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Kovalenko Svetlana Olegovna 、薬局による医学的評価、 最終更新日:03.04.2022
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Manta (amantadine hydrochloride) is indicated for the prophylaxis and treatment of signs and symptoms of infection caused by various strains of influenza A virus. Manta (amantadine hydrochloride) is also indicated in the treatment of parkinsonism and drug-induced extrapyramidal reactions.
Influenza A Prophylaxis
Manta (amantadine hydrochloride) is indicated for chemoprophylaxis against signs and symptoms of influenza A virus infection. Because Manta (amantadine hydrochloride) does not completely prevent the host immune response to influenza A infection, individuals who take this drug may still develop immune responses to natural disease or vaccination and may be protected when later exposed to antigenically related viruses. Following vaccination during an influenza A outbreak, Manta (amantadine hydrochloride) prophylaxis should be considered for the 2- to 4-week time period required to develop an antibody response.
Influenza A Treatment
Manta (amantadine hydrochloride) is also indicated in the treatment of uncomplicated respiratory tract illness caused by influenza A virus strains especially when administered early in the course of illness. There are no well-controlled clinical studies demonstrating that treatment with Manta (amantadine hydrochloride) will avoid the development of influenza A virus pneumonitis or other complications in high risk patients.
There is no clinical evidence indicating that Manta (amantadine hydrochloride) is effective in the prophylaxis or treatment of viral respiratory tract illnesses other than those caused by influenza A virus strains.
The following points should be considered before initiating treatment or prophylaxis with Manta (amantadine hydrochloride) :
- Manta (amantadine hydrochloride) is not a substitute for early vaccination on an annual basis as recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.
- Influenza viruses change over time. Emergence of resistance mutations could decrease drug effectiveness. Other factors (for example, changes in viral virulence) might also diminish clinical benefit of antiviral drugs. Prescribers should consider available information on influenza drug susceptibility patterns and treatment effects when deciding whether to use Manta (amantadine hydrochloride).
Parkinson's Disease/Syndrome
Manta (amantadine hydrochloride) is indicated in the treatment of idiopathic Parkinson's disease (Paralysis Agitans), postencephalitic parkinsonism, and symptomatic parkinsonism which may follow injury to the nervous system by carbon monoxide intoxication. It is indicated in those elderly patients believed to develop parkinsonism in association with cerebral arteriosclerosis. In the treatment of Parkinson's disease, Manta (amantadine hydrochloride) is less effective than levodopa, (-)-3-(3,4- dihydroxyphenyl)-L-alanine, and its efficacy in comparison with the anticholinergic antiparkinson drugs has not yet been established.
Drug-Induced Extrapyramidal Reactions
Manta (amantadine hydrochloride) is indicated in the treatment of drug-induced extrapyramidal reactions. Although anticholinergic-type side effects have been noted with Manta (amantadine hydrochloride) when used in patients with drug-induced extrapyramidal reactions, there is a lower incidence of these side effects than that observed with the anticholinergic antiparkinson drugs.
The dose of Manta (Amantadine Hydrochloride, USP) may need reduction in patients with congestive heart failure, peripheral edema, orthostatic hypotension, or impaired renal function (see Dosage for Impaired Renal Function).
Dosage for Prophylaxis and Treatment of Uncomplicated Influenza A Virus Illness
Adult
The adult daily dosage of Manta (amantadine hydrochloride) is 200 mg; two 100 mg tablets (or four teaspoonfuls of syrup) as a single daily dose. The daily dosage may be split into one tablet of 100 mg (or two teaspoonfuls of syrup) twice a day. If central nervous system effects develop in once-a-day dosage, a split dosage schedule may reduce such complaints. In persons 65 years of age or older, the daily dosage of Manta (amantadine hydrochloride) is 100 mg.
A 100 mg daily dose has also been shown in experimental challenge studies to be effective as prophylaxis in healthy adults who are not at high risk for influenza-related complications. However, it has not been demonstrated that a 100 mg daily dose is as effective as a 200 mg daily dose for prophylaxis, nor has the 100 mg daily dose been studied in the treatment of acute influenza illness. In recent clinical trials, the incidence of central nervous system (CNS) side effects associated with the 100 mg daily dose was at or near the level of placebo. The 100 mg dose is recommended for persons who have demonstrated intolerance to 200 mg of Manta (amantadine hydrochloride) daily because of CNS or other toxicities.
