WordNet

tetracycline antibacterial (trade name Declomycin) effective in the treatment of some bacterial and rickettsial and other infections (同)Declomycin
a complex consisting of an organic base in association with hydrogen chloride

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2018/01/04 02:38:45」(JST)

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Demeclocycline (INN, BAN, USAN) (brand names Declomycin, Declostatin, Ledermycin, Bioterciclin, Deganol, Deteclo), also known under the brand names Detravis, Meciclin, Mexocine, Clortetrin, is a semisynthetic tetracycline antibiotic which was derived from a strain of Streptomyces aureofaciens.^[1]^[2]^[3]

Uses

It is officially indicated for the treatment of various types of bacterial infections.^[4] It is used as an antibiotic in the treatment of Lyme disease, acne, and bronchitis.^{[citation needed]} Resistance, though, is gradually becoming more common, and demeclocycline is now rarely used for infections.

It is widely used (though off-label in many countries including the United States) in the treatment of hyponatremia (low blood sodium concentration) due to the syndrome of inappropriate antidiuretic hormone (SIADH) when fluid restriction alone has been ineffective.^[5] Physiologically, this works by reducing the responsiveness of the collecting tubule cells to ADH.

The use in SIADH actually relies on a side effect; demeclocycline induces nephrogenic diabetes insipidus (dehydration due to the inability to concentrate urine).^[5] The use of demeclocycline in SIADH was first reported in 1975,^[6] and, in 1978, a larger study found it to be more effective and better tolerated than lithium carbonate, the only available treatment at the time.^[7] Demeclocycline has since been the drug of choice for treating SIADH, although it may be superseded as vasopressin receptor antagonists, such as tolvaptan, become available.^[7]

Contraindications

Like other tetracyclines, demeclocycline is contraindicated in children and pregnant or nursing women. All members of this class interfere with bone development and may discolour teeth.^[8]

Side effects and interactions

These are similar to those of other tetracyclines. Skin reactions with sunlight have been reported.^[7] Demeclocycline is unique in that it is the only tetracycline known to cause nephrogenic diabetes insipidus.

Tetracyclines bind to cations, such as calcium, iron (when given orally), and magnesium, rendering them insoluble and inabsorbable for the gastrointestinal tract. Demeclocycline should not be taken with food (particularly milk and other dairy products) or antacids.^[8]

Mechanism of action

As with related tetracycline antibiotics, demeclocycline acts by binding to the 30S ribosomal subunit to inhibit binding of aminoacyl tRNA which impairs protein synthesis by bacteria. It is bacteriostatic (it impairs bacterial growth, but does not kill bacteria directly).

Demeclocycline inhibits the renal action of antidiuretic hormone by interfering with the intracellular second messenger cascade (specifically, inhibiting adenylyl cyclase activation) after the hormone binds to vasopressin V₂ receptors in the kidney.^[9]^[10]^[11] Exactly how demeclocycline does this has yet to be elucidated, however.^[11]

References

^ "demeclocycline" at Dorland's Medical Dictionary
^ J. Elks (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. pp. 356–. ISBN 978-1-4757-2085-3.
^ I.K. Morton; Judith M. Hall (6 December 2012). Concise Dictionary of Pharmacological Agents: Properties and Synonyms. Springer Science & Business Media. pp. 92–. ISBN 978-94-011-4439-1.
^ "DailyMed: About DailyMed". Retrieved 2008-12-20.
^ ^a ^b Goh KP (May 2004). "Management of hyponatremia". American Family Physician. 69 (10): 2387–94. PMID 15168958.
^ Cherrill DA, Stote RM, Birge JR, Singer I (November 1975). "Demeclocycline treatment in the syndrome of inappropriate antidiuretic hormone secretion". Annals of Internal Medicine. 83 (5): 654–6. doi:10.7326/0003-4819-83-5-654. PMID 173218.
^ ^a ^b ^c Tolstoi LG (2002). "A brief review of drug-induced syndrome of inappropriate secretion of antidiuretic hormone". Medscape Pharmacotherapy. 4 (1). Retrieved on October 27, 2008.
^ ^a ^b Lexi-Comp (August 2008). "Demeclocycline". The Merck Manual Professional. Retrieved on October 27, 2008.
^ Eric Fliers; Marta Korbonits; J.A. Romijn (28 August 2014). Clinical Neuroendocrinology. Elsevier Science. pp. 43–. ISBN 978-0-444-62612-7.
^ L. Kovács; B. Lichardus (6 December 2012). Vasopressin: Disturbed Secretion and Its Effects. Springer Science & Business Media. pp. 180–. ISBN 978-94-009-0449-1.
^ ^a ^b Ajay K. Singh; Gordon H. Williams (12 January 2009). Textbook of Nephro-Endocrinology. Academic Press. pp. 251–. ISBN 978-0-08-092046-7.

UpToDate Contents

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1. 低ナトリウム血症の治療：抗利尿ホルモン不適合分泌（SIADH）症候群およびreset osmostat症候群 treatment of hyponatremia syndrome of inappropriate antidiuretic hormone secretion siadh and reset osmostat
2. テトラサイクリン tetracyclines
3. 肝硬変患者における低ナトリウム血症 hyponatremia in patients with cirrhosis
4. 肺癌の危険因子、病理、および臨床症状の概要 overview of the risk factors pathology and clinical manifestations of lung cancer
5. 腎性骨異栄養症の骨生検および診断 bone biopsy and the diagnosis of renal osteodystrophy

English Journal

Evidence for the use of demeclocycline in the treatment of hyponatraemia secondary to SIADH: a systematic review.

