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阿普唑仑：修订间差异

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[[File:Alprazolam synthesis.svg|thumb|650px]]
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'''阿普唑仑'''（'''{{lang|en|Alprazolam}}'''）又名'''佳静安定'''，欧美部分国家[[商品名]]为'''赞安诺'''（{{lang|en|Xanax}}）。长期服用会导致[[成瘾]]。此药在中国通常为0.4mg/片的片剂，临床一般用于抗[[焦虑]]和[[催眠]]。


⚫
与氯硝西泮的[[镇静]]作用不同，该药的药效镇静的同时又有一定[[改善情绪]]的作用，因而阿普唑仑多用于[[抑郁]]伴有[[失眠]]或[[焦虑]]的患者，而[[氯硝西泮]]多用于伴有[[兴奋]]、[[躁动]]的[[精神疾病]]患者。
⚫
'''阿普唑仑'''（'''{{lang|en|Alprazolam}}'''），又名'''佳静安定'''。长期服用会导致[[成瘾]]，欧美部分国家[[商品名]]为'''赞安诺'''（{{lang|en|Xanax}}）。

⚫
此药在中国通常为0.4mg/片的片剂，临床一般用于抗[[焦虑]]和[[催眠]]。该药的药效与氯硝西泮的[[镇静]]作用不同，又有一定改善情绪的作用，因而佳静安定多用于[[抑郁]]伴有[[失眠]]或[[焦虑]]的患者，而[[氯硝西泮]]多用于[[兴奋]][[躁动]]的患者。


[[File:Alprazolam sales in China.jpg|thumb|在中国大陆销售的阿普唑仑片]]
[[File:Alprazolam sales in China.jpg|thumb|在中国大陆销售的阿普唑仑片]]


==不良反應==
==副作用==
[[File:Xanax 2 mg.jpg|thumb|Xanax(阿普唑崙)2公絲三片連狀錠劑]]
[[File:Xanax 2 mg.jpg|thumb|Xanax（阿普唑崙）2毫克三片連狀錠劑]]
可能的副作用包括：
可能的副作用包括：
⚫
*[[視覺變化]]
⚫
*[[醉酒感]]
⚫
*[[興奮]]
⚫
*[[打电话]]、[[网络聊天]]
⚫
*[[驾驶]]车辆
*[[失控 (心理學)|失控]](Disinhibition)<ref name="Michel L, Lang JP 2003 479–85">{{Cite journal | last1 = Michel | first1 = L. | last2 = Lang | first2 = J. P. | trans_title = Benzodiazepines and Forensic Aspects | language = fr | journal = Encephale | year = 2003 | volume = 29 | issue = 6 | pages = 479–485 | pmid = 15029082 | url = http://www.masson.fr/masson/MDOI-ENC-12-2003-29-6-0013-7006-101019-ART2 | title = Benzodiazépines et passage à l'acte criminel | deadurl = no | accessdate = 9 April 2013}}</ref>
*[[失控 (心理學)|失控]](Disinhibition)<ref name="Michel L, Lang JP 2003 479–85">{{Cite journal | last1 = Michel | first1 = L. | last2 = Lang | first2 = J. P. | trans_title = Benzodiazepines and Forensic Aspects | language = fr | journal = Encephale | year = 2003 | volume = 29 | issue = 6 | pages = 479–485 | pmid = 15029082 | url = http://www.masson.fr/masson/MDOI-ENC-12-2003-29-6-0013-7006-101019-ART2 | title = Benzodiazépines et passage à l'acte criminel | deadurl = no | accessdate = 9 April 2013}}</ref>
*[[性冲动|性慾]]變化<ref>{{cite web | url = http://www.medicinenet.com/alprazolam-oral/article.htm | title = ALPRAZOLAM – ORAL (Xanax) side effects, medical uses, and drug interactions | accessdate = 2 August 2007 | publisher = Medicinenet.com | archiveurl = https://web.archive.org/web/20070825072108/http://www.medicinenet.com/alprazolam-oral/article.htm | archivedate = 25 August 2007 | deadurl = no}}</ref>
*[[性冲动|性慾]]變化<ref>{{cite web | url = http://www.medicinenet.com/alprazolam-oral/article.htm | title = ALPRAZOLAM – ORAL (Xanax) side effects, medical uses, and drug interactions | accessdate = 2 August 2007 | publisher = Medicinenet.com | archiveurl = https://web.archive.org/web/20070825072108/http://www.medicinenet.com/alprazolam-oral/article.htm | archivedate = 25 August 2007 | deadurl = no}}</ref>
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*[[睡意]](Somnolence)、[[暈眩]](dizziness)、[[頭重腳輕]](lightheadedness)、[[疲倦]]、不穩定及受損的[[运动协调]]、[[眩暈 (醫學)|眩暈]](vertigo)<ref name=drftb>{{Cite journal | last = Rawson | first = N. S. | last2 = Rawson | first2 = M. J. | title = Acute Adverse Event Signalling Scheme Using the Saskatchewan Administrative Health Care Utilization Datafiles: Results for Two Benzodiazepines | journal = Canadian Journal of Clinical Pharmacology | year = 1999 | volume = 6 | issue = 3 | pages = 159–166 | pmid = 10495368}}</ref><ref name="acmirttoadom">{{cite web | url = http://www.medicinenet.com/alprazolam/article.htm | title = Alprazolam – Complete Medical Information Regarding This Treatment of Anxiety Disorders | publisher = MedicineNet | website = Medicinenet.com | accessdate = 2 August 2007}}</ref>
*[[睡意]](Somnolence)、[[暈眩]](dizziness)、[[頭重腳輕]](lightheadedness)、[[疲倦]]、不穩定及受損的[[运动协调]]、[[眩暈 (醫學)|眩暈]](vertigo)<ref name=drftb>{{Cite journal | last = Rawson | first = N. S. | last2 = Rawson | first2 = M. J. | title = Acute Adverse Event Signalling Scheme Using the Saskatchewan Administrative Health Care Utilization Datafiles: Results for Two Benzodiazepines | journal = Canadian Journal of Clinical Pharmacology | year = 1999 | volume = 6 | issue = 3 | pages = 159–166 | pmid = 10495368}}</ref><ref name="acmirttoadom">{{cite web | url = http://www.medicinenet.com/alprazolam/article.htm | title = Alprazolam – Complete Medical Information Regarding This Treatment of Anxiety Disorders | publisher = MedicineNet | website = Medicinenet.com | accessdate = 2 August 2007}}</ref>


