Brand names: Symmetrel, Gocovri, Osmolex ER

Amantadine is also an antiviral drug against RNA viruses, and its mechanism of action is not completely clear. Prevents RNA viruses from penetrating host cells. If the virus has penetrated the host cell, it can also prevent the virus from unshelling and releasing nucleic acids, interfering with the virus's early replication. In addition, the virus channel on the host cell membrane can be blocked to prevent the virus from penetrating into human cells. In tissue culture, amantadine can prevent infection by myxoviruses and paramyxoviruses, and is effective against rhabdoviruses in vitro. However, it is only clinically effective against influenza A virus. Although all the latest natural influenza A viruses are sensitive to amantadine, resistance mutations have been observed in tissue cultured strains exposed to amantadine.

Amantadine Hydrochloride (8-38) is a symmetrical tricyclic amine, which can inhibit the virus from penetrating into the host cells, affect the shelling of the virus, inhibit its reproduction, and treat and prevent viral infection. Amantadine has a narrow antiviral spectrum and is mainly used for the prevention of influenza A in Asia. It is not effective against influenza B virus and rubella virus, measles virus, mumps virus, and herpes simplex virus infection. Because it can cross the blood-brain barrier after oral absorption, it can cause toxic side effects in the central nervous system.

Amantadine was developed as an antiviral medication but also is useful in the treatment of chronic pain. It works by partially blocking a receptor within the central nervous system that is associated with pain pathways. Works best combined with other pain relievers such as NSAIDS, gabapentin, and/or tramadol.

It has a relief effect on all types of Parkinson's disease, and the effect is stronger than anticholinergic drugs but weaker than levodopa. It is effective 2 weeks after taking, and lasts 4-8 weeks. Amantadine has inhibitory activity on influenza A virus in Asia, inhibits virus proliferation, and is effective for patients who have already developed the disease. It can also reduce the body temperature within 24 hours and significantly reduce symptoms within 36 hours. Inactive against Asian Influenza B virus, measles virus, mumps virus and herpes simplex virus.

1. Oral antitremoral paralysis, commonly used in adults: 100 mg once, 1 or 2 times a day, the maximum daily amount is 400 mg. Renal dysfunction should be reduced. Not for children.
2. Oral antiviral, commonly used for adults: 200 mg once, once daily; or 100 mg once every 12 hours, the maximum amount is 200 mg daily. For renal dysfunction, the dose should be reduced.
Commonly used in children: ① newborns and infants under one-year-old; ② children 1 to 9 years old, 1.5-8 mg / kg body weight every 8 hours, or 2.2-4.4 mg / kg body weight every 12 hours; Use 1.5 mg / kg for body weight; the maximum daily amount should not exceed 150 mg; ③ children 9 to 12 years old, 100 mg orally every 12 hours; ④ children 12 years old or older, generally the same as adults.

Applicable to primary Parkinson's disease, Parkinson's syndrome after encephalitis, drug-induced extrapyramidal response, Parkinson's syndrome after carbon monoxide poisoning, and Parkinson's syndrome in the elderly with cerebral arteriosclerosis. It can also be used to prevent or treat respiratory infections caused by Asian A-II influenza virus. When combined with inactivated influenza A virus vaccine, this product can promote the body to produce preventive antibodies.

① This product should not be used with ethanol, which will strengthen the adverse effects of the central nervous system, such as dizziness, light-footedness, fainting, mental disorders and circulatory disorders; ② other antitremor paralysis drugs, anticholinergics, antihistamines, phenothiazines The combination of triazine or tricyclic antidepressants with this product can strengthen atropine-like side effects, especially in patients with mental disorders, hallucinations and nightmares, the dosage of these drugs or this product needs to be adjusted; When used together, it can strengthen the excitement of the central nervous system. In severe cases, it can cause adverse reactions such as convulsions or arrhythmias.
Amantadine is used in the prevention and treatment of influenza in small doses and rare adverse reactions. For the treatment of Parkinson's disease and anti-tremor, the dosage is large, the medication time is long, and it is often combined with a large number of other drugs. Therefore, attention should be paid to drug interactions and side effects.

After the amantadine (tricyclodecanamine, amantadine) enters the brain tissue, it can promote the release of dopamine from the nerve endings and reduce the dopamine uptake, thus exerting anti-tremor paralysis effect; in addition, it has anticholinergic properties. It has obvious curative effect on tremor paralysis, and has a good effect in alleviating tremor and rigidity. Onset of action is relatively fast, obvious after 48 hours. The half-life in vivo is 10 to 28 hours, the distribution volume is 4 to 8 L / kg, and the protein binding rate is 60% to 70%. Its clearance in vivo depends entirely on renal function.

The main points of treatment for amantadine poisoning are:
1. There is no specific antidote for amantadine poisoning, mainly symptomatic supportive treatment.
2. Those who take too much, immediately wash the stomach, induce vomiting, swallow medicinal charcoal. Extensive fluid replacement and acidification of urine.
3. Too much action, give sedatives, convulsants to stop spasm, arrhythmia commonly used antiarrhythmic drugs.
4. Patients with high fever should urgently cool down, and at the same time apply dantroline 1 ~ 2mg / kg, rapid intravenous injection, once every 5 ~ 10min, the total amount is 10mg / kg, 4 / d for a total of 2 ~ 3 days. If it occurs during the removal of amantadine, amantadine can also be used as a therapeutic drug.
5. Control of central nervous system symptoms can be slowly intravenous injection of physostigmine, 1 to 2 mg / (l to 2) h for adults.
6. Poisoned people with renal function must undergo hemodialysis or hemoperfusion.

Amantadine is the earliest antiviral drug used to suppress influenza viruses, and the United States approved it as a preventive drug in 1966 when the Asian pandemic became common. In 1976, it was confirmed as a therapeutic drug on the basis of preventive drugs. The efficacy and safety of the drug in adult patients have been widely recognized. However, the therapeutic dose is very close to the dose that causes side effects. The dose and administration plan for the elderly and those with chronic heart and lung disease or kidney disease are difficult to determine, so it has not been promoted and applied in clinical practice.
The [Homegrown] Amantadine-20PCS Test kit provided by BALLYA can effectively detect Amantadine. This kit is not only simple to operate, but also has a short test time and high accuracy, and the test results comply with EU standards.

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