普瑞巴林

普瑞巴林
(Pregabalin)
臨床資料
其他名稱	Isobutyl GABA
AHFS/Drugs.com	國際藥品名稱
MedlinePlus	a605045
核准狀況	美 FDA: Pregabalin;
懷孕分級	澳: B3 ; ;
給藥途徑	口服
ATC碼	N03AX16 (WHO) ;
法律規範狀態
法律規範	澳：限醫生處方（S4）; 加：處方藥（℞-only）; 英：處方藥（℞-only） (POM); 美：附表V; 處方藥（℞-only）;
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
藥效起始時間（英語：Onset of action）	1.5 小時
生物半衰期	6.3 小時
排泄途徑	腎
識別資訊
	IUPAC命名法 (S)-3-(aminomethyl)-5-methylhexanoic acid; ;
CAS號	148553-50-8
PubChem CID	5486971;
DrugBank	DB00230 ;
ChemSpider	4589156 ;
UNII	55JG375S6M;
KEGG	D02716 ;
ChEBI	CHEBI:64356 ;
ChEMBL	ChEMBL1059 ;
CompTox Dashboard（英語：CompTox Chemicals Dashboard） (EPA)	DTXSID1045950 ;
ECHA InfoCard	100.119.513
化學資訊
化學式	C8H17NO2
摩爾質量	159.23 g.mol−1
3D模型（JSmol（英語：JSmol））	交互式圖像;
	SMILES O=C(O)C[C@H](CC(C)C)CN;
	InChI 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 ; Key:AYXYPKUFHZROOJ-ZETCQYMHSA-N ;

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

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、鎮痛和抗焦慮效果的原因。^[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（K_i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

^ 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）.
^ ^2.0 ^2.1 Pharmacotherapy Update - Pregabalin (Lyrica®):Part I. [2016-02-22]. （原始內容存檔於2017-02-27）.
^ 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.
^ Pregabalin. The American Society of Health-System Pharmacists. [2015-10-23]. （原始內容存檔於2020-08-09）.
^ ^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.
^ ^6.0 ^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.
^ ^7.0 ^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  .
^ ^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.
^ 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.
^ 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.
^ 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）.
^ 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.
^ ^13.0 ^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.
^ 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  . PMID 21897498. doi:10.4103/0970-9185.83672  .
^ McMahon SB. Wall and Melzack's textbook of pain 6th. Philadelphia, PA: Elsevier/Saunders. 2013: 515. ISBN 9780702040597.
^ 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）.
^ ^17.0 ^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

Pfizer website for Lyrica （頁面存檔備份，存於網際網路檔案館）
U.S. prescribing information （頁面存檔備份，存於網際網路檔案館）
Lyrica Oral at WebMD.com （頁面存檔備份，存於網際網路檔案館）
Erowid Lyrica (Pregabalin) Vault （頁面存檔備份，存於網際網路檔案館）

[emea-spc-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）.

[clevelandclinicmeded.com-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.

[AHFS2015-4] Pregabalin. The American Society of Health-System Pharmacists. [2015-10-23]. （原始內容存檔於2020-08-09）.

[pmid10189176-5] 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.

[Cal2016-6] 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.

[Uch2010-7] 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  .

[pmid16376147-8] 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.

[BenzonRathmell2013-9] 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.

[pmid23642658-13] 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.

[pmid21897498-14] 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  . PMID 21897498. doi:10.4103/0970-9185.83672  .

[15] McMahon SB. Wall and Melzack's textbook of pain 6th. Philadelphia, PA: Elsevier/Saunders. 2013: 515. ISBN 9780702040597.

[pmid17126531-16] 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）.

[EOID-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.

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