===異常反應===
=== 異常反應 ===
[[File:Side effects of alprazolam.svg|thumb|阿普唑崙的[[副作用]].]]
[[File:Side effects of alprazolam.svg|thumb|阿普唑崙的[[副作用]].]]


雖然是不尋常，下面的異常反應已被證實會發生：
使用阿普唑仑有可能會發生下面的異常反應：
⚫
*[[視覺變化]]

⚫
*[[醉酒感]]
⚫
*[[興奮]]
⚫
*[[打电话]]、[[网络聊天]]
⚫
*[[驾驶]]车辆
*[[侵略 (社會科學)|侵略]]<ref>{{Cite journal | last1 = Rapaport | first1 = M. | last2 = Braff | first2 = D. L. | title = Alprazolam and Hostility | journal = American Journal of Psychiatry | year = 1985 | volume = 142 | issue = 1 | page = 146 | pmid = 2857070}}</ref>
*[[侵略 (社會科學)|侵略]]<ref>{{Cite journal | last1 = Rapaport | first1 = M. | last2 = Braff | first2 = D. L. | title = Alprazolam and Hostility | journal = American Journal of Psychiatry | year = 1985 | volume = 142 | issue = 1 | page = 146 | pmid = 2857070}}</ref>
*[[憤怒 (情感)|憤怒]](Rage (emotion))、敵意<ref name="Michel L, Lang JP 2003 479–85" />
*[[憤怒 (情感)|憤怒]]、敵意<ref name="Michel L, Lang JP 2003 479–85" />
*[[震顫]](Fasciculations)及[[手震]]<ref>{{Cite journal | last1 = Béchir | first1 = M. | last2 = Schwegler | first2 = K. | last3 = Chenevard | first3 = R. | last4 = Binggeli | first4 = C. | last5 = Caduff | first5 = C. | last6 = Büchi | first6 = S. | last7 = Buddeberg | first7 = C. | last8 = Lüscher | first8 = T. F. | last9 = Noll | first9 = G. | displayauthors = 6 | title = Anxiolytic Therapy with Alprazolam Increases Muscle Sympathetic Activity in Patients with Panic Disorders | journal = Autonomic Neuroscience | year = 2007 | volume = 134 | issue = 1–2 | pages = 69–73 | pmid = 17363337 | doi = 10.1016/j.autneu.2007.01.007}}</ref>
*[[震顫]]（Fasciculations）及[[手震]]<ref>{{Cite journal | last1 = Béchir | first1 = M. | last2 = Schwegler | first2 = K. | last3 = Chenevard | first3 = R. | last4 = Binggeli | first4 = C. | last5 = Caduff | first5 = C. | last6 = Büchi | first6 = S. | last7 = Buddeberg | first7 = C. | last8 = Lüscher | first8 = T. F. | last9 = Noll | first9 = G. | displayauthors = 6 | title = Anxiolytic Therapy with Alprazolam Increases Muscle Sympathetic Activity in Patients with Panic Disorders | journal = Autonomic Neuroscience | year = 2007 | volume = 134 | issue = 1–2 | pages = 69–73 | pmid = 17363337 | doi = 10.1016/j.autneu.2007.01.007}}</ref>
*[[瘋狂]](Mania)、[[躁動]](Psychomotor agitation)、[[肺熱]](hyperactivity)及"慌張"(restlessness)<ref>{{Cite journal | last1 = Arana | first1 = G. W. | last2 = Pearlman | first2 = C. | last3 = Shader | first3 = R. I. | title = Alprazolam-Induced Mania: Two Clinical Cases | journal = American Journal of Psychiatry | year = 1985 | volume = 142 | issue = 3 | pages = 368–369 | pmid = 2857534}}</ref><ref>{{Cite journal | last1 = Strahan | first1 = A. | last2 = Rosenthal | first2 = J. | last3 = Kaswan | first3 = M. | last4 = Winston | first4 = A. | title = Three Case Reports of Acute Paroxysmal Excitement Associated with Alprazolam Treatment | journal = American Journal of Psychiatry | volume = 142 | issue = 7 | pages = 859–861 | year = 1985 | pmid = 2861755}}</ref><ref>{{Cite journal | last1 = Reddy | first1 = J. | last2 = Khanna | first2 = S. | last3 = Anand | first3 = U. | last4 = Banerjee | first4 = A. | title = Alprazolam-Induced Hypomania | journal = Australia and New Zealand Journal of Psychiatry | year = 1996 | volume = 30 | issue = 4 | pages = 550–552 | pmid = 8887708 | doi = 10.3109/00048679609065031}}</ref>