Pediatric Patients: 1 yr.-9 yrs. of age
The total daily dose should be calculated on the basis of 2 to 4 mg/lb/day (4.4 to 8.8 mg/kg/day), but not to exceed 150 mg per day.
9 yrs.-12 yrs. of age
The total daily dose is 200 mg given as one tablet of 100 mg (or two teaspoonfuls of syrup) twice a day. The 100 mg daily dose has not been studied in this pediatric population. Therefore, there are no data which demonstrate that this dose is as effective as or is safer than the 200 mg daily dose in this patient population.
Prophylactic dosing should be started in anticipation of an influenza A outbreak and before or after contact with individuals with influenza A virus respiratory tract illness.
Manta (amantadine hydrochloride) should be continued daily for at least 10 days following a known exposure. If Manta (amantadine hydrochloride) is used chemoprophylactically in conjunction with inactivated influenza A virus vaccine until protective antibody responses develop, then it should be administered for 2 to 4 weeks after the vaccine has been given. When inactivated influenza A virus vaccine is unavailable or contraindicated, Manta (amantadine hydrochloride) should be administered for the duration of known influenza A in the community because of repeated and unknown exposure.
Treatment of influenza A virus illness should be started as soon as possible, preferably within 24 to 48 hours after onset of signs and symptoms, and should be continued for 24 to 48 hours after the disappearance of signs and symptoms.
Dosage for Parkinsonism
Adult
The usual dose of Manta (amantadine hydrochloride) is 100 mg twice a day when used alone. Manta (amantadine hydrochloride) has an onset of action usually within 48 hours.
The initial dose of Manta (amantadine hydrochloride) is 100 mg daily for patients with serious associated medical illnesses or who are receiving high doses of other antiparkinson drugs. After one to several weeks at 100 mg once daily, the dose may be increased to 100 mg twice daily, if necessary.
Occasionally, patients whose responses are not optimal with Manta (amantadine hydrochloride) at 200 mg daily may benefit from an increase up to 400 mg daily in divided doses. However, such patients should be supervised closely by their physicians.
Patients initially deriving benefit from Manta (amantadine hydrochloride) not uncommonly experience a fall-off of effectiveness after a few months. Benefit may be regained by increasing the dose to 300 mg daily. Alternatively, temporary discontinuation of Manta (amantadine hydrochloride) for several weeks, followed by reinitiation of the drug, may result in regaining benefit in some patients. A decision to use other antiparkinson drugs may be necessary.
Dosage for Concomitant Therapy
Some patients who do not respond to anticholinergic antiparkinson drugs may respond to Manta (amantadine hydrochloride). When Manta (amantadine hydrochloride) or anticholinergic antiparkinson drugs are each used with marginal benefit, concomitant use may produce additional benefit.
When Manta (amantadine hydrochloride) and levodopa are initiated concurrently, the patient can exhibit rapid therapeutic benefits. Manta (amantadine hydrochloride) should be held constant at 100 mg daily or twice daily while the daily dose of levodopa is gradually increased to optimal benefit.
When Manta (amantadine hydrochloride) is added to optimal well-tolerated doses of levodopa, additional benefit may result, including smoothing out the fluctuations in improvement which sometimes occur in patients on levodopa alone. Patients who require a reduction in their usual dose of levodopa because of development of side effects may possibly regain lost benefit with the addition of Manta (amantadine hydrochloride).
Dosage for Drug-Induced Extrapyramidal Reactions
Adult
The usual dose of Manta (amantadine hydrochloride) is 100 mg twice a day. Occasionally, patients whose responses are not optimal with Manta (amantadine hydrochloride) at 200 mg daily may benefit from an increase up to 300 mg daily in divided doses.
Dosage for Impaired Renal Function
Depending upon creatinine clearance, the following dosage adjustments are recommended:
CREATININE CLEARANCE (mL/min/1.73m2) | Manta DOSAGE |
30-50 | 200 mg 1st day and 100 mg each day thereafter |
15-29 | 200 mg 1st day followed by 100 mg on alternate days |
< 15 | 200 mg every 7 days |
The recommended dosage for patients on hemodialysis is 200 mg every 7 days.
Manta (amantadine hydrochloride) is contraindicated in patients with known hypersensitivity to amantadine hydrochloride or to any of the other ingredients in Manta (amantadine hydrochloride).
