酮替酚

酮替酚
臨床資料
商品名（英語：Drug nomenclature）	Zaditor
AHFS/Drugs.com	Monograph
MedlinePlus	a604033
懷孕分級	澳: B1 ; ;
給藥途徑	By mouth (tablets), topical eye drops
ATC碼	R06AX17 (WHO) S01GX08;
法律規範狀態
法律規範	美：Oral — withdrawn, was Rx-only; Eye drops — over-the-counter;
藥物動力學數據
生物利用度	60%
血漿蛋白結合率	75%
藥物代謝	Hepatic
生物半衰期	12 hours
識別資訊
	IUPAC命名法 4-(1-Methylpiperidin-4-ylidene)-4,9-dihydro-10H-benzo[4,5]cyclohepta[1,2-b]thiophen-10-one; ;
CAS號	34580-14-8
PubChem CID	3827;
IUPHAR/BPS	7206;
DrugBank	DB00920 ;
ChemSpider	3695 ;
UNII	HBD503WORO;
KEGG	D01332 ;
ChEBI	CHEBI:92511;
ChEMBL	ChEMBL534 ;
CompTox Dashboard（英語：CompTox Chemicals Dashboard） (EPA)	DTXSID7023190 ;
ECHA InfoCard	100.047.348
化學資訊
化學式	C19H19NOS
摩爾質量	309.43 g·mol−1
3D模型（JSmol（英語：JSmol））	交互式圖像;
	SMILES O=C3c1sccc1C(\c2c(cccc2)C3)=C4/CCN(C)CC4;
	InChI InChI=1S/C19H19NOS/c1-20-9-6-13(7-10-20)18-15-5-3-2-4-14(15)12-17(21)19-16(18)8-11-22-19/h2-5,8,11H,6-7,9-10,12H2,1H3 ; Key:ZCVMWBYGMWKGHF-UHFFFAOYSA-N ;

酮替酚（英語：Ketotifen），商品名包括Zaditor等，是第二代非競爭性H₁抗組胺藥和肥大細胞穩定劑，常見的酮替酚藥物一般為其富馬酸鹽（富馬酸酮替酚）。酮替酚有兩種給藥途徑。眼部給藥時用於治療過敏性結膜炎^[1]，口服給藥時用於預防哮喘發作、過敏反應及各種過敏性肥大細胞疾病。 ^[2] ^[3] ^[4]^[5]

Quick Facts 臨床資料, 商品名（英語：Drug nomenclature） ...

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酮替酚於 1970 年獲得專利，並於 1976 年投入醫療使用。 ^[6]

醫療用途

酮替芬可用於緩解和預防大多數季節性過敏相關的眼部瘙癢和刺激，起效時間約在給藥後幾分鐘內，其藥物代謝半衰期約為 12 小時。該藥物尚未在三歲以下兒童中進行過研究。 ^[1] ^[7]除了抗組胺活性外，它還是一種功能性白三烯拮抗劑^[8]和磷酸二酯酶抑制劑。 ^[9]

口服酮替酚在加拿大、歐洲和墨西哥已用於治療哮喘、過敏性鼻炎、過敏性結膜炎、特應性皮炎、慢性蕁麻疹、寒冷性蕁麻疹、膽鹼能性蕁麻疹，以及包括肥大細胞增多症、肥大細胞活化綜合症 (MCAS)、過敏性和非過敏性過敏反應、血管性水腫和食物過敏在內的系統性肥大細胞疾病。

在美國，酮替酚可憑處方購買。對於患哮喘或過敏性疾病的成人及年齡較大的兒童，酮替芬的推薦劑量為1毫克/次，每天兩次。對於治療蕁麻疹相關的用途，FDA 工作人員建議進行更廣泛的評估。^[4]^[5]

該藥品還可能有助於緩解腸易激綜合症。 ^[10]

副作用

全身性給藥（口服）的副作用包括嗜睡、體重增加（5千克左右）、口乾、易怒和鼻出血增加等。 ^[11]^{[來源可靠？]}

藥理

酮替芬是一種選擇性抗組胺藥（即 H₁ 組胺受體的反激動劑）(K _i = 0.166 nM) ^[12] 和肥大細胞穩定劑。 ^[13]此外，酮替芬有較弱的抗膽鹼能（K _i = 204 nM 對於mACh ) 和抗血清素(K _i = 38.9 nM 對於 5-HT_2A ) 活性。 ^[12] ^[14]然而在常用臨床劑量下，酮替芬的抗膽鹼能和抗血清素活性均不顯著。 ^[15]

社會與文化

商品名

酮替芬在全球以許多不同商品名銷售。 ^[16]

