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Jsjsjs1111/青霉胺
臨床資料
商品名英语Drug nomenclatureCuprimine
AHFS/Drugs.comMonograph
懷孕分級
  • : D
给药途径Oral
ATC碼
法律規範狀態
法律規範
  • 处方药(-only)
藥物動力學數據
生物利用度Variable
药物代谢Hepatic
生物半衰期1 hour
排泄途徑Renal
识别信息
  • (2S)-2-amino-3-methyl-3-sulfanyl-butanoic acid
CAS号52-67-5  checkY
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
化学信息
化学式C5H11NO2S
摩尔质量149.212 g/mol
3D模型(JSmol英语JSmol
  • CC(C)([C@H](C(=O)O)N)S
  • InChI=1S/C5H11NO2S/c1-5(2,9)3(6)4(7)8/h3,9H,6H2,1-2H3,(H,7,8)/t3-/m0/s1 checkY
  • Key:VVNCNSJFMMFHPL-VKHMYHEASA-N checkY

青霉胺(英語:Penicillamine)是一种有络合作用药物,商品名为CuprimineDepen[1] 药用青霉胺成分是D-青霉胺,因为L-异构体具有毒性(它会抑制吡哆醇的功能)。[2] 青霉胺是青霉素的一种α-氨基酸代谢产物,不过它并不具有任何抗生素活性。 [3]

用途

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作为一种免疫抑制剂,青霉胺常被用于治疗类风湿性关节炎。It works by reducing numbers of T-lymphocytes, inhibiting macrophage function, decreasing IL-1, decreasing rheumatoid factor, and preventing collagen from cross-linking.[4]

It is used as a chelating agent:

Adverse effects

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Bone marrow suppression, dysgeusia, anorexia, vomiting and diarrhea are the most common side effects, occurring in ~20-30% of the patients treated with penicillamine.[4][9]

Other possible adverse effects include:

Besides, people allergic to penicillin may have hypersensitivity to penicillamine.[3]

History

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Dr. John Walshe first described the use of penicillamine in Wilson's disease in 1956.[16] He had discovered the compound in the urine of patients (including himself) who had taken penicillin, and experimentally confirmed that it increased urinary copper excretion by chelation. He had initial difficulty convincing several world experts of the time (Drs Denny Brown and Cumings) of its efficacy, as they held that Wilson's disease was not primarily a problem of copper homeostasis but of amino acid metabolism, and that dimercaprol should be used as a chelator. Later studies confirmed both the copper-centered theory and the efficacy of D-penicillamine. Walshe also pioneered other chelators in Wilson's such as triethylene tetramine, 2HCl, and tetrathiomolybdate.[17]

Penicillamine has been used in rheumatoid arthritis since the first successful case in 1964.[18]

