아세트아미노펜

진통제, 해열제

아세트아미노펜(파라세타몰)은 합성 비마약성 진통해열제입니다. **임상 요점 및 수의학적 배경:** * 글루쿠론산 전이효소의 결핍으로 인해 독성 대사산물인 NAPQI가 축적되므로, **고양이와 페럿에게는 어떠한 용량에서도 매우 치명적인 독성**을 나타냅니다. * NSAID 사용이 금기인 경우(예: 신기능 장애), 개와 소형 포유류의 경도 내지 중등도 통증 완화를 위해 간혹 사용됩니다. * 임상 용량에서는 말초 항염증 작용이 거의 없으며 혈소판 기능을 억제하지 않습니다. * 상승적 진통 효과를 위해 오피오이드(예: 코데인, 하이드로코돈)와 복합제로 자주 사용됩니다.

작용 기전: Produces analgesia and antipyresis via weak, reversible, isoform-nonspecific inhibition of **cyclooxygenase (COX-3 / COX-1-v1)** in the central nervous system. **Mechanism Pathway:** Inhibition of central **COX** enzymes → decreased **prostaglandin** synthesis in the CNS → elevation of the pain threshold and alteration of the hypothalamic thermoregulatory center → analgesia and antipyresis. *Note: It lacks significant peripheral COX-1 or COX-2 inhibition, which explains its lack of anti-inflammatory and anti-platelet effects.*

동물 종별 용량

SmallMammals

Analgesic (Rabbits) · 1-2 mg/mL in drinking water · PO · Ad libitum · Using Children's Tylenol. Effective for controlling low-grade nociception.
Analgesic (Mice, Rats, Gerbils, Hamsters, Guinea pigs, Chinchillas) · 1-2 mg/mL in drinking water · PO · Ad libitum

Dogs

Analgesic · 15 mg/kg PO q8h · PO · q8h
Analgesic · 10 mg/kg PO q12h · PO · q12h
Analgesic · 10-15 mg/kg PO q12h · PO · q12h · 5 days
Treatment of degenerative myelopathy (in German Shepherds) · 5 mg/kg PO (not to exceed 20 mg/kg per day) · PO · Daily

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

금기

Cats (at any dosage)
Ferrets
Sugar Gliders
Hedgehogs

이상반응

Methemoglobinemia (especially in cats and dogs at high doses)
Hepatotoxicity (liver necrosis)
Renal effects
Gastrointestinal disturbances
Facial and paw swelling (edema)
Keratoconjunctivitis sicca (KCS)
Cyanosis
Hypothermia

약물 상호작용

Other Analgesics · Chronic use with acetaminophen may lead to renal pathologies
Barbiturates · Increased conversion of acetaminophen to hepatotoxic metabolites; potentially increased risk for hepatotoxicity
Doxorubicin · May deplete hepatic glutathione, thereby leading to increased hepatic toxicity
Halothane · Not recommended for postoperative analgesia in animals that received halothane anesthesia
Isoniazid · Possible increased risk of hepatotoxicity
Phenothiazines · Possible increased risk for hypothermia
Propylene Glycol · May increase the severity of acetaminophen-induced methemoglobinemia or Heinz body formation
Warfarin · Large doses may potentiate anticoagulant effects

모니터링

Liver enzymes (ALT, AST, ALP)
Renal function (BUN, Creatinine)
Hematologic parameters (CBC for methemoglobinemia or Heinz bodies)
Clinical signs of toxicity (edema, cyanosis, lethargy)

과용량

**Acute Toxicity & Overdose:** * **Clinical Signs:** Methemoglobinemia (brown blood/mucous membranes), liver necrosis, renal effects, facial and paw swelling, keratoconjunctivitis sicca (KCS), vomiting, lethargy, cyanosis, hypothermia. * **Species Differences:** Liver effects are more common in dogs; facial/paw swelling and methemoglobinemia are more common in cats. * **Treatment:** Standard gut emptying techniques (emesis/lavage) and activated charcoal if recent. Administer **acetylcysteine (NAC)** as a glutathione precursor to bind toxic metabolites. Supportive care includes **s-adenosyl methionine (SAMe)**, oxygen therapy, IV fluids, and blood transfusions or methylene blue for severe methemoglobinemia.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.