Pharmacological properties : תכונות פרמקולוגיות

Pharmacodynamic Properties

5.1 Pharmacodynamic properties

Pharmacotherapeutic group: Anti-Parkinson Drug ATC code: NO4BB01
Pharmacological properties:
Amantadine has various pharmacological effects. The agent has an indirectly agonistic effect at the striatal dopamine receptor. Animal studies have shown that amantadine increases the extracellular dopamine concentration both by increased dopamine release and through blockade of rte-uptake into the presynaptic neurons. At therapeutic concentrations, amantadine inhibits the release of acetylcholine mediated by NMDA receptors and can thus trigger anticholinergic effects. The agent has synergistic effects with L-dopa.

Pharmacokinetic Properties

5.2 Pharmacokinetic properties
Plasma concentration, elimination:
Pick plasma concentrations are reached about 2-8 hours (tmax) after administration of a single dose. The freely soluble amantadine hydrochloride gives higher peak plasma amantadine concentrations than the more sparingly soluble amantadine sulphate, for which the peak plasma concentration (Cmax) is reached later than that of the hydrochloride. After a single oral dose of 250 mg amantadine hydrochloride, a Cmax of 0.5 µg/ml is attained.
At a dosage of 200 mg/day steady state is reached after 4-7 days, with plasma concentrations of 400-900 ng/ml. After administration of 100 mg amantadine sulphate Cmax is 0.15 µg/ml.
The total amount of active substance absorbed (AUC) is the same for the two amantadine salts. Plasma clearance was found to be identical to renal clearance, at 17.7 ± 10 L/h in healthy elderly volunteers. The apparent volume of distribution (4.2 ± 1.9 L/kg) is age-dependent; in the elderly it is 6.0 L/kg.
The elimination half-life is between 10 and 30 hours with a mean of approximately 15 hours and is largely dependent on the age of the patient. Elderly male patients (62-72 years) show an elimination half-life of 30 h. In patients with renal insufficiency the terminal plasma half-life may be substantially prolonged, to 68 ± 10 h.
Administration as an infusion:
Infusion of 200 mg amantadine sulphate over a 3-hours period resulted in a mean plasma concentration of 0.54 µg/ml. After treatment at a dose of 200 mg/day a mean plasma concentration of 0.76 µg/ml was reached at the end of the infusion on day 6.
The mean total clearance was calculated at 3.6 L/hours; the plasma half-life ranged from 7 to 23 hours with a mean of approximately 10 hours.
In vitro: Amantadine is approximately 67% plasma protein bound approximately 33% are present in plasma in an unbound form.
It overcomes the blood-brain barrier by virtue of a saturatable transporter system.
Amantadine is excreted in the urine almost completely unmetabolized (90% of a single dose), small amounts being excreted with the faeces.

The dialyzability of amantadine hydrochloride is low, at some 5% for a single dialysis.
Metabolism:
Amantadine is not metabolized in humans.