*[[瘋狂]]（Mania）、[[躁動]]（Psychomotor agitation）、[[肺熱]]（hyperactivity）、慌張（restlessness）<ref>{{Cite journal | last1 = Arana | first1 = G. W. | last2 = Pearlman | first2 = C. | last3 = Shader | first3 = R. I. | title = Alprazolam-Induced Mania: Two Clinical Cases | journal = American Journal of Psychiatry | year = 1985 | volume = 142 | issue = 3 | pages = 368–369 | pmid = 2857534}}</ref><ref>{{Cite journal | last1 = Strahan | first1 = A. | last2 = Rosenthal | first2 = J. | last3 = Kaswan | first3 = M. | last4 = Winston | first4 = A. | title = Three Case Reports of Acute Paroxysmal Excitement Associated with Alprazolam Treatment | journal = American Journal of Psychiatry | volume = 142 | issue = 7 | pages = 859–861 | year = 1985 | pmid = 2861755}}</ref><ref>{{Cite journal | last1 = Reddy | first1 = J. | last2 = Khanna | first2 = S. | last3 = Anand | first3 = U. | last4 = Banerjee | first4 = A. | title = Alprazolam-Induced Hypomania | journal = Australia and New Zealand Journal of Psychiatry | year = 1996 | volume = 30 | issue = 4 | pages = 550–552 | pmid = 8887708 | doi = 10.3109/00048679609065031}}</ref>

⚫
===食品和藥物相互作用===
⚫
阿普唑崙的代謝主要是通過[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]進行。<ref name="Otani-2003">{{Cite journal | last1 = Otani | first1 = K. | title = Cytochrome P450 3A4 and Benzodiazepines | language = ja | journal = Seishin Shinkeigaku Zasshi | volume = 105 | issue = 5 | pages = 631–642 | year = 2003 | pmid = 12875231}}</ref> 結合[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]抑製劑諸如[[西咪替丁]]，[[紅黴素]]，[[氟西汀]]，[[氟伏沙明]]，[[伊曲康唑]]，[[酮康唑]]，[[奈法唑酮]](nefazodone)，[[丙氧芬]](propoxyphene)，[[利托那韋]](ritonavir)等延緩阿普唑崙的肝清除率，這可能導致阿普唑崙的過度積纍。<ref>{{Cite journal | last1 = Dresser | first1 = G. K. | last2 = Spence | first2 = J. D. | last3 = Bailey | first3 = D. G. | title = Pharmacokinetic-Pharmacodynamic Consequences and Clinical Relevance of Cytochrome P450 3A4 Inhibition | journal = Clinical Pharmacokinetics | year = 2000 | volume = 38 | issue = 1 | pages = 41–57 | pmid = 10668858 | doi = 10.2165/00003088-200038010-00003}}</ref> 如此能會導致其不良反應更加的惡化。<ref name=cpoati>{{cite journal | last1 = Greenblatt | first1 = D. J. | last2 = Wright | first2 = C. E. | title = Clinical Pharmacokinetics of Alprazolam. Therapeutic Implications | journal = Clinical Pharmacokinetics | year = 1993 | volume = 24 | issue = 6 | pages = 453–471 | doi = 10.2165/00003088-199324060-00003 | pmid = 8513649}}</ref><ref>{{Cite journal | last1 = Wang | first1 = J. S. | last2 = Chase | first2 = C. L. | title = Pharmacokinetics and Drug Interactions of the Sedative Hypnotics | journal = Psychopharmacological Bulletin | year = 2003 | volume = 37 | issue = 1 | pages = 10–29 | pmid = 14561946 | doi = 10.1007/BF01990373 | url = http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archiveurl = https://web.archive.org/web/20070709230745/http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archivedate = 2007-07-09 | format = PDF}}</ref>