參考

[1]
Zaditor- ketotifen fumarate solution. DailyMed. 13 February 2020 [4 September 2020]. （原始內容存檔於2021-06-11）. 引用錯誤：帶有name屬性「Zaditor_pi」的<ref>標籤用不同內容定義了多次
[2]
Sokol, Kristin C.; Amar, Neil K.; Starkey, Jonathan; Grant, J. Andrew. Ketotifen in the management of chronic urticaria: Resurrection of an old drug. Annals of Allergy, Asthma & Immunology. 2013, 111 (6): 433–6. PMC 4309375 . PMID 24267353. doi:10.1016/j.anai.2013.10.003.
[3]
Shawky, Rabah M.; Seifeldin, Neveen S. The relation between antihistamine medication during early pregnancy & birth defects. Egyptian Journal of Medical Human Genetics. 2015, 16 (4): 287–90. doi:10.1016/j.ejmhg.2015.04.003.
[4]
Zuberbier, Torsten. A Summary of the New International EAACI/GA2LEN/EDF/ WAO Guidelines in Urticaria. World Allergy Organization Journal. 2012, 5 (1): S1–S5. PMC 3488932 . PMID 23268477. doi:10.1186/1939-4551-5-S1-S1.
[5]
Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, Grattan CE, Kapp A, Maurer M, Merk HF, Rogala B, Saini S, Sánchez-Borges M, Schmid-Grendelmeier P, Schünemann H, Staubach P, Vena GA, Wedi B. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. October 2009, 64 (10): 1427–1443. PMID 19772513. S2CID 14587946. doi:10.1111/j.1398-9995.2009.02178.x.
[6]
Fischer, Jnos; Ganellin, C. Robin. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 548 [2022-03-19]. ISBN 9783527607495. （原始內容存檔於2020-08-13）.
[7]
Grahnén, A.; Lönnebo, A.; Beck, O.; Eckernäs, S-Å; Dahlström, B.; Lindström, B. Pharmacokinetics of ketotiffn after oral administration to healthy male subjects. Biopharmaceutics & Drug Disposition. 1992, 13 (4): 255–62. PMID 1600111. doi:10.1002/bdd.2510130404.
[8]
Fink, A.; Bibi, H.; Eliraz, A.; Schlesinger, M.; Bentwich, Z. Ketotifen, disodium cromoglycate, and verapamil inhibit leukotriene activity: determination by tube leukocyte adherence inhibition assay. Annals of Allergy. 1986, 57 (2): 103–106 [2022-03-19]. ISSN 0003-4738. PMID 3090908. （原始內容存檔於2021-06-11）.
[9]
Castillo, J. G.; Gamboa, P. M.; García, B. E.; Oehling, A. Effect of ketotifen on phosphodiesterase activity from asthmatic individuals. Allergologia Et Immunopathologia. 1990, 18 (4): 197–201 [2022-03-19]. ISSN 0301-0546. PMID 1702263. （原始內容存檔於2021-06-11）.
[10]
Klooker, T. K.; Braak, B.; Koopman, K. E.; Welting, O.; Wouters, M. M.; Van Der Heide, S.; Schemann, M.; Bischoff, S. C.; Van Den Wijngaard, R. M. The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome (PDF). Gut. 2010, 59 (9): 1213–21 [2022-03-19]. PMID 20650926. doi:10.1136/gut.2010.213108. （原始內容 (PDF)存檔於2021-06-11）.
[11]
Zaditen - MIMS online. www.mims.co.uk. [2022-03-19]. （原始內容存檔於2020-10-25）.
[12]
Studies on the novel antiallergic agent HSR-609: its penetration into the central nervous system in mice and guinea pigs and its selectivity for the histamine H1-receptor. Jpn. J. Pharmacol. 1997, 73 (4): 291–8. PMID 9165365. doi:10.1254/jjp.73.291.
[13]
Thomas L. Lemke; David A. Williams. Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. 2008: 1019– [2022-03-19]. ISBN 978-0-7817-6879-5. （原始內容存檔於2021-06-11）.
[14]
V Alagarsamy. Textbook of Medicinal Chemistry Vol II - E-Book. Elsevier Health Sciences. 16 June 2012: 38– [2022-03-19]. ISBN 978-81-312-3259-0. （原始內容存檔於2021-06-20）.
[15]
Jürgen Drews. Immunopharmacology: Principles and Perspectives. Springer Science & Business Media. 6 December 2012: 282– [2022-03-19]. ISBN 978-3-642-75561-3. （原始內容存檔於2021-06-18）.
[16]
Ketotifen International. Drugs.com. [4 September 2020]. （原始內容存檔於2021-04-11）.

外部連結

Ketotifen. Drug Information Portal. U.S. National Library of Medicine. [2022-03-19]. （原始內容存檔於2022-03-19）.