REFERENCES
2. D.F. Casey, N. Engl. J. Med. 298:516, 1978.
3. C.D. Berkowitz, J. Pediatr. 95:144, 1979.
WARNINGS
Deaths
Deaths have been reported from overdose with Manta (amantadine hydrochloride). The lowest reported acute lethal dose was 1 gram. Acute toxicity may be attributable to the anticholinergic effects of amantadine. Drug overdose has resulted in cardiac, respiratory, renal or central nervous system toxicity. Cardiac dysfunction includes arrhythmia, tachycardia and hypertension (see OVERDOSAGE).
Suicide Attempts
Suicide attempts, some of which have been fatal, have been reported in patients treated with Manta (amantadine hydrochloride) , many of whom received short courses for influenza treatment or prophylaxis. The incidence of suicide attempts is not known and the pathophysiologic mechanism is not understood. Suicide attempts and suicidal ideation have been reported in patients with and without prior history of psychiatric illness. Manta (amantadine hydrochloride) can exacerbate mental problems in patients with a history of psychiatric disorders or substance abuse. Patients who attempt suicide may exhibit abnormal mental states which include disorientation, confusion, depression, personality changes, agitation, aggressive behavior, hallucinations, paranoia, other psychotic reactions, and somnolence or insomnia. Because of the possibility of serious adverse effects, caution should be observed when prescribing Manta (amantadine hydrochloride) to patients being treated with drugs having CNS effects, or for whom the potential risks outweigh the benefit of treatment.
CNS Effects
Patients with a history of epilepsy or other “seizures” should be observed closely for possible increased seizure activity.
Patients receiving Manta (amantadine hydrochloride) who note central nervous system effects or blurring of vision should be cautioned against driving or working in situations where alertness and adequate motor coordination are important.
Other
Patients with a history of congestive heart failure or peripheral edema should be followed closely as there are patients who developed congestive heart failure while receiving Manta (amantadine hydrochloride).
Patients with Parkinson's disease improving on Manta (amantadine hydrochloride) should resume normal activities gradually and cautiously, consistent with other medical considerations, such as the presence of osteoporosis or phlebothrombosis.
Because Manta (amantadine hydrochloride) has anticholinergic effects and may cause mydriasis, it should not be given to patients with untreated angle closure glaucoma.
PRECAUTIONS
Manta (amantadine hydrochloride) should not be discontinued abruptly in patients with Parkinson's disease since a few patients have experienced a parkinsonian crisis, i.e., a sudden marked clinical deterioration, when this medication was suddenly stopped. The dose of anticholinergic drugs or of Manta (amantadine hydrochloride) should be reduced if atropine-like effects appear when these drugs are used concurrently. Abrupt discontinuation may also precipitate delirium, agitation, delusions, hallucinations, paranoid reaction, stupor, anxiety, depression and slurred speech.
Neuroleptic Malignant Syndrome (NMS)
Sporadic cases of possible Neuroleptic Malignant Syndrome (NMS) have been reported in association with dose reduction or withdrawal of Manta (amantadine hydrochloride) therapy. Therefore, patients should be observed carefully when the dosage of Manta (amantadine hydrochloride) is reduced abruptly or discontinued, especially if the patient is receiving neuroleptics.
NMS is an uncommon but life-threatening syndrome characterized by fever or hyperthermia; neurologic findings including muscle rigidity, involuntary movements, altered consciousness; mental status changes; other disturbances such as autonomic dysfunction, tachycardia, tachypnea, hyper- or hypotension; laboratory findings such as creatine phosphokinase elevation, leukocytosis, myoglobinuria, and increased serum myoglobin.
The early diagnosis of this condition is important for the appropriate management of these patients. Considering NMS as a possible diagnosis and ruling out other acute illnesses (e.g., pneumonia, systemic infection, etc.) is essential. This may be especially complex if the clinical presentation includes both serious medical illness and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology.
The management of NMS should include: 1) intensive symptomatic treatment and medical monitoring, and 2) treatment of any concomitant serious medical problems for which specific treatments are available. Dopamine agonists, such as bromocriptine, and muscle relaxants, such as dantrolene are often used in the treatment of NMS, however, their effectiveness has not been demonstrated in controlled studies.
Renal disease
Because Manta (amantadine hydrochloride) is mainly excreted in the urine, it accumulates in the plasma and in the body when renal function declines. Thus, the dose of Manta (amantadine hydrochloride) should be reduced in patients with renal impairment and in individuals who are 65 years of age or older (see DOSAGE AND ADMINISTRATION; Dosage for Impaired Renal Function).
