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普瑞巴林

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普瑞巴林
(Pregabalin)
臨床資料
其他名稱Isobutyl GABA
AHFS/Drugs.com國際藥品名稱
MedlinePlusa605045
核准狀況
懷孕分級
給藥途徑口服
ATC碼
法律規範狀態
法律規範
藥物動力學數據
生物利用度≥90%
血漿蛋白結合率Nil
藥物代謝Negligible
代謝產物N-methylpregabalin[1]
藥效起始時間英語Onset of action1.5 小時[2]
生物半衰期6.3 小時[2]
排泄途徑
識別資訊
  • (S)-3-(aminomethyl)-5-methylhexanoic acid
CAS號148553-50-8  checkY
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard英語CompTox Chemicals Dashboard (EPA)
ECHA InfoCard100.119.513 編輯維基數據鏈接
化學資訊
化學式C8H17NO2
摩爾質量159.23 g.mol−1
3D模型(JSmol英語JSmol
  • O=C(O)C[C@H](CC(C)C)CN
  • InChI=1S/C8H17NO2/c1-6(2)3-7(5-9)4-8(10)11/h6-7H,3-5,9H2,1-2H3,(H,10,11)/t7-/m0/s1 checkY
  • Key:AYXYPKUFHZROOJ-ZETCQYMHSA-N checkY

普瑞巴林(英語:Pregabalin), 是一款被用作治療癲癇神經性疼痛纖維肌痛廣泛性焦慮症[3][4]的藥物。

藥理學

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普瑞巴林是神經遞質γ-氨基丁酸的衍生物,[5] 也是種強效的加巴噴丁類化合物,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。[6][7]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。[6] [8]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,[6]但具有電壓依賴性鈣通道的α2δ亞基選擇性。[8] [9] 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,[7][8]但它會增加L-穀氨酸脫羧酶(GAD)在大腦中的表達[10][11] [12] 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。[8] [13] 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。[8][13]


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,[14][15]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)。[16]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,[5][17]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。[5][17]


參考文獻

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  1. ^ Summary of product characteristics (PDF). European Medicines Agency. 2013-03-06 [2013-05-06]. (原始內容存檔 (PDF)於2018-09-16). 
  2. ^ 2.0 2.1 Pharmacotherapy Update - Pregabalin (Lyrica®):Part I. [2016-02-22]. (原始內容存檔於2017-02-27). 
  3. ^ Frampton, JE. Pregabalin: a review of its use in adults with generalized anxiety disorder.. CNS Drugs. September 2014, 28 (9): 835–54. PMID 25149863. doi:10.1007/s40263-014-0192-0. 
  4. ^ Pregabalin. The American Society of Health-System Pharmacists. [2015-10-23]. (原始內容存檔於2020-08-09). 
  5. ^ 5.0 5.1 5.2 Bryans JS, Wustrow DJ. 3-substituted GABA analogs with central nervous system activity: a review. Medicinal Research Reviews. March 1999, 19 (2): 149–177. PMID 10189176. S2CID 38496241. doi:10.1002/(SICI)1098-1128(199903)19:2<149::AID-MED3>3.0.CO;2-B. 
  6. ^ 6.0 6.1 6.2 Calandre EP, Rico-Villademoros F, Slim M. Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: a review of their clinical pharmacology and therapeutic use. Expert Review of Neurotherapeutics. November 2016, 16 (11): 1263–1277. PMID 27345098. S2CID 33200190. doi:10.1080/14737175.2016.1202764. 
  7. ^ 7.0 7.1 Uchitel OD, Di Guilmi MN, Urbano FJ, Gonzalez-Inchauspe C. Acute modulation of calcium currents and synaptic transmission by gabapentinoids. Channels. 2010, 4 (6): 490–496. PMID 21150315. doi:10.4161/chan.4.6.12864可免費查閱. 
  8. ^ 8.0 8.1 8.2 8.3 8.4 Sills GJ. The mechanisms of action of gabapentin and pregabalin. Current Opinion in Pharmacology. February 2006, 6 (1): 108–113. PMID 16376147. doi:10.1016/j.coph.2005.11.003. 
  9. ^ Benzon HM, Rathmell JP, Wu CL, Turk DC, Argoff CE, Hurley RW. Practical Management of Pain. Elsevier Health Sciences. September 11, 2013: 1006. ISBN 978-0-323-17080-2. 
  10. ^ Lin GQ, You QD, Cheng JF (編). Chiral Drugs: Chemistry and Biological Action. John Wiley & Sons. August 8, 2011: 88 [August 17, 2016]. ISBN 9781118075630. (原始內容存檔於April 25, 2022) –透過Google Books. 
  11. ^ Li Z, Taylor CP, Weber M, Piechan J, Prior F, Bian F, et al. Pregabalin is a potent and selective ligand for α(2)δ-1 and α(2)δ-2 calcium channel subunits. European Journal of Pharmacology. September 2011, 667 (1–3): 80–90 [October 20, 2020]. PMID 21651903. doi:10.1016/j.ejphar.2011.05.054. (原始內容存檔於October 21, 2020). 
  12. ^ Sze PY. L-Glutamate Decarboxylase. GABA—Biochemistry and CNS Functions. Advances in Experimental Medicine and Biology 123. 1979: 59–78. ISBN 978-1-4899-5201-1. PMID 390996. doi:10.1007/978-1-4899-5199-1_4. 
  13. ^ 13.0 13.1 Stahl SM, Porreca F, Taylor CP, Cheung R, Thorpe AJ, Clair A. The diverse therapeutic actions of pregabalin: is a single mechanism responsible for several pharmacological activities?. Trends in Pharmacological Sciences. June 2013, 34 (6): 332–339. PMID 23642658. doi:10.1016/j.tips.2013.04.001. 
  14. ^ Baidya DK, Agarwal A, Khanna P, Arora MK. Pregabalin in acute and chronic pain. Journal of Anaesthesiology Clinical Pharmacology. July 2011, 27 (3): 307–314. PMC 3161452可免費查閱. PMID 21897498. doi:10.4103/0970-9185.83672可免費查閱. 
  15. ^ McMahon SB. Wall and Melzack's textbook of pain 6th. Philadelphia, PA: Elsevier/Saunders. 2013: 515. ISBN 9780702040597. 
  16. ^ Taylor CP, Angelotti T, Fauman E. Pharmacology and mechanism of action of pregabalin: the calcium channel alpha2-delta (alpha2-delta) subunit as a target for antiepileptic drug discovery. Epilepsy Research. February 2007, 73 (2): 137–150 [October 19, 2020]. PMID 17126531. S2CID 54254671. doi:10.1016/j.eplepsyres.2006.09.008. (原始內容存檔於October 23, 2020). 
  17. ^ 17.0 17.1 Lauria-Horner BA, Pohl RB. Pregabalin: a new anxiolytic. Expert Opinion on Investigational Drugs. April 2003, 12 (4): 663–672. PMID 12665421. S2CID 36137322. doi:10.1517/13543784.12.4.663. 

外部連結

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