#invoke:navboxTemplate:Tricyclics

[Zaditor_pi-1] [1]
Zaditor- ketotifen fumarate solution. DailyMed. 13 February 2020 [4 September 2020]. （原始內容存檔於2021-06-11）. 引用錯誤：帶有name屬性「Zaditor_pi」的<ref>標籤用不同內容定義了多次

[2] [2]
Sokol, Kristin C.; Amar, Neil K.; Starkey, Jonathan; Grant, J. Andrew. Ketotifen in the management of chronic urticaria: Resurrection of an old drug. Annals of Allergy, Asthma & Immunology. 2013, 111 (6): 433–6. PMC 4309375 . PMID 24267353. doi:10.1016/j.anai.2013.10.003.

[3] [3]
Shawky, Rabah M.; Seifeldin, Neveen S. The relation between antihistamine medication during early pregnancy & birth defects. Egyptian Journal of Medical Human Genetics. 2015, 16 (4): 287–90. doi:10.1016/j.ejmhg.2015.04.003.

[Zuberbier2012-4] [4]
Zuberbier, Torsten. A Summary of the New International EAACI/GA2LEN/EDF/ WAO Guidelines in Urticaria. World Allergy Organization Journal. 2012, 5 (1): S1–S5. PMC 3488932 . PMID 23268477. doi:10.1186/1939-4551-5-S1-S1.

[Zuberbier_et_al_2009-5] [5]
Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, Grattan CE, Kapp A, Maurer M, Merk HF, Rogala B, Saini S, Sánchez-Borges M, Schmid-Grendelmeier P, Schünemann H, Staubach P, Vena GA, Wedi B. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. October 2009, 64 (10): 1427–1443. PMID 19772513. S2CID 14587946. doi:10.1111/j.1398-9995.2009.02178.x.

[Fis2006-6] [6]
Fischer, Jnos; Ganellin, C. Robin. Analogue-based Drug Discovery. John Wiley & Sons. 2006: 548 [2022-03-19]. ISBN 9783527607495. （原始內容存檔於2020-08-13）.

[7] [7]
Grahnén, A.; Lönnebo, A.; Beck, O.; Eckernäs, S-Å; Dahlström, B.; Lindström, B. Pharmacokinetics of ketotiffn after oral administration to healthy male subjects. Biopharmaceutics & Drug Disposition. 1992, 13 (4): 255–62. PMID 1600111. doi:10.1002/bdd.2510130404.

[8] [8]
Fink, A.; Bibi, H.; Eliraz, A.; Schlesinger, M.; Bentwich, Z. Ketotifen, disodium cromoglycate, and verapamil inhibit leukotriene activity: determination by tube leukocyte adherence inhibition assay. Annals of Allergy. 1986, 57 (2): 103–106 [2022-03-19]. ISSN 0003-4738. PMID 3090908. （原始內容存檔於2021-06-11）.

[9] [9]
Castillo, J. G.; Gamboa, P. M.; García, B. E.; Oehling, A. Effect of ketotifen on phosphodiesterase activity from asthmatic individuals. Allergologia Et Immunopathologia. 1990, 18 (4): 197–201 [2022-03-19]. ISSN 0301-0546. PMID 1702263. （原始內容存檔於2021-06-11）.

[10] [10]
Klooker, T. K.; Braak, B.; Koopman, K. E.; Welting, O.; Wouters, M. M.; Van Der Heide, S.; Schemann, M.; Bischoff, S. C.; Van Den Wijngaard, R. M. The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome (PDF). Gut. 2010, 59 (9): 1213–21 [2022-03-19]. PMID 20650926. doi:10.1136/gut.2010.213108. （原始內容 (PDF)存檔於2021-06-11）.

[11] [11]
Zaditen - MIMS online. www.mims.co.uk. [2022-03-19]. （原始內容存檔於2020-10-25）.

[pmid9165365-12] [12]
Studies on the novel antiallergic agent HSR-609: its penetration into the central nervous system in mice and guinea pigs and its selectivity for the histamine H1-receptor. Jpn. J. Pharmacol. 1997, 73 (4): 291–8. PMID 9165365. doi:10.1254/jjp.73.291.

[LemkeWilliams2008-13] [13]
Thomas L. Lemke; David A. Williams. Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. 2008: 1019– [2022-03-19]. ISBN 978-0-7817-6879-5. （原始內容存檔於2021-06-11）.

[Alagarsamy2012-14] [14]
V Alagarsamy. Textbook of Medicinal Chemistry Vol II - E-Book. Elsevier Health Sciences. 16 June 2012: 38– [2022-03-19]. ISBN 978-81-312-3259-0. （原始內容存檔於2021-06-20）.

[Drews2012-15] [15]
Jürgen Drews. Immunopharmacology: Principles and Perspectives. Springer Science & Business Media. 6 December 2012: 282– [2022-03-19]. ISBN 978-3-642-75561-3. （原始內容存檔於2021-06-18）.

[16] [16]
Ketotifen International. Drugs.com. [4 September 2020]. （原始內容存檔於2021-04-11）.

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