氯氮平：修订间差异

**氯氮平**
臨床資料
商品名（英语：Drug nomenclature）	Clozaril, Leponex, Versacloz, others
AHFS/Drugs.com	Monograph
MedlinePlus	a691001
懷孕分級	澳: C ; ;
给药途径	by mouth
藥物類別（英语：Drug class）	atypical antipsychotic（英语：atypical antipsychotic）
ATC碼	N05AH02 (WHO) ;
法律規範狀態
法律規範	澳：限医生处方（S4）; 美：处方药（℞-only）;
藥物動力學數據
生物利用度	60 to 70%
药物代谢	Liver, by several CYP isozymes
生物半衰期	6 to 26 hours (mean value 14.2 hours in steady state conditions)
排泄途徑	80% in metabolized state: 30% biliary and 50% kidney
识别信息
	IUPAC命名法 8-Chloro-11-(4-methylpiperazin-1-yl)-5H-dibenzo[b,e][1,4]diazepine; ;
CAS号	5786-21-0
PubChem CID	2818;
IUPHAR/BPS	38;
DrugBank	DB00363 ;
ChemSpider	10442628 ;
UNII	J60AR2IKIC;
KEGG	D00283 ;
ChEBI	CHEBI:3766 ;
ChEMBL	ChEMBL42 ;
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)	DTXSID5022855 ;
ECHA InfoCard	100.024.831
化学信息
化学式	C18H19ClN4
摩尔质量	326.83 g·mol−1
3D模型（JSmol（英语：JSmol））	交互式图像;
熔点	183 °C（361 °F）
水溶性	0.1889 mg/mL (20 °C)
	SMILES CN1CCN(CC1)C2=Nc3cc(ccc3Nc4c2cccc4)Cl;
	InChI InChI=1S/C18H19ClN4/c1-22-8-10-23(11-9-22)18-14-4-2-3-5-15(14)20-16-7-6-13(19)12-17(16)21-18/h2-7,12,20H,8-11H2,1H3 ; Key:QZUDBNBUXVUHMW-UHFFFAOYSA-N ;

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2018年1月25日 (四) 15:06的版本

氯氮平（Clozapine），常見商標名Clozaril^[1]，為一種非典型抗精神病藥物^[2]。主要用於治療其他精神科藥物治療無效的精神分裂症^[2]。精神分裂症及分裂情感性障碍用藥可能會增加自殺的機會^[2]。本品藥效較其他電典型抗精神病藥物（英语：typical antipsychotics）為強，因此可用於治療對於其他藥物產生抗性的患者^[4]^[5]^[6]。本品由口服給藥^[2]。

本品可能會增加發生粒細胞缺乏症（英语：agranulocytosis）的風險，可能會導致死亡^[2]。為了降低不良反應的風險，用藥時最好進行血液監測^[2]。其他嚴重副作用包含癲癇發作、心肌炎、高血糖。因失智症導致精神錯亂的年長者用藥可能增加死亡的風險^[2]^[7]。常見副作用包含昏睡、口乾、低血壓、視覺障礙，以及頭暈等等^[2]。有5%的人用藥後會產生遲發性運動不能等永久性動作障礙的風險^[7]。其藥理作用迄今尚未明朗^[2]。

氯氮平於1958年首次合成，並於1972年開始上市^[8]，為第一種典型抗精神病藥物^[9]。本品列名於世界卫生组织基本药物标准清单之中，為基礎公衛體系必備藥物之一^[10]。本品屬於通用名药物^[2]。在2014年，其每日劑量於发展中国家的批發價約介於0.05和2.10美金之間^[11]

