阿莫待奎

**阿莫待奎**
臨床資料
商品名（英语：Drug nomenclature）	Amdaquine、Amobin、Camoquin及其他
AHFS/Drugs.com	国际药品名称
ATC碼	P01BA06 (WHO) ;
识别信息
	IUPAC命名法 4-[(7-chloroquinolin-4-yl)amino]-2-[(diethylamino)methyl]phenol; ;
CAS号	86-42-0
PubChem CID	2165;
DrugBank	DB00613 ;
ChemSpider	2080 ;
UNII	220236ED28;
KEGG	D02922 ;
ChEBI	CHEBI:2674 ;
ChEMBL	ChEMBL682 ;
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)	DTXSID2022597 ;
ECHA InfoCard	100.001.518
化学信息
化学式	C20H22ClN3O
摩尔质量	355.87 g·mol−1
3D模型（JSmol（英语：JSmol））	交互式图像;
	SMILES Clc1cc2nccc(c2cc1)Nc3cc(c(O)cc3)CN(CC)CC;
	InChI InChI=1S/C20H22ClN3O/c1-3-24(4-2)13-14-11-16(6-8-20(14)25)23-18-9-10-22-19-12-15(21)5-7-17(18)19/h5-12,25H,3-4,13H2,1-2H3,(H,22,23) ; Key:OVCDSSHSILBFBN-UHFFFAOYSA-N ;

阿莫待奎（英語：Amodiaquine，簡稱ADQ) 是一種用於治療瘧疾（包括尚未出現併發症的惡性瘧原蟲瘧疾）的藥物。^[2]^[3]建議此藥物與青蒿琥酯一起服用，以降低發生抗藥性風險。^[2]由於此藥物可能會產生罕見，但嚴重的副作用，通常不建議用於預防之用。^[2]但世界衛生組織 (WHO) 在2013年建議在兒童的高風險感染季節中將其與磺胺多辛/乙胺嘧啶（英语：Sulfadoxine/pyrimethamine）聯合，用於預防感染。^[4]根據一份發表於2010年8月的研究報告，實驗者針對迦納的兒童採用阿莫待奎與青蒿琥酯組合，與採用阿莫待奎與磺胺多辛/乙胺嘧啶組合，進行季節性瘧疾預防性用藥，發現前者組合較後者更具有成本上的優勢。^[5]

此藥物經由口服方式給藥。^[6]

阿莫待奎是一種與氯化奎寧相關的4-氨基喹啉化合物。^[2]使用後的副作用與使用氯化奎寧相似，程度通常為輕微至中度。^[3]其中很少會出現肝病或粒细胞减少症（英语：Agranulocytosis）（白細胞減少症）。^[2]過量服用後，可能會發生頭痛、視力障礙、癲癇發作和心搏停止。^[2]WHO建議孕婦可在懷孕中期和晚期，以及於哺乳期使用，但報告指出在懷孕早期使用，是否對於胎兒有害，證據仍然不足。^[7]

阿莫地奎於1948年開始生產。^[8]它已被列入世界衛生組織基本藥物標準清單之中。^[9]^[10]

歐盟或美國等國家因為阿莫待奎的副作用而不再使用，WHO於1990年將其由其瘧疾控制計畫中剔除。^[11]但此藥物仍在其他地區（包括非洲^[12] 和大洋洲）使用。^[11]

醫療用途[编辑]

阿莫待奎是非洲於瘧疾聯合療法中的重要藥物。^[13]它通常與青蒿琥酯聯合使用，稱為青蒿素聯合療法（ACT），以治療尚未出現併發症的惡性瘧原蟲瘧疾。^[14]

此藥物也可與磺胺多辛/乙胺嘧啶（複方劑）聯合使用。^[15]^[16]

非洲迄2006年已有39個國家更新其國家藥物政策，將青蒿素聯合療法 (ACT) 納入瘧疾病例管理指南。口服青蒿素不僅可單獨使用 (對於非抗藥性瘧疾)，也可與其他長效抗瘧疾藥物，例如阿莫待奎、美爾奎寧、磺胺多辛/乙胺嘧啶或是苯芴醇組合使用，達到ACT療法的目的。^[17]

