アミノペンタミド
アミノペンタミドは、犬および猫の急性腹部内臓痙攣、幽門痙攣、肥厚性胃炎、およびそれに伴う悪心、嘔吐、下痢の管理に歴史的に使用されてきた獣医特有の**抗コリン薬および鎮痙薬**です。 > **臨床のポイント:** かつては一般的でしたが、イレウス（腸閉塞）や全身性の副作用を引き起こすリスクがあるため、非特異的な胃腸の不調に対する全身性抗コリン薬の使用は、現在ではマロピタントやオンダンセトロンなどのより標的を絞った制吐薬や消化管運動機能改善薬にほぼ取って代わられています。
作用機序: Aminopentamide acts as a **competitive antagonist at muscarinic acetylcholine receptors (mAChRs)** in the parasympathetic nervous system. By blocking acetylcholine binding, it inhibits parasympathetic tone. * **GI Tract:** → Decreases smooth muscle contractions (reducing colonic spasms) and reduces gastric acid secretion. * **Systemic:** Compared to atropine, it reportedly has a greater targeted effect on reducing colonic contractions with relatively fewer mydriatic (pupil dilating) and salivary (dry mouth) effects, though classic anticholinergic signs can still occur.
動物種別の用量
- Acute abdominal visceral spasm, nausea, vomiting, diarrhea · 10 lbs or less: 0.1 mg; 11-20 lbs: 0.2 mg; 21-50 lbs: 0.3 mg; 51-100 lbs: 0.4 mg; over 100 lbs: 0.5 mg. If desired effect is not attained, dosage may be gradually increased up to 5 times these amounts. · PO, IM, SC · q8-12h
- Second-line adjunctive therapy for refractory IBD · 0.1-0.4 mg/kg · SC · BID-TID
- Acute abdominal visceral spasm, nausea, vomiting, diarrhea · 10 lbs or less: 0.1 mg; 11-20 lbs: 0.2 mg; 21-50 lbs: 0.3 mg; 51-100 lbs: 0.4 mg; over 100 lbs: 0.5 mg. If desired effect is not attained, dosage may be gradually increased up to 5 times these amounts. · PO, IM, SC · q8-12h
- To decrease tenesmus in malabsorption/maldigestion syndromes · 0.1-0.4 mg (total dose) · SC, IM · BID-TID
用量は獣医療従事者向けの臨床リファレンスです。必ず最新の添付文書と個々の患者で確認してください。
投与経路
禁忌
- Glaucoma (absolute contraindication)
- Pyloric obstruction
- Hypersensitivity to anticholinergic drugs
- Tachycardias secondary to thyrotoxicosis or cardiac insufficiency
- Myocardial ischemia
- Unstable cardiac status during acute hemorrhage
- GI obstructive disease
- Paralytic ileus
- Severe ulcerative colitis
- Obstructive uropathy
- Myasthenia gravis (unless used to reverse adverse muscarinic effects)
- Known or suspected GI infections (e.g., parvovirus enteritis)
有害事象
- Dry mouth (xerostomia)
- Dry eyes (keratoconjunctivitis sicca)
- Blurred vision (mydriasis)
- Urinary hesitancy or retention
- Tachycardia
- Decreased GI motility (constipation/ileus)
薬物相互作用
- Antihistamines · May enhance the activity of anticholinergic derivatives
- Procainamide · May enhance the activity of anticholinergic derivatives
- Quinidine · May enhance the activity of anticholinergic derivatives
- Meperidine · May enhance the activity of anticholinergic derivatives
- Benzodiazepines · May enhance the activity of anticholinergic derivatives
- Phenothiazines · May enhance the activity of anticholinergic derivatives
- Primidone · May potentiate the adverse effects of anticholinergic derivatives
- Disopyramide · May potentiate the adverse effects of anticholinergic derivatives
- Nitrates · May potentiate the adverse effects of anticholinergic derivatives
- Corticosteroids (long-term use) · May increase intraocular pressure
- Nitrofurantoin · Anticholinergic derivatives may enhance actions
- Thiazide Diuretics · Anticholinergic derivatives may enhance actions
- Sympathomimetics · Anticholinergic derivatives may enhance actions
モニタリング
- Clinical efficacy (resolution of spasms, vomiting, or diarrhea)
- Heart rate (monitor for tachycardia)
- Urination frequency and volume (monitor for urinary retention)
- Eye moisture and pupil size
過量投与
No specific information was located regarding acute overdosage clinical signs or treatment for aminopentamide. Guidelines for atropine overdose may be applied: * **Decontamination:** If recent oral ingestion, empty gut contents and administer activated charcoal and saline cathartics. * **Supportive Care:** Treat clinical signs symptomatically. Fluid therapy and standard treatments for shock may be instituted. **Do not use phenothiazines** as they may contribute to anticholinergic effects. * **Antidote (Severe Cases):** The use of physostigmine is controversial and reserved for extreme agitation or life-threatening supraventricular/sinus tachycardias. Human pediatric dose (reasonable for small animals): 0.02 mg/kg slow IV, repeat q10 minutes until reversal of toxic effects. Physostigmine adverse effects (bronchoconstriction, bradycardia, seizures) may be treated with small doses of IV atropine.
VetSheet の薬剤リファレンスは、獣医療従事者向けの臨床意思決定支援を目的としており、専門的判断やメーカーの最新添付文書に代わるものではありません。