臨牀透析 Vol.18 No.8(2-3-3)


特集名 薬物・毒物中毒と血液浄化法(症例集)
題名 [中毒症例]III. 医薬品 (3) 塩酸アマンタジン(抗ウイルス薬，抗パーキンソン病薬)
発刊年月 2002年 07月
著者 長屋 豊彦 岐阜県厚生連岐北総合病院臨床工学室
著者 早川 和良 岐阜県厚生連岐北総合病院内科
著者 安田 洋 岐阜県厚生連岐北総合病院内科
【 要旨 】 塩酸アマンタジン中毒の血液浄化法に関してわれわれが調べたかぎりでは，腹膜透析において血中濃度1,500ng/mlの患者に対し48時間の腹膜透析を施行後900ng/mlに減少，血液透析では，透析患者に塩酸アマンタジン300mg/day経口投与した結果，4時間の透析にて5％以下の除去率であった．さらに血液直接吸着(DHP)では，治療前2,400ng/mlがDHP施行により翌日には1,400ng/mlであったとの報告がなされている．
今回の症例供覧では，DHP開始30分後の塩酸アマンタジン吸着率は93.5％，および血液濾過での施行前後で除去率は，置換液量20l使用時21.4％であることを確認した．
Theme Intoxication of Drugs and Poisons and Blood Purification Therapy (Case Report)
Title Amantadine hydrochloride intoxication and hemocatharsis
Author Toyohiko Nagaya Laboratory of Clinical Engineering, Gifu-ken Koseiren-Gihoku General Hospital
Author Kazuyoshi Hayakawa Department of Internal Medicine, Gifu-ken Koseiren-Gihoku General Hospital
Author Yo Yasuda Department of Internal Medicine, Gifu-ken Koseiren-Gihoku General Hospital
[ Summary ] In our investigation of the literature on the treatment of amantadine intoxication with hemocatharsis, it was reported that in 48 hr peritoneal dialysis decreased the blood drug concentration from 1,500ng/ml to 900ng/ml, and 4 hr hemodialysis showed the rate of elimination to be less than 5% when 300mg/day of amantadine hydrochloride was administered to dialysis patients. It has also been reported that Direct hemoperfusion (DHP) decreased the blood concentration of amantadine from a pre-DHP level of 2,400ng/ml to 1,400ng/ml the next day. In the present case, the rate of adsorption of amantadine was 93.5% 30min after the start of DHP, and it was also confirmed that the rate of removal by Hemofiltration was 21.4% when the replaced fluid volume was 20l.
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