Miell J1, Dhanjal P2, Jamookeeah C3.
International journal of clinical practice.Int J Clin Pract.2015 Dec;69(12):1396-417. doi: 10.1111/ijcp.12713. Epub 2015 Aug 19.
AIMS: Hyponatraemia (HN) is the most common electrolyte balance disorder in clinical practice. Since the 1970s, demeclocycline has been used in some countries to treat chronic HN secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH). The precise mechanism of action of demeclo
PMID 26289137

Response to 'How we define hyponatremia?'.

Grant P1, Ayuk J2, Bouloux PM3, Cohen M3, Cranston I4, Murray RD5, Rees A6, Thatcher N7, Grossman A8.
European journal of clinical investigation.Eur J Clin Invest.2015 Nov;45(11):1218. doi: 10.1111/eci.12515. Epub 2015 Sep 6.
PMID 26343423

How we define hyponatraemia?

Cervellin G1, Lippi G1.
European journal of clinical investigation.Eur J Clin Invest.2015 Nov;45(11):1219. doi: 10.1111/eci.12516. Epub 2015 Sep 2.
PMID 26259932

「hydrochloride」

Demeclocycline
Clinical data
Trade names	Declomycin
Synonyms	RP-10192
AHFS/Drugs.com	Monograph
MedlinePlus	a682103
Pregnancy; category	US: D (Evidence of risk); ;
Routes of; administration	Oral
ATC code	D06AA01 (WHO) J01AA01 (WHO);
Legal status
Legal status	In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	60–80%
Protein binding	41–50%
Metabolism	Hepatic
Biological half-life	10–17 hours
Excretion	Renal
Identifiers
	IUPAC name (2E,4S,4aS,5aS,6S,12aS)-2-[amino(hydroxy)methylidene]-7-chloro-4-(dimethylamino)-6,10,11,12a-tetrahydroxy-1,2,3,4,4a,5,5a,6,12,12a-decahydrotetracene-1,3,12-trione;
CAS Number	127-33-3 ; 64-73-3 (HCl);
PubChem CID	54680690;
DrugBank	DB00618 ;
ChemSpider	10482117 ;
UNII	5R5W9ICI6O;
KEGG	D03680 ;
ChEBI	CHEBI:4392 ;
ChEMBL	CHEMBL1591 ;
ECHA InfoCard	100.004.396
Chemical and physical data
Formula	C21H21ClN2O8
Molar mass	464.853 g/mol
3D model (JSmol)	Interactive image;
	SMILES NC(=O)C1C(=O)[C@@]2(O)C(O)=C3C(=O)c4c(O)ccc(Cl)c4[C@@H](O)[C@H]3C[C@H]2C(C=1O)N(C)C ;
	InChI InChI=1S/C21H21ClN2O8/c1-24(2)14-7-5-6-10(16(27)12-9(25)4-3-8(22)11(12)15(6)26)18(29)21(7,32)19(30)13(17(14)28)20(23)31/h3-4,6-7,14-15,25-26,28-29,32H,5H2,1-2H3,(H2,23,31)/t6-,7-,14-,15-,21-/m0/s1 ; Key:FMTDIUIBLCQGJB-SEYHBJAFSA-N ;
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「demeclocycline」

　　[★] デメクロサイクリン

[1] "demeclocycline" at Dorland's Medical Dictionary

[Elks2014-2] J. Elks (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. pp. 356–. ISBN 978-1-4757-2085-3.

[MortonHall2012-3] I.K. Morton; Judith M. Hall (6 December 2012). Concise Dictionary of Pharmacological Agents: Properties and Synonyms. Springer Science & Business Media. pp. 92–. ISBN 978-94-011-4439-1.

[urlDailyMed:_About_DailyMed-4] "DailyMed: About DailyMed". Retrieved 2008-12-20.

[Goh-5] Goh KP (May 2004). "Management of hyponatremia". American Family Physician. 69 (10): 2387–94. PMID 15168958.

[Cherrill-6] Cherrill DA, Stote RM, Birge JR, Singer I (November 1975). "Demeclocycline treatment in the syndrome of inappropriate antidiuretic hormone secretion". Annals of Internal Medicine. 83 (5): 654–6. doi:10.7326/0003-4819-83-5-654. PMID 173218.

[Tolstoi-7] Tolstoi LG (2002). "A brief review of drug-induced syndrome of inappropriate secretion of antidiuretic hormone". Medscape Pharmacotherapy. 4 (1). Retrieved on October 27, 2008.

[Lexi-Comp-8] Lexi-Comp (August 2008). "Demeclocycline". The Merck Manual Professional. Retrieved on October 27, 2008.

[FliersKorbonits2014-9] Eric Fliers; Marta Korbonits; J.A. Romijn (28 August 2014). Clinical Neuroendocrinology. Elsevier Science. pp. 43–. ISBN 978-0-444-62612-7.

[KovácsLichardus2012-10] L. Kovács; B. Lichardus (6 December 2012). Vasopressin: Disturbed Secretion and Its Effects. Springer Science & Business Media. pp. 180–. ISBN 978-94-009-0449-1.

[SinghWilliams2009-11] Ajay K. Singh; Gordon H. Williams (12 January 2009). Textbook of Nephro-Endocrinology. Academic Press. pp. 251–. ISBN 978-0-08-092046-7.

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案内

demeclocycline hydrochloride