==化學程序==
⚫
[[File:Alprazolam synthesis.svg|650px|center]]


⚫
=== 食品和藥物相互作用 ===
==商標名稱==
⚫
阿普唑崙的代謝主要是通過[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]進行<ref name="Otani-2003">{{Cite journal | last1 = Otani | first1 = K. | title = Cytochrome P450 3A4 and Benzodiazepines | language = ja | journal = Seishin Shinkeigaku Zasshi | volume = 105 | issue = 5 | pages = 631–642 | year = 2003 | pmid = 12875231}}</ref>，結合[[CYP3A4|CYP<sub>3</sub>A<sub>4</sub>]]临床上，抑製劑諸如[[西咪替丁]]、[[紅黴素]]、[[氟西汀]]、[[氟伏沙明]]、[[伊曲康唑]]、[[酮康唑]]、[[奈法唑酮]]（Nefazodone）、[[丙氧芬]]（Propoxyphene）、[[利托那韋]]（Ritonavir）等可以延緩阿普唑崙的[[肝清除率]]，但是這可能導致阿普唑崙在人体内部的的過度積纍<ref>{{Cite journal | last1 = Dresser | first1 = G. K. | last2 = Spence | first2 = J. D. | last3 = Bailey | first3 = D. G. | title = Pharmacokinetic-Pharmacodynamic Consequences and Clinical Relevance of Cytochrome P450 3A4 Inhibition | journal = Clinical Pharmacokinetics | year = 2000 | volume = 38 | issue = 1 | pages = 41–57 | pmid = 10668858 | doi = 10.2165/00003088-200038010-00003}}</ref>，如此很有可能會導致其不良反應更加的惡化<ref name=cpoati>{{cite journal | last1 = Greenblatt | first1 = D. J. | last2 = Wright | first2 = C. E. | title = Clinical Pharmacokinetics of Alprazolam. Therapeutic Implications | journal = Clinical Pharmacokinetics | year = 1993 | volume = 24 | issue = 6 | pages = 453–471 | doi = 10.2165/00003088-199324060-00003 | pmid = 8513649}}</ref><ref>{{Cite journal | last1 = Wang | first1 = J. S. | last2 = Chase | first2 = C. L. | title = Pharmacokinetics and Drug Interactions of the Sedative Hypnotics | journal = Psychopharmacological Bulletin | year = 2003 | volume = 37 | issue = 1 | pages = 10–29 | pmid = 14561946 | doi = 10.1007/BF01990373 | url = http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archiveurl = https://web.archive.org/web/20070709230745/http://www.medworksmedia.com/psychopharmbulletin/pdf/12/010-029_PB%20W03_Wang_final.pdf | archivedate = 2007-07-09 | format = PDF}}</ref>。
* {{lang|en|Amprazo}}(柔安)<small>(淺粉紅色橢圓形)</small>錠劑0.5公絲，"中國化學製藥股份有限公司". Amprazo 0.5mg(Alprazolam) tablet。