阿莫待奎也可對抗具氯化奎寧抗藥性的惡性瘧原蟲菌株，但其對抗氯化奎寧抗藥性菌株的活性存有地域上的差異。^[18]^[19]

與其他藥物交互作用[编辑]

有報導稱接受齊多夫定或依法韋倫以治療愛滋病的患者，當同時採含阿莫待奎的ACT方案時，其肝臟毒性會增加，因此建議此類人避免使用阿莫待奎。^[14]

藥物動力學和藥物遺傳學[编辑]

阿莫待奎因為會經過肝臟廣泛的首過效應，在人體中的生物半衰期為5.3–7.7小時。^[20]阿莫待奎主要以去乙基阿莫待奎（N-desethylamodiaquine）的形式由胆汁排出。^[20]

此藥物經由細胞色素P450中的CYP2C8（英语：CYP2C8）酵素在肝臟被生物轉化為主要代謝物 - 去乙基阿莫待奎。在阿莫待奎使用者中，已有幾種罕見但嚴重的副作用發生，這些副作用與CYP2C8等位基因的變異有關。阿莫待奎代謝不良的人在瘧疾的治療效果會較低，且毒性會增加。^[21]目前已進行幾項研究來確定於東非的瘧疾患者中，其CYP2C8等位基因的盛行率，初步顯示變異等位基因在此地有顯著的盛行率。^[22]有約3.6%的受研究族群在接受阿莫待奎治療時表現出不良反應升高或治療結果降低的風險。這些資訊對於在東非制定藥物安全計劃（英语：pharmacovigilance）時有其用處，且對於在CYP2C8同位基因變異頻率高的地區開立抗瘧藥物處方時會將其作為重要的臨床考慮。

參見[编辑]

FGI-104（英语：FGI-104），此實驗性藥物的結構與阿莫待奎相似

參考文獻[编辑]

