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司来吉兰的药理学。

The pharmacology of selegiline.

机构信息

Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary.

出版信息

Int Rev Neurobiol. 2011;100:65-84. doi: 10.1016/B978-0-12-386467-3.00004-2.

Abstract

Selegiline, the R-optical enantiomer of deprenyl (phenyl-isopropyl-methyl-propargylamine), was almost exclusively used MAO-B inhibitor during the past decades to treat Parkinson's disease. Oral treatment prolongs the need of levodopa administration. Selegiline is rapidly metabolized by the microsomal enzymes to amphetamine, methamphetamine, and desmethyl-deprenyl. In addition, the flavin-containing monooxigenase is synthesizing deprenyl-N-oxide. Selegiline in rather low concentrations (10⁻⁹-10⁻¹³ M), does not influence MAO-B, but it has an antiapoptotic activity in tissue culture. The neuroprotective effect of selegiline has a biphasic character. In higher concentrations than 10⁻⁷ M increases the rate of apoptosis (proapoptotic activity). The metabolites are also taking part in the complex pharmacological activity of selegiline. The simultaneous presence of the pro- and antiapoptotic effects of selegiline and its metabolites frequently hindered its clinical usage. During the past years rasagiline has been introduced to replace selegiline in clinical application. MAO-B inhibitors beside their effect on the enzyme MAO-B could hold different spectrum of pharmacological activities. Selegiline is administered orally and it possesses an intensive "first pass" metabolism. To circumvent the "first pass" metabolism, parenteral administration of the drug might lead to different distribution and pharmacological activity of selegiline.

摘要

司来吉兰,即去甲丙炔苯丙胺(苯丙基异丙基甲基丙炔胺)的 R-对映异构体,在过去几十年中几乎是唯一被用于治疗帕金森病的 MAO-B 抑制剂。口服治疗可以延长左旋多巴的使用需求。司来吉兰被细胞色素 P450 同工酶迅速代谢为苯丙胺、甲基苯丙胺和去甲丙炔苯丙胺。此外,黄素单加氧酶合成去甲丙炔苯丙胺-N-氧化物。司来吉兰在较低浓度(10⁻⁹-10⁻¹³ M)下不影响 MAO-B,但在组织培养中具有抗细胞凋亡作用。司来吉兰的神经保护作用具有双相特征。在高于 10⁻⁷ M 的浓度下,它会增加细胞凋亡的速度(促凋亡活性)。其代谢产物也参与了司来吉兰复杂的药理学活性。司来吉兰及其代谢产物的促凋亡和抗凋亡作用同时存在,常常阻碍了其临床应用。近年来,雷沙吉兰已被引入临床应用以替代司来吉兰。MAO-B 抑制剂除了对 MAO-B 酶的作用外,还具有不同的药理学活性。司来吉兰口服给药,具有强烈的“首过”代谢。为了避免“首过”代谢,药物的肠外给药可能导致司来吉兰的分布和药理学活性不同。

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