Liver disease
Care should be exercised when administering Manta (amantadine hydrochloride) to patients with liver disease. Rare instances of reversible elevation of liver enzymes have been reported in patients receiving Manta (amantadine hydrochloride) , though a specific relationship between the drug and such changes has not been established.
Melanoma
Epidemiological studies have shown that patients with Parkinson's disease have a higher risk (2-to approximately 6-fold higher) of developing melanoma than the general population. Whether the increased risk observed was due to Parkinson's disease or other factors, such as drugs used to treat Parkinson's disease, is unclear.
For the reasons stated above, patients and providers are advised to monitor for melanomas frequently and on a regular basis when using Manta (amantadine hydrochloride) for any indication. Ideally, periodic skin examinations should be performed by appropriately qualified individuals (e.g., dermatologists).
Other
The dose of Manta (amantadine hydrochloride) may need careful adjustment in patients with congestive heart failure, peripheral edema, or orthostatic hypotension. Care should be exercised when administering Manta (amantadine hydrochloride) to patients with a history of recurrent eczematoid rash, or to patients with psychosis or severe psychoneurosis not controlled by chemotherapeutic agents.
Serious bacterial infections may begin with influenza-like symptoms or may coexist with or occur as complications during the course of influenza. Manta (amantadine hydrochloride) has not been shown to prevent such complications.
Carcinogenesis and Mutagenesis
Long-term in vivo animal studies designed to evaluate the carcinogenic potential of Manta (amantadine hydrochloride) have not been performed. In several in vitro assays for gene mutation, Manta (amantadine hydrochloride) did not increase the number of spontaneously observed mutations in four strains of Salmonella typhimurium (Ames Test) or in a mammalian cell line (Chinese Hamster Ovary cells) when incubations were performed either with or without a liver metabolic activation extract. Further, there was no evidence of chromosome damage observed in an in vitro test using freshly derived and stimulated human peripheral blood lymphocytes (with and without metabolic activation) or in an in vivo mouse bone marrow micronucleus test (140-550 mg/kg; estimated human equivalent doses of 11.7-45.8 mg/kg based on body surface area conversion).
Impairment of Fertility
The effect of amantadine on fertility has not been adequately tested, that is, in a study conducted under Good Laboratory Practice (GLP) and according to current recommended methodology. In a three litter, non-GLP, reproduction study in rats, Manta (amantadine hydrochloride) at a dose of 32 mg/kg/day (equal to the maximum recommended human dose on a mg/m2 basis) administered to both males and females slightly impaired fertility. There were no effects on fertility at a dose level of 10 mg/kg/day (or 0.3 times the maximum recommended human dose on a mg/m2 basis); intermediate doses were not tested.
Failed fertility has been reported during human in vitro fertilization (IVF) when the sperm donor ingested amantadine 2 weeks prior to, and during the IVF cycle.
Pregnancy Category C
The effect of amantadine on embryofetal and peri-postnatal development has not been adequately tested, that is, in studies conducted under Good Laboratory Practice (GLP) and according to current recommended methodology. However, in two non-GLP studies in rats in which females were dosed from 5 days prior to mating to Day 6 of gestation or on Days 7-14 of gestation, Manta (amantadine hydrochloride) produced increases in embryonic death at an oral dose of 100 mg/kg (or 3 times the maximum recommended human dose on a mg/m2 basis). In the non-GLP rat study in which females were dosed on Days 7-14 of gestation, there was a marked increase in severe visceral and skeletal malformations at oral doses of 50 and 100 mg/kg (or 1.5 and 3 times, respectively, the maximum recommended human dose on a mg/m2 basis). The no-effect dose for teratogenicity was 37 mg/kg (equal to the maximum recommended human dose on a mg/m2 basis). The safety margins reported may not accurately reflect the risk considering the questionable quality of the study on which they are based. There are no adequate and well-controlled studies in pregnant women. Human data regarding teratogenicity after maternal use of amantadine is scarce. Tetralogy of Fallot and tibial hemimelia (normal karyotype) occurred in an infant exposed to amantadine during the first trimester of pregnancy (100 mg P.O. for 7 days during the 6th and 7th week of gestation). Cardiovascular maldevelopment (single ventricle with pulmonary atresia) was associated with maternal exposure to amantadine (100 mg/d) administered during the first 2 weeks of pregnancy. Manta (amantadine hydrochloride) should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus.
Nursing Mothers
Manta (amantadine hydrochloride) is excreted in human milk. Use is not recommended in nursing mothers.