References

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  1. ^ 1.0 1.1 J. Peisach, W. E. Blumberg. A mechanism for the action of penicillamine in the treatment of Wilson's disease. Molecular Pharmacology. 1969-03, 5 (2): 200–209 [2019-06-25]. ISSN 0026-895X. PMID 4306792. 
  2. ^ I. A. Jaffe, K. Altman, P. Merryman. THE ANTIPYRIDOXINE EFFECT OF PENICILLAMINE IN MAN. The Journal of Clinical Investigation. 1964-10, 43: 1869–1873 [2019-06-25]. ISSN 0021-9738. PMC 289631可免费查阅. PMID 14236210. doi:10.1172/JCI105060. 
  3. ^ 3.0 3.1 C. W. Parker, J. Shapiro, M. Kern, H. N. Eisen. Hypersensitivity to penicillenic acid derivatives in human beings with penicillin allergy. The Journal of Experimental Medicine. 1962-04-01, 115: 821–838 [2019-06-25]. ISSN 0022-1007. PMC 2137514可免费查阅. PMID 14483916. doi:10.1084/jem.115.4.821. 
  4. ^ 4.0 4.1 4.2 4.3 A. V. Camp. Penicillamine in the treatment of rheumatoid arthritis. Proceedings of the Royal Society of Medicine. 1977-02, 70 (2): 67–69 [2019-06-25]. ISSN 0035-9157. PMC 1542978可免费查阅. PMID 859814. 
  5. ^ 5.0 5.1 Leon E. Rosenberg. Nephrotoxic Effects of Penicillamine in Cystinuria. JAMA: The Journal of the American Medical Association. 1967-08-28, 201 (9): 698 [2019-06-25]. ISSN 0098-7484. doi:10.1001/jama.1967.03130090062021 (英语). 
  6. ^ V. D. Steen, T. A. Medsger, G. P. Rodnan. D-Penicillamine therapy in progressive systemic sclerosis (scleroderma): a retrospective analysis. Annals of Internal Medicine. 1982-11, 97 (5): 652–659 [2019-06-25]. ISSN 0003-4819. PMID 7137731. doi:10.7326/0003-4819-97-5-652. 
  7. ^ Robert G. Peterson, Barry H. Rumack. d-Penicillamine therapy of acute arsenic poisoning. The Journal of Pediatrics. 1977-10, 91 (4): 661–666 [2019-06-25]. doi:10.1016/S0022-3476(77)80528-3 (英语). 
  8. ^ Alan H Hall. Chronic arsenic poisoning. Toxicology Letters. 2002-03, 128 (1-3): 69–72 [2019-06-25]. doi:10.1016/S0378-4274(01)00534-3 (英语). 
  9. ^ K. Grasedyck. [D-penicillamine--side effects, pathogenesis and decreasing the risks]. Zeitschrift Fur Rheumatologie. 1988,. 47 Suppl 1: 17–19 [2019-06-25]. ISSN 0340-1855. PMID 3063003. 
  10. ^ 10.0 10.1 B. Fishel, M. Tishler, D. Caspi, M. Yaron. Fatal aplastic anaemia and liver toxicity caused by D-penicillamine treatment of rheumatoid arthritis. Annals of the Rheumatic Diseases. 1989-07, 48 (7): 609–610 [2019-06-25]. ISSN 0003-4967. PMC 1003826可免费查阅. PMID 2774703. doi:10.1136/ard.48.7.609. 
  11. ^ Table 14-2 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson. Robbins Basic Pathology. Philadelphia: Saunders. ISBN 1-4160-2973-7.  8th edition.
  12. ^ A. Chalmers, D. Thompson, H. E. Stein, G. Reid, A. C. Patterson. Systemic lupus erythematosus during penicillamine therapy for rheumatoid arthritis. Annals of Internal Medicine. 1982-11, 97 (5): 659–663 [2019-06-25]. ISSN 0003-4819. PMID 6958210. doi:10.7326/0003-4819-97-5-659. 
  13. ^ Bolognia, Jean; et al. Dermatology. Philadelphia: Elsevier. 2007. ISBN 1-4160-2999-0. 2nd edition.
  14. ^ Underwood, J. C. E. General and systemic Pathology. Elsevier Limited. 2009. ISBN 978-0-443-06889-8. 
  15. ^ Taylor, Cumming, Corenblum. Successful treatment of D-penicillamine-induced breast gigantism with danazol. Taylor, Cumming, Corenblum. Br Med J. January 31, 1981 [2013-04-06]. 
  16. ^ Walshe JM. Wilson's disease; new oral therapy. Lancet. 1956, 267 (6906): 25–6. PMID 13279157. doi:10.1016/S0140-6736(56)91859-1.  已忽略未知参数|month=(建议使用|date=) (帮助)
  17. ^ Walshe JM. The story of penicillamine: a difficult birth. Mov. Disord. 2003, 18 (8): 853–9. PMID 12889074. doi:10.1002/mds.10458.  已忽略未知参数|month=(建议使用|date=) (帮助)
  18. ^ I. A. Jaffe. RHEUMATOID ARTHRITIS WITH ARTERITIS; REPORT OF A CASE TREATED WITH PENICILLAMINE. Annals of Internal Medicine. 1964-09, 61: 556–563 [2019-06-25]. ISSN 0003-4819. PMID 14218939. doi:10.7326/0003-4819-61-3-556. 
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