==參考資料==
==參考資料==

2019年2月19日 (二) 11:05的版本

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阿普唑仑
臨床資料
商品名（英语：Drug nomenclature）Xanax
AHFS/Drugs.comMonograph
MedlinePlusa684001
依賴性高
给药途径口服，舌下
ATC碼
法律規範狀態
法律規範
藥物動力學數據
生物利用度80–90%
药物代谢肝脏, 通过CYP3A4酶
生物半衰期普释片: 11.2 小时,[1]
缓释片: 10.7–15.8 小时[2]
排泄途徑肾脏
识别信息
  • 8-Chloro-1-methyl-6-phenyl-4H-[1,2,4]triazolo[4,3-a][1,4]benzodiazepine
CAS号28981-97-7  checkY
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard（英语：CompTox Chemicals Dashboard） (EPA)
ECHA InfoCard100.044.849 編輯維基數據鏈接
化学信息
化学式C17H13ClN4
摩尔质量308.765
3D模型（JSmol（英语：JSmol））
  • ClC1=CC2=C(C=C1)N3C(C)=NN=C3CN=C2C4=CC=CC=C4
  • InChI=1S/C17H13ClN4/c1-11-20-21-16-10-19-17(12-5-3-2-4-6-12)14-9-13(18)7-8-15(14)22(11)16/h2-9H,10H2,1H3 checkY
  • Key:VREFGVBLTWBCJP-UHFFFAOYSA-N checkY

阿普唑仑（Alprazolam）又名佳静安定，欧美部分国家商品名为赞安诺（Xanax）。长期服用会导致成瘾。此药在中国通常为0.4mg/片的片剂，临床一般用于抗焦虑和催眠。

与氯硝西泮的镇静作用不同，该药的药效镇静的同时又有一定改善情绪的作用，因而阿普唑仑多用于抑郁伴有失眠或焦虑的患者，而氯硝西泮多用于伴有兴奋、躁动的精神疾病患者。

在中国大陆销售的阿普唑仑片

副作用

Xanax（阿普唑崙）2毫克三片連狀錠劑

可能的副作用包括：

異常反應

阿普唑崙的副作用.

使用阿普唑仑有可能會發生下面的異常反應：

食品和藥物相互作用

阿普唑崙的代謝主要是通過CYP3A4進行[20]，結合CYP3A4临床上，抑製劑諸如西咪替丁、紅黴素、氟西汀、氟伏沙明、伊曲康唑、酮康唑、奈法唑酮（Nefazodone）、丙氧芬（Propoxyphene）、利托那韋（Ritonavir）等可以延緩阿普唑崙的肝清除率，但是這可能導致阿普唑崙在人体内部的的過度積纍[21]，如此很有可能會導致其不良反應更加的惡化[22][23]。

參考資料

  1. ^ Xanax (Alprazolam) Clinical Pharmacology – Prescription Drugs and Medications. RxList. First DataBank. July 2008. 
  2. ^ Xanax XR (Alprazolam) Clinical Pharmacology – Prescription Drugs and Medications. RxList. First DataBank. July 2008. 
  3. ^ 3.0 3.1 Michel, L.; Lang, J. P. Benzodiazépines et passage à l'acte criminel [Benzodiazepines and Forensic Aspects]. Encephale. 2003, 29 (6): 479–485 [9 April 2013]. PMID 15029082 （法语）. 
  4. ^ ALPRAZOLAM – ORAL (Xanax) side effects, medical uses, and drug interactions. Medicinenet.com. [2 August 2007]. （原始内容存档于25 August 2007）. 
  5. ^ Noyes, R.; DuPont, R. L.; Pecknold, J. C.; Rifkin, A.; Rubin, R. T.; Swinson, R. P.; et al. Alprazolam in Panic Disorder and Agoraphobia: Results from a Multicenter Trial. II. Patient Acceptance, Side Effects, and Safety. Archives of General Psychiatry. 1988, 45 (5): 423–428. PMID 3358644. doi:10.1001/archpsyc.1988.01800290037005. 
  6. ^ Complete Alprazolam Information. Drugs.com. [2 August 2007]. （原始内容存档于5 August 2007）. 
  7. ^ Elie, R.; Lamontagne, Y. Alprazolam and Diazepam in the Treatment of Generalized Anxiety. Journal of Clinical Psychopharmacology. 1984, 4 (3): 125–129. PMID 6145726. doi:10.1097/00004714-198406000-00002. 
  8. ^ Cassano, G. B.; Toni, C.; Petracca, A.; Deltito, J.; Benkert, O.; Curtis, G.; et al. Adverse Effects Associated with the Short-term Treatment of Panic Disorder with Imipramine, Alprazolam or Placebo. European Neuropsychopharmacology. 1994, 4 (1): 47–53. PMID 8204996. doi:10.1016/0924-977X(94)90314-X. 
  9. ^ Hori, A. Pharmacotherapy for Personality Disorders. Psychiatry and Clinical Neurosciences. 1998, 52 (1): 13–19. PMID 9682928. doi:10.1111/j.1440-1819.1998.tb00967.x. 
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外部連結

维基共享资源上的相关多媒体资源：阿普唑仑
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