Pediatric Use
The safety and efficacy of Manta (amantadine hydrochloride) in newborn infants and infants below the age of 1 year have not been established.
Usage in the Elderly
Because Manta (amantadine hydrochloride) is primarily excreted in the urine, it accumulates in the plasma and in the body when renal function declines. Thus, the dose of Manta (amantadine hydrochloride) should be reduced in patients with renal impairment and in individuals who are 65 years of age or older. The dose of Manta (amantadine hydrochloride) may need reduction in patients with congestive heart failure, peripheral edema, or orthostatic hypotension (see DOSAGE AND ADMINISTRATION).
マンタの推奨用量(塩酸アマンタジン)で最も頻繁に報告された副作用(5-10%)は、吐き気、めまい(立ちくらみ)、不眠症です。.
あまり報告されていない(1〜5%)副作用は、うつ病、不安と過敏症、幻覚、混乱、食欲不振、口渇、便秘、運動失調、網状網膜、末 ⁇ 浮腫、起立性低血圧、頭痛、傾眠、緊張、夢の異常、興奮、鼻渇、下 ⁇ 、疲労感。.
まれに(0.1〜1%)発生する副作用は次のとおりです:うっ血性心不全、精神病、尿閉、呼吸困難、皮膚の発疹、 ⁇ 吐、脱力感、不明 ⁇ な発話、陶酔感、思考異常、健忘症、運動過多、高血圧、性欲の低下、視覚障害、点状上皮下または他の角膜の不透明度、角膜浮腫、視覚的.
まれに(0.1%未満)発生する副作用は次のとおりです:けいれん、白血球減少症、好中球減少症、湿疹性皮膚炎、眼科エピソード、自殺未遂、自殺、自殺念慮の事例(参照)。 警告。).
マンタ(塩酸アマンタジン)の使用による市販後の経験中に報告された他の副作用は次のとおりです。
神経系/精神医学。
⁇ 睡、 ⁇ 迷、せん妄、低運動、緊張 ⁇ 進、妄想、攻撃的な行動、偏執的な反応、 ⁇ 病の反応、不随意の筋肉の収縮、歩行異常、感覚異常、脳波の変化、および振戦。. 突然の停止はまた、せん妄、興奮、妄想、幻覚、妄想反応、 ⁇ 迷、不安、うつ病、不明 ⁇ な発話を引き起こす可能性があります。
心血管。
心停止、悪性不整脈を含む不整脈、低血圧、頻脈;
呼吸器。
急性呼吸不全、肺水腫、頻呼吸;
消化器。
⁇ 下障害;。
血液学。
白血球増加症;無 ⁇ 粒球症。
特別感覚。
角膜炎と散 ⁇ ;。
皮膚と付属物。
⁇ と発汗;。
その他。
神経遮断薬悪性症候群(参照。 警告。)、アナフィラキシー反応、浮腫、発熱、病的賭博を含むアレルギー反応、性欲 ⁇ 進を含む性欲の増加、衝動制御症状。.
実験室試験。
高架:CPK、BUN、血清クレアチニン、アルカリホスファターゼ、LDH、ビリルビン、GGT、SGOT、およびSGPT .
マンタ(塩酸アマンタジン)の過剰摂取による死亡が報告されています。. 報告された最低の急性致死量は1グラムでした。. 一部の患者はアマンタジンを過剰摂取して自殺を試みたため、処方は適切な患者管理と一致する最小量で作成する必要があります。.
急性毒性は、アマンタジンの抗コリン作用に起因する可能性があります。. 薬物の過剰摂取は、心臓、呼吸器、腎臓または中枢神経系の毒性をもたらしました。. 心機能障害には、不整脈、頻脈、高血圧が含まれます。. 肺水腫と呼吸器苦痛(成人呼吸 ⁇ 迫症候群-ARDSを含む)が報告されています。 BUNの増加、クレアチニンクリアランスの低下、腎不全などの腎機能障害が発生する可能性があります。. 報告されている中枢神経系の影響には、不眠症、不安、興奮、攻撃的な行動、緊張 ⁇ 進、運動過多、運動失調、歩行異常、振戦、混乱、見当識障害、離人化、恐怖、せん妄、幻覚、精神病反応、 ⁇ 眠、傾眠、 ⁇ 睡などがあります。. 発作は、発作障害の既往歴のある患者では悪化する可能性があります。. 高体温症は、薬物の過剰摂取が発生した場合にも観察されています。.
