿ÀÏÇϰųª ¾à°£ ³ôÀº ¼öÁØÀ̾ú´Ù.
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º¹¾àÀ̹ÌÁö´Â ¸ðµç º¹¾àÁöµµ »çÇ×À» Ç¥½ÃÇѰÍÀº ¾Æ´Ï¸ç, Ãß°¡ÀûÀ¸·Î ¾÷µ¥ÀÌÆ®µÇ°Å³ª ¼öÁ¤µÉ ¼ö ÀÖ½À´Ï´Ù. |
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| º¸°ü»ó ÁÖÀÇ |
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| Ç׸ñ |
³»¿ë |
| DUR (ÀǾàǰ»ç¿ëÆò°¡) |
º´¿ë±Ý±â :
°í½ÃµÈ º´¿ë±Ý±â ³»¿ëÀº ¾ø½À´Ï´Ù.
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| Mechanism of Action |
Memantine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Memantine exerts its action through uncompetitive NMDA receptor antagonism, binding preferentially to the NMDA receptor-operated cation channels. Prolonged increased levels of glutamate in the brain of demented patients are sufficient to counter the voltage-dependent block of NMDA receptors by Mg2+ ions and allow continuous influx of Ca2+ ions into cells and ultimately neuronal degeneration. Studies suggest that memantine binds more effectively than Mg2+ ions at the NMDA receptor, and thereby effectively blocks this prolonged influx of Ca2+ ions through the NMDA channel whilst preserving the transient physiological activation of the channels by higher concentrations of synaptically released glutamate. Thus memantine protects against chronically elevated concentrations of glutamate.
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| Pharmacology |
Memantine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Memantine, an amantadine derivative, is an NMDA receptor antagonist used in the treatment of Alzheimer's disease. It differs from traditional agents used in Alzheimer's disease by acting on glutamatergic neurotransmission, rather than cholinergic. There is some evidence that dysfunction of glutamatergic neurotransmission, manifested as neuronal excitotoxicity, is involved in the aetiology of Alzheimer's disease (Cacabelos et al., 1999). As such, targeting the glutamatergic system, specifically NMDA receptors, was a novel approach to treatment in view of the limited efficacy of existing drugs targeting the cholinergic system. A systematic review of randomised controlled trials found that memantine has a positive effect on cognition, mood, behaviour, and the ability to perform daily activities. There is no evidence that memantine prevents or slows neurodegeneration in patients with Alzheimer's disease.
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| Metabolism |
Memantine¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Cytochrome P450 2B6 (CYP2B6)
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| Protein Binding |
Memantine¿¡ ´ëÇÑ ´Ü¹é°áÇÕ Á¤º¸ 45%
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| Half-life |
Memantine¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ 60-100 hours
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| Absorption |
Memantine¿¡ ´ëÇÑ Absorption Á¤º¸ Well absorbed orally with a bioavailability of approximately 100%. Peak plasma concentrations are reached in 3-7 hours. Food has no effect on absorption.
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| Biotransformation |
Memantine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Excreted largely unchanged. About 20% is metabolized to 1-amino-3-hydroxymethyl-5-methyl-adamantane and 3-amino-1-hydroxy-5,7-dimethyl-adamantane.
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| Toxicity |
Memantine¿¡ ´ëÇÑ Toxicity Á¤º¸ Side effects include pain, abnormal crying, leg pain, fever, increased apetite. Adverse drug reactions include: dizziness, confusion, headache, hallucinations, tiredness. Less common side effects include: vomiting, anxiety, hypertonia, cystitis, and increased libido. Doses of up to 400 mg have been tolerated.
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| Drug Interactions |
Memantine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Acetazolamide Possible increased levels of memantineDichlorphenamide Possible increased levels of memantineMethazolamide Possible increased levels of memantineSodium bicarbonate Possible increased levels of memantineAmantadine Increased risk of CNS adverse effects with this associationDextromethorphan Increased risk of CNS adverse effects with this associationKetamine Increased risk of CNS adverse effects with this association
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CYP450 Drug Interaction |
[CYP450 TableÁ÷Á¢Á¶È¸]
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| Food Interaction |
Memantine¿¡ ´ëÇÑ Food Interaction Á¤º¸ Take without regard to meals.