^ Amodiaquine. drugs.com. [2016-11-27]. （原始内容存档于2016-11-27）.
^ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 ^2.5 Nair A, Abrahamsson B, Barends DM, Groot DW, Kopp S, Polli JE, et al. Biowaiver monographs for immediate release solid oral dosage forms: amodiaquine hydrochloride. Journal of Pharmaceutical Sciences. December 2012, 101 (12): 4390–4401. PMID 22949374. doi:10.1002/jps.23312.
^ ^3.0 ^3.1 Olliaro P, Mussano P. Amodiaquine for treating malaria. The Cochrane Database of Systematic Reviews. 2003, (2): CD000016. PMC 6532704 . PMID 12804382. doi:10.1002/14651858.CD000016.
^ Seasonal malaria chemoprevention with sulfadoxine–pyrimethamine plus amodiaquine in children: a field guide. (PDF). Geneva: The World Health Organization. August 2013. ISBN 978-92-4-150473-7.
^ Conteh, Lesong; Patouillard, Edith. Cost effectiveness of seasonal intermittent preventive treatment using amodiaquine & artesunate or sulphadoxine-pyrimethamine in Ghanaian children. PLoS. 2010-08-17, 5 (8) [2024-05-16]. doi:10.1371/journal.pone.0012223.
^ Pharmacology and Therapeutics Principles to Practice（2008）. Elsevier Inc. [2024-05-16]. ISBN 978-1-4160-3291-5.
^ WHO Guidelines for malaria. www.who.int. [2024-01-22] （英语）.
^ Ahmad I, Ahmad T, Usmanghani K. Amodiaquine hydrochloride. Profiles of Drug Substances, Excipients and Related Methodology. Analytical Profiles of Drug Substances and Excipients 21. Academic Press. 1992: 45. ISBN 978-0-08-086116-6. doi:10.1016/S0099-5428(08)60388-3. （原始内容存档于2017-09-08）（英语）.
^ World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. hdl:10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^ World Health Organization. World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. hdl:10665/345533 . WHO/MHP/HPS/EML/2021.02.
^ ^11.0 ^11.1 Meyler's Side Effects of Drugs (Fifteenth Edition). Elsevier Science. 2006 [2024-05-16]. ISBN 978-0-444-51005-1.
^ Amodiaquine. Livertox. [2016-11-27]. （原始内容存档于2016-11-27）.
^ Kerb R, Fux R, Mörike K, Kremsner PG, Gil JP, Gleiter CH, Schwab M. Pharmacogenetics of antimalarial drugs: effect on metabolism and transport. The Lancet. Infectious Diseases. December 2009, 9 (12): 760–774. PMID 19926036. doi:10.1016/S1473-3099(09)70320-2.
^ ^14.0 ^14.1 World Health Organization. Guidelines for the treatment of malaria 3rd. World Health Organization. 2015. ISBN 978-92-4-154912-7. hdl:10665/162441 .
^ Staedke SG, Kamya MR, Dorsey G, Gasasira A, Ndeezi G, Charlebois ED, Rosenthal PJ. Amodiaquine, sulfadoxine/pyrimethamine, and combination therapy for treatment of uncomplicated falciparum malaria in Kampala, Uganda: a randomised trial. Lancet. August 2001, 358 (9279): 368–374. PMID 11502317. S2CID 42745422. doi:10.1016/S0140-6736(01)05557-X.
^ World Health Organization. Seasonal malaria chemoprevention with sulfadoxine–pyrimethamine plus amodiaquine in children: a field guide. World Health Organization. 2013. ISBN 978-92-4-150473-7. hdl:10665/85726 .
^ Odunfa, OO; Adegoke, OA. Pharmaceutical Equivalence of Some Commercial Samples of Artesunate and Amodiaquine Tablets Sold in Southwestern Nigeria. Tropical Journal of Pharmaceutical Research. December 2009, 8 (6): 491–499 [2024-05-16].
^ Amodiaquine. PubChem. U.S. National Library of Medicine. [2016-10-28]. （原始内容存档于2016-10-29）.
^ Bennett, John Eugene; Dolin, Raphael; Blaser, Martin J. (编). 41 - Antimalarial Drugs. Mandell, Douglas, and Bennett's principles and practice of infectious diseases Ninth. Philadelphia, PA: Elsevier. 2020: 519–534. ISBN 978-0-323-48255-4.
^ ^20.0 ^20.1 Antimalarial Agents Design and Mechanism of Action （2020）. Elsevier Ltd. [2024-05-16]. ISBN 978-0-08-101210-9.
^ Elyazar IR, Hay SI, Baird JK. Malaria distribution, prevalence, drug resistance and control in Indonesia. Advances in Parasitology. April 2011, 74 (74): 41–175. ISBN 978-0-12-385897-9. PMC 3075886 . PMID 21295677. doi:10.1016/B978-0-12-385897-9.00002-1.
^ Roederer MW, McLeod H, Juliano JJ. Can pharmacogenomics improve malaria drug policy?. Bulletin of the World Health Organization. November 2011, 89 (11): 838–845. PMC 3209725 . PMID 22084530. doi:10.2471/BLT.11.087320.

外部連結[编辑]

Amodiaquine. Drug Information Portal. U.S. National Library of Medicine.

Scholia上有關阿莫地喹（Q239569）的信息

Template:Monoamine metabolism modulators

{{draft categories|

[1] Amodiaquine. drugs.com. [2016-11-27]. （原始内容存档于2016-11-27）.

[Na2012-2] 2.0 ^2.1 ^2.2 ^2.3 ^2.4 ^2.5 Nair A, Abrahamsson B, Barends DM, Groot DW, Kopp S, Polli JE, et al. Biowaiver monographs for immediate release solid oral dosage forms: amodiaquine hydrochloride. Journal of Pharmaceutical Sciences. December 2012, 101 (12): 4390–4401. PMID 22949374. doi:10.1002/jps.23312.

[Co2003-3] 3.0 ^3.1 Olliaro P, Mussano P. Amodiaquine for treating malaria. The Cochrane Database of Systematic Reviews. 2003, (2): CD000016. PMC 6532704 . PMID 12804382. doi:10.1002/14651858.CD000016.

[4] Seasonal malaria chemoprevention with sulfadoxine–pyrimethamine plus amodiaquine in children: a field guide. (PDF). Geneva: The World Health Organization. August 2013. ISBN 978-92-4-150473-7.

