期刊
PARKINSONISM & RELATED DISORDERS
卷 15, 期 5, 页码 351-353出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2008.08.005
关键词
Amantadine; Parkinson's disease; Plasma concentration; Side effects; Renal function; Creatinine clearance
资金
- Ministry of Health, Labour and Welfare of Japan
- SRFJ
- Ehime University
We determined plasma amantadine concentrations in patients with Parkinson's disease (PD) in daily clinical practice and investigated the relationship between plasma concentration and adverse reactions to clarify the safe therapeutic range. Seventy-eight consecutive PD patients on stable amantadine treatment were recruited. Plasma concentration of amantadine was measured 3 h after the administration of morning amantadine dose. Serum creatinine was measured to estimate renal function. The mean daily dose of amantadme was 135.1 +/- 62.3 mg/day, and the mean plasma amantadine concentration was 812.5 +/- 839.5 ng/ml (range, 91-4400 ng/ml). Plasma amantadine concentration increased according to increasing renal dysfunction. Three patients exhibited adverse reactions, such as myoclonus, hallucinations, and delirium, and all of them showed plasma amantadine concentration >3000 ng/ml. None of the three cases had previously shown such side effects. PD patients who have not developed any psychiatric symptoms as adverse reactions to the treatment may develop myoclonus, hallucination, or delirium when the plasma concentration of amantadine exceeds 3000 ng/ml. It is therefore recommended to use amantadine at the plasma concentration of less than 3000 ng/ml in the treatment of Parkinson's disease, especially in elderly patients. (C) 2008 Published by Elsevier Ltd.
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