Running head: AMANTADINE HYDEOCHLORIDE (SYMMETREL)

Amantadine hydrochloride (Symmetrel)

Southern University School of Nursing Pharmacology Mrs. Washington Joel Semien

Amantadine (Symmetrel)
Viruses are not technically considered living organisms because they are devoid of biological processes and cannot reproduce on their own but require a living cell to make more viruses. Viruses reproduce first either by injecting their genetic material into the host cell or by fully entering the cell and shedding their protein coat. The genetic material may then be incorporated into the cell's own genome or remain in the cytoplasm. Eventually the viral genes instruct the cell to produce new viruses, which often cause the cell to die upon their exit. Rather than being primordial forms of life, viruses probably evolved from rogue pieces of cellular nucleic acids. Influenza is one of many diseases caused by viruses. To prevent influenza A (flu), the drug of choice that was most often prescribed is Amantadine (Symmetrel); however, this drug is also used to for treatment with Parkinson's disease. Amantadine is a synthetic anti-viral drug that can inhibit the replication of viruses in cells, (Cunha, 2006). To prevent a viral infection, the drug should be present before exposure to the virus. It was initially used to prevent influenza A during flu season, and, if given within 24 to 48 hours of the onset of flu symptoms, to decrease the severity of the flu. Later Amantadine was found to cause improvement in the symptoms of Parkinson's disease. Amantadine's mechanism of action in Parkinson's disease is not fully understood. Its effects may be related to its ability to amplify the effects of dopamine, a neurotransmitter in the brain, which is reduced in Parkinson's disease, (Martinez, 2006). Amantadine is used for the prevention or treatment of infections with influenza A virus, especially for individuals at high-risk such as immunosuppressed patients and nursing home residents, (Gravenstein, 2008). It should be Store at room temperature between 15 and 30C (59 and 86F). It should be taken once or twice daily with or without food. If it causes an upset stomach, it can be taken with food. People with reduced kidney function and elderly may need lower doses. Amantadine adds to the sedating effects alcohol and other sedating drugs such as the benzodiazepine class of anti-anxiety drugs (Valium, Ativan, Klonopin, Xanax, Ambien), the tricyclic class of antidepressants (Elavil, Tofranil, Norpramin), dicyclomine (Bentyl), certain antihistamines (Benadryl, Vistaril, Atarax, Tavist), opiate agonists (Dilaudid; Vicodin; Percocet; Codeine) and certain antihypertensive medications (Catapres, Inderal). Such combinations can cause dizziness, confusion, lightheadedness, fainting, or dizziness upon standing. Physicians may choose to use Amantadine during pregnancy when the potential benefits outweigh the potential but unknown risks to the fetus. The most frequent side effects associated with Amantadine include dizziness, loss of coordination, inability to sleep, and nervousness, nausea, and vomiting. All effects can appear after a few hours or several days of therapy. Less common side effects include headache, irritability, nightmares, depression, confusion, drowsiness, and hallucinations, weakness, amnesia, slurred speech, diarrhea, constipation, and loss of appetite, and discolorations in the eye, (Furuse,2009) . In conclusion, Amantadine was an influenza treatment but is not recommended any longer. For the 2008/2009 flu season, the United States' Centers for Disease Control and Prevention (CDC) found that 100% of seasonal H3N2 and 2009 pandemic flu samples tested have shown resistance to adamantanes, (Anita). The CDC issued an alert to doctors to prescribe the neuraminidase inhibitors oseltamivir and zanamivir instead of Amantadine for treatment of current circulating flu. All in all, It also is still used for treatment with Parkinsons disease.

References Anita, M. (n.d). CDC: Major flu strain resistant to two anti-virals. USA Today. Retrieved from EBSCOhost. Cunha, B. A. (2006). Amantadine May Be Lifesaving In Severe Influenza A. Clinical Infectious Diseases, 43(10), 1372-1373. Retrieved from EBSCOhost. Furuse, Y., Suzuki, A., Shimizu, M., Kishi, M., Sawayama, R., Saito, M., & ... Oshitani, H. (2009). Reassortment between Amantadine- Resistant and -Sensitive H1N1 Influenza A Viruses Generated an Amantadine-Sensitive Virus during the 20072008 Season. Journal of Infectious Diseases, 200(11), 1766-1773. doi:10.1086/647989 Gravenstein, S. (2008, July). Initiating Influenza Chemoprophylaxis with the First Influenza Case: A New Institutional Standard?. Clinical Infectious Diseases. pp. 53-55. doi:10.1086/588659. Martinez-Martin, P., Catalan, M., Benito-Leon, J., Moreno, A., Zamarbide, I., Cubo, E., & ... Frades, B. (2006). Impact of Fatigue in Parkinsons Disease: The Fatigue Impact Scale for Daily Use (D-FIS). Quality of Life Research, 15(4), 597-606. doi:10.1007/s11136-005-4181-0