[5] Conteh, Lesong; Patouillard, Edith. Cost effectiveness of seasonal intermittent preventive treatment using amodiaquine & artesunate or sulphadoxine-pyrimethamine in Ghanaian children. PLoS. 2010-08-17, 5 (8) [2024-05-16]. doi:10.1371/journal.pone.0012223.

[6] Pharmacology and Therapeutics Principles to Practice（2008）. Elsevier Inc. [2024-05-16]. ISBN 978-1-4160-3291-5.

[7] WHO Guidelines for malaria. www.who.int. [2024-01-22] （英语）.

[8] Ahmad I, Ahmad T, Usmanghani K. Amodiaquine hydrochloride. Profiles of Drug Substances, Excipients and Related Methodology. Analytical Profiles of Drug Substances and Excipients 21. Academic Press. 1992: 45. ISBN 978-0-08-086116-6. doi:10.1016/S0099-5428(08)60388-3. （原始内容存档于2017-09-08）（英语）.

[WHO21st-9] World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. hdl:10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.

[WHO22nd-10] World Health Organization. World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. hdl:10665/345533 . WHO/MHP/HPS/EML/2021.02.

[Elsevier_Science-11] 11.0 ^11.1 Meyler's Side Effects of Drugs (Fifteenth Edition). Elsevier Science. 2006 [2024-05-16]. ISBN 978-0-444-51005-1.

[12] Amodiaquine. Livertox. [2016-11-27]. （原始内容存档于2016-11-27）.

[13] Kerb R, Fux R, Mörike K, Kremsner PG, Gil JP, Gleiter CH, Schwab M. Pharmacogenetics of antimalarial drugs: effect on metabolism and transport. The Lancet. Infectious Diseases. December 2009, 9 (12): 760–774. PMID 19926036. doi:10.1016/S1473-3099(09)70320-2.

[:02-14] 14.0 ^14.1 World Health Organization. Guidelines for the treatment of malaria 3rd. World Health Organization. 2015. ISBN 978-92-4-154912-7. hdl:10665/162441 .

[15] Staedke SG, Kamya MR, Dorsey G, Gasasira A, Ndeezi G, Charlebois ED, Rosenthal PJ. Amodiaquine, sulfadoxine/pyrimethamine, and combination therapy for treatment of uncomplicated falciparum malaria in Kampala, Uganda: a randomised trial. Lancet. August 2001, 358 (9279): 368–374. PMID 11502317. S2CID 42745422. doi:10.1016/S0140-6736(01)05557-X.

[16] World Health Organization. Seasonal malaria chemoprevention with sulfadoxine–pyrimethamine plus amodiaquine in children: a field guide. World Health Organization. 2013. ISBN 978-92-4-150473-7. hdl:10665/85726 .

[17] Odunfa, OO; Adegoke, OA. Pharmaceutical Equivalence of Some Commercial Samples of Artesunate and Amodiaquine Tablets Sold in Southwestern Nigeria. Tropical Journal of Pharmaceutical Research. December 2009, 8 (6): 491–499 [2024-05-16].

[18] Amodiaquine. PubChem. U.S. National Library of Medicine. [2016-10-28]. （原始内容存档于2016-10-29）.

[19] Bennett, John Eugene; Dolin, Raphael; Blaser, Martin J. (编). 41 - Antimalarial Drugs. Mandell, Douglas, and Bennett's principles and practice of infectious diseases Ninth. Philadelphia, PA: Elsevier. 2020: 519–534. ISBN 978-0-323-48255-4.

[Mechanism-20] 20.0 ^20.1 Antimalarial Agents Design and Mechanism of Action （2020）. Elsevier Ltd. [2024-05-16]. ISBN 978-0-08-101210-9.

[21] Elyazar IR, Hay SI, Baird JK. Malaria distribution, prevalence, drug resistance and control in Indonesia. Advances in Parasitology. April 2011, 74 (74): 41–175. ISBN 978-0-12-385897-9. PMC 3075886 . PMID 21295677. doi:10.1016/B978-0-12-385897-9.00002-1.

[22] Roederer MW, McLeod H, Juliano JJ. Can pharmacogenomics improve malaria drug policy?. Bulletin of the World Health Organization. November 2011, 89 (11): 838–845. PMC 3209725 . PMID 22084530. doi:10.2471/BLT.11.087320.

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