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**μμΈν νλλ‘μΌμ°(AHA)**μ μ£Όλ‘ λ°λ €κ²¬μ **λμΉμ± μ€νΈλ£¨λ°μ΄νΈ μμμ¦**(λ°©κ΄ κ²°μ) λ° **μ°λ μμ μμ± λ°ν 리μ**λ‘ μΈν λ§μ± μλ‘ κ°μΌμ 보쑰 μΉλ£μ λ‘ μ¬μ©λλ νΉμ μ½λ¬Όμ λλ€. * **μμ μμ **: λΆμμ©μ΄ λ§μ μΌλ°μ μΌλ‘ νμ€ νμμ λ° μμ΄ μλ²μ΄ μ€ν¨ν λμΉμ± μ¬λ‘μλ§ μ¬μ©λ©λλ€. * **κ²½κ³ **: κ³ μμ΄μκ²λ μ¬κ°ν λ μ±μ΄ μμΌλ―λ‘ μ λ κΈκΈ°μ λλ€.
μμ© κΈ°μ : AHA acts as a potent, reversible inhibitor of the bacterial enzyme **urease**. * **Urease** normally hydrolyzes urea β ammonia + carbon dioxide. * By inhibiting **urease**, AHA β decreases urinary ammonia, bicarbonate, and carbonate concentrations β prevents the alkalinization of urine (keeps pH lower). * This acidic environment increases the solubility of struvite (magnesium ammonium phosphate) and carbonate-apatite crystals, and enhances the efficacy of concurrent antimicrobial therapy (e.g., carbenicillin, gentamicin, clindamycin, trimethoprim-sulfa, or chloramphenicol).
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- Adjunctive therapy of persistent struvite uroliths and persistent urease-producing bacteria after treating with antibiotics and calculolytic diets Β· 12.5 mg/kg twice daily PO Β· PO Β· twice daily
μ©λμ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μ°Έκ³ μλ£μ λλ€. νμ μ΅μ λΌλ²¨κ³Ό κ°λ³ νμμ λν΄ νμΈνμμμ€.
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- Cats (highly toxic)
- Patients with poor renal function (e.g., serum creatinine >2.5 mg/dL)
- Pregnancy (FDA Category X - severe teratogenic effects)
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- Anorexia
- Vomiting
- Mouth and esophageal ulcers
- Hemolytic anemia
- Hyperbilirubinemia
- Bilirubinuria
- CNS disturbances (anxiety, depression, tremulousness)
- Reticulocytosis
- Bone marrow depression
- Phlebitis
- Skin rashes and alopecia
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- Iron salts Β· AHA may chelate iron salts in the gut if given concomitantly, reducing absorption.
- Methenamine Β· AHA may have a synergistic effect with methenamine in inhibiting urine pH increases caused by urease-producing Proteus spp., and may potentiate antibacterial effects.
- Alcohol Β· In humans, concurrent use of AHA with alcohol has resulted in skin rashes.
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- CBC (Complete Blood Count)
- Renal function (including urinalysis)
- Hepatic function (specifically bilirubin levels)
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Acute overdoses can lead to severe hematologic and neurologic signs. * **Clinical Signs**: Anorexia, tremors, lethargy, vomiting, and anxiety. * **Hematologic Effects**: Increased reticulocyte counts and severe **hemolytic reactions**. Mild overdoses over several weeks can also result in hemolysis, particularly in patients with reduced renal function. * **Treatment**: Intensive hematologic monitoring with adjunctive supportive therapy, including possible blood transfusions.
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