マンタ(塩酸アマンタジン)の過剰摂取に対する特定の解毒剤はありません。. ただし、成人では、1 mgおよび2 mgの用量でゆっくりと静脈内フィゾスチグミンを投与します。2 子供の1〜2時間間隔と0.5 mg用量。3 5〜10分間隔で最大2 mg /時間までが、塩酸アマンタジンによって引き起こされる中枢神経系毒性の制御に効果的であると報告されています。. 急性の過剰摂取については、即時の胃洗浄または ⁇ 吐の誘発とともに、一般的な支援策を採用する必要があります。. 体液は強制し、必要に応じて静脈内投与する必要があります。. 尿のpHは、マンタ(塩酸アマンタジン)の排 ⁇ 率に影響を与えると報告されています。. マンタ(塩酸アマンタジン)の排 ⁇ 率は、尿が酸性になると急速に増加するため、尿酸性化薬の投与により、体からの薬物の排出が増加する可能性があります。. 血圧、脈拍、呼吸、体温を監視する必要があります。. 患者は多動とけいれんについて観察されるべきです。必要に応じて、鎮静、抗けいれん療法を実施する必要があります。. 不整脈と低血圧の可能性のある発症について患者を観察する必要があります。必要に応じて、適切な抗不整脈および抗降圧療法を行う必要があります。. 過剰摂取後に悪性頻脈性不整脈が現れる可能性があるため、摂取後に心電図モニタリングが必要になる場合があります。.
マンタ(塩酸アマンタジン)のドーパミン作動性が悪性不整脈を誘発すると報告されているため、マンタ(塩酸アマンタジン)の過剰摂取の患者にイソプロテレノールなどのアドレナリン作動薬を投与する場合は注意が必要です。.
血液電解質、尿のpH、尿量を監視する必要があります。. 最近の無効化の記録がない場合は、カテーテル法化を行う必要があります。.
作用機序:抗ウイルス。
アマンタジンが抗ウイルス活性を発揮するメカニズムは明確に理解されていません。. それは主にウイルスM2タンパク質の膜貫通領域の機能を妨害することにより、感染性ウイルス核酸の宿主細胞への放出を防ぐようです。. 場合によっては、アマンタジンはウイルス複製中のウイルス集合を防ぐことも知られています。. 不活化インフルエンザAウイルスワクチンの免疫原性を妨げるようには見えません。.
抗ウイルス活性。
アマンタジンは、各サブタイプからのインフルエンザAウイルス分離株の複製を阻害します。.、H1N1、H2N2およびH3N2。. インフルエンザBウイルス分離株に対する活動はほとんどまたはまったくありません。. 間の量的関係。 in vitro。 インフルエンザAウイルスのアマンタジンに対する感受性と治療に対する臨床反応は、男性では確立されていません。. 感度テスト結果。, ウイルスの増殖を50%阻害するために必要なアマンタジンの濃度として表されます。 (ED50。) 組織培養では大きく異なります。 (0.1 ⁇ µg/ mLから25.0 ⁇ µg/ mLまで。) 使用されるアッセイプロトコルによって異なります。, ウイルス接種材料のサイズ。, テストされたインフルエンザAウイルス株の分離株。, 使用するセルタイプ。. 組織培養の宿主細胞は、100 µg / mLの濃度までアマンタジンを容易に耐えました。
薬剤耐性。
インフルエンザAのバリエーションが減少しています。 in vitro。 アマンタジンに対する感受性は、アダマンタン誘導体が使用されている地域の流行株から分離されています。. 減少したインフルエンザウイルス。 in vitro。 感受性は伝染性であり、典型的なインフルエンザの病気を引き起こすことが示されています。. 間の量的関係。 in vitro。 アマンタジンに対するインフルエンザA変異体の感受性と治療に対する臨床反応は確立されていません。.
行動メカニズム:パーキンソン病。
パーキンソン病および薬物誘発性 ⁇ 体外路反応の治療におけるアマンタジンの作用機序は知られていない。. 以前の動物研究のデータは、マンタ(塩酸アマンタジン)がドーパミンニューロンに直接的および間接的な影響を与える可能性があることを示唆しています。. より最近の研究では、アマンタジンが弱くて競争力のないNMDA受容体 ⁇ 抗薬であることが示されています(Ki = 10µM)。. アマンタジンは動物実験で直接抗コリン作用を示すことは示されていませんが、臨床的には、口渇、尿閉、便秘などの抗コリン作用のような副作用を示します。.