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| Drug Target |
[Drug Target]
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| Description |
Memantine¿¡ ´ëÇÑ Description Á¤º¸ Amantadine derivative that has some dopaminergic effects. It has been proposed as an antiparkinson agent. [PubChem]
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| Drug Category |
Memantine¿¡ ´ëÇÑ Drug_Category Á¤º¸ AntidyskineticsAntiparkinson AgentsCentral Nervous System AgentsDopamine AgentsExcitatory Amino Acid Antagonists
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| Smiles String Canonical |
Memantine¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CC12CC3CC(C)(C1)CC(N)(C3)C2
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| Smiles String Isomeric |
Memantine¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ C[C@@]12C[C@H]3C[C@@](C)(C1)C[C@](N)(C3)C2
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| InChI Identifier |
Memantine¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C12H21N/c1-10-3-9-4-11(2,6-10)8-12(13,5-9)7-10/h9H,3-8,13H2,1-2H3
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| Chemical IUPAC Name |
Memantine¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 3,5-dimethyladamantan-1-amine
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ÃÖ±ÙÁ¤º¸¼öÁ¤ÀÏ 2024-05-02
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º» ¼öÁ¤ÀÏ Á¤º¸´Â Çã°¡Á¤º¸ ÀÌ¿ÜÀÇ ±âŸÁ¤º¸ ¼öÁ¤ÀÏÀ» ÀǹÌÇϹǷÎ, Çã°¡Á¤º¸¼öÁ¤ÀÏÀº º»¹®¿¡ Ç¥±âµÈ ³¯Â¥¸¦ ÂüÁ¶ÇϽñ⠹ٶø´Ï´Ù.
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»ó¼¼Á¤º¸´Â ½ÄǰÀǾàǰ¾ÈÀüóÀÇ Á¦Ç°Çã°¡»çÇ×À» Åä´ë·Î ÀÛ¼ºµÇ¾úÀ¸¸ç ¿ä¾àÁ¤º¸´Â »ó¼¼Á¤º¸ ¹× ±âŸ¹®ÇåÀ» ±â¹ÝÀ¸·Î µå·°ÀÎÆ÷¿¡¼ ÆíÁýÇÑ ³»¿ëÀÔ´Ï´Ù. Á¦Ç°Çã°¡»çÇ×ÀÇ ¸ñÂ÷¿Í ´Ù¼Ò »óÀÌÇÒ ¼ö ÀÖ½À´Ï´Ù. |
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µå·°ÀÎÆ÷ ÀǾàÇмúÁ¤º¸´Â ½ÄǰÀǾàǰ¾ÈÀüóÀÇ Á¦Ç°Çã°¡»çÇ×, Çмú¹®Çå, Á¦¾àȸ»ç Á¦°øÁ¤º¸ µîÀ» ±Ù°Å·Î ÀÛ¼ºµÈ Âü°í Á¤º¸ÀÔ´Ï´Ù.
Á¤º¸ÀÇ Á¤È®¼ºÀ» À§ÇØ ³ë·ÂÇϰí ÀÖÀ¸³ª ÆíÁý»óÀÇ ¿À·ù, Çã°¡»çÇ× º¯°æ, Ãß°¡ÀûÀÎ Çмú¿¬±¸ ¶Ç´Â Àӻ󿬱¸ ¹ßÇ¥ µîÀ¸·Î ÀÎÇØ ¹ß»ýÇÏ´Â ¹®Á¦¿¡ ´ëÇØ µå·°ÀÎÆ÷´Â
Ã¥ÀÓÀ» ÁöÁö ¾Ê½À´Ï´Ù. ÀÚ¼¼ÇÑ ³»¿ëÀº ¡°Ã¥ÀÓÀÇ ÇÑ°è ¹× ¹ýÀû°íÁö¡±¸¦ ÂüÁ¶ÇØ ÁֽʽÿÀ.
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ÀüÈ: 02-3486-1061 ¤Ó À̸ÞÀÏ: webmaster@druginfo.co.kr
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