參見

DHA-clozapine（英语：DHA-clozapine）
Drug of last resort（英语：Drug of last resort）

參考文獻

^ ^1.0 ^1.1 引证错误：没有为名为brands的参考文献提供内容
^ ^2.00 ^2.01 ^2.02 ^2.03 ^2.04 ^2.05 ^2.06 ^2.07 ^2.08 ^2.09 ^2.10 Clozapine. The American Society of Health-System Pharmacists. [Dec 1, 2015]. （原始内容存档于2015-12-08）.
^ Hopfinger A, Esposito EX, Llinas A, Glen RC, Goodman JM. Findings of the Challenge To Predict Aqueous Solubility. Journal of Chemical Information and Modeling. 2009, 49: 1–5. PMID 19117422. doi:10.1021/ci800436c.
^ Leucht, Stefan; Cipriani, Andrea; Spineli, Loukia; Mavridis, Dimitris; Örey, Deniz; Richter, Franziska; Samara, Myrto; Barbui, Corrado; Engel, Rolf R; Geddes, John R; Kissling, Werner; Stapf, Marko Paul; Lässig, Bettina; Salanti, Georgia; Davis, John M. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. The Lancet. 2013, 382 (9896): 951–62. PMID 23810019. doi:10.1016/S0140-6736(13)60733-3.
^ Essali, A; Al-Haj Haasan, N; Li, C; Rathbone, J. Clozapine versus typical neuroleptic medication for schizophrenia.. The Cochrane Database of Systematic Reviews. 21 January 2009, (1): CD000059. PMID 19160174. doi:10.1002/14651858.CD000059.pub2.
^ Siskind, D; McCartney, L; Goldschlager, R; Kisely, S. Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.. The British journal of psychiatry : the journal of mental science. 7 July 2016, 209: 385–392. PMID 27388573. doi:10.1192/bjp.bp.115.177261.
^ ^7.0 ^7.1 Hartling, L; Abou-Setta, AM; Dursun, S; Mousavi, SS; Pasichnyk, D; Newton, AS. Antipsychotics in adults with schizophrenia: comparative effectiveness of first-generation versus second-generation medications: a systematic review and meta-analysis.. Annals of Internal Medicine. 2 October 2012, 157 (7): 498–511. PMID 22893011. doi:10.7326/0003-4819-157-7-201210020-00525.
^ Crilly, John. The history of clozapine and its emergence in the US market a review and analysis. History of Psychiatry. 2007-03-01, 18 (1): 39–60. ISSN 0957-154X. PMID 17580753. doi:10.1177/0957154X07070335. （原始内容存档于2016-07-10）（英语）.
^ Corey, edited by Jie Jack Li, E.J. Drug discovery practices, processes, and perspectives. Hoboken, N.J.: John Wiley & Sons. 2013: 248. ISBN 9781118354469. （原始内容存档于2017-09-08）.
^ WHO Model List of Essential Medicines (19th List) (PDF). World Health Organization. April 2015 [8 December 2016]. （原始内容存档 (PDF)于13 December 2016）.
^ Clozapine. International Drug Price Indicator Guide. [2 December 2015]. ^{[永久失效連結]}

延伸閱讀

Benkert, Hippius: Kompendium der Psychiatrischen Pharmakotherapie (German), 4th. ed., Springer Verlag
B. Bandelow, S. Bleich, and S. Kropp: Handbuch Psychopharmaka (German), 2nd. ed. Hogrefe
Crilly J. The history of clozapine and its emergence in the US market: a review and analysis. History of Psychiatry. Mar 2007, 18 (1): 39–60. PMID 17580753. doi:10.1177/0957154X07070335.

外部連結

Template:Tricyclics

[brands-1] 1.0 ^1.1 引证错误：没有为名为brands的参考文献提供内容

[AHFS2015-2] 2.00 ^2.01 ^2.02 ^2.03 ^2.04 ^2.05 ^2.06 ^2.07 ^2.08 ^2.09 ^2.10 Clozapine. The American Society of Health-System Pharmacists. [Dec 1, 2015]. （原始内容存档于2015-12-08）.

[Hopfinger-3] Hopfinger A, Esposito EX, Llinas A, Glen RC, Goodman JM. Findings of the Challenge To Predict Aqueous Solubility. Journal of Chemical Information and Modeling. 2009, 49: 1–5. PMID 19117422. doi:10.1021/ci800436c.

[Lancet2013-4] Leucht, Stefan; Cipriani, Andrea; Spineli, Loukia; Mavridis, Dimitris; Örey, Deniz; Richter, Franziska; Samara, Myrto; Barbui, Corrado; Engel, Rolf R; Geddes, John R; Kissling, Werner; Stapf, Marko Paul; Lässig, Bettina; Salanti, Georgia; Davis, John M. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. The Lancet. 2013, 382 (9896): 951–62. PMID 23810019. doi:10.1016/S0140-6736(13)60733-3.

[5] Essali, A; Al-Haj Haasan, N; Li, C; Rathbone, J. Clozapine versus typical neuroleptic medication for schizophrenia.. The Cochrane Database of Systematic Reviews. 21 January 2009, (1): CD000059. PMID 19160174. doi:10.1002/14651858.CD000059.pub2.

[6] Siskind, D; McCartney, L; Goldschlager, R; Kisely, S. Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.. The British journal of psychiatry : the journal of mental science. 7 July 2016, 209: 385–392. PMID 27388573. doi:10.1192/bjp.bp.115.177261.

[Hart2012-7] 7.0 ^7.1 Hartling, L; Abou-Setta, AM; Dursun, S; Mousavi, SS; Pasichnyk, D; Newton, AS. Antipsychotics in adults with schizophrenia: comparative effectiveness of first-generation versus second-generation medications: a systematic review and meta-analysis.. Annals of Internal Medicine. 2 October 2012, 157 (7): 498–511. PMID 22893011. doi:10.7326/0003-4819-157-7-201210020-00525.

[Cri2007-8] Crilly, John. The history of clozapine and its emergence in the US market a review and analysis. History of Psychiatry. 2007-03-01, 18 (1): 39–60. ISSN 0957-154X. PMID 17580753. doi:10.1177/0957154X07070335. （原始内容存档于2016-07-10）（英语）.

[Cor2013-9] Corey, edited by Jie Jack Li, E.J. Drug discovery practices, processes, and perspectives. Hoboken, N.J.: John Wiley & Sons. 2013: 248. ISBN 9781118354469. （原始内容存档于2017-09-08）.

[WHO19th-10] WHO Model List of Essential Medicines (19th List) (PDF). World Health Organization. April 2015 [8 December 2016]. （原始内容存档 (PDF)于13 December 2016）.

[11] Clozapine. International Drug Price Indicator Guide. [2 December 2015]. ^{[永久失效連結]}

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