아시클로버

항바이러스제 (헤르페스)

**아시클로버(Acyclovir)**는 합성 퓨린 뉴클레오시드 유사체로, 수의학에서는 주로 특정 헤르페스 바이러스에 대한 항바이러스 특성 때문에 사용됩니다. 주요 임상 적용 분야: * **조류 의학**: **파체코병(Pacheco's disease)**(조류에서 매우 치명적인 헤르페스 바이러스 감염)의 치료 및 예방. * **고양이 의학**: **고양이 헤르페스 바이러스-1(FHV-1)** 감염, 특히 각막 또는 결막 병변의 관리. *임상 팁: 팜시클로버, 간시클로버 또는 시도포비어와 같은 최신 항바이러스제에 비해 FHV-1에 대한 활성이 비교적 약하며, 고양이에서 전신 독성의 위험이 더 높습니다.* * **말 의학**: **말 헤르페스 바이러스 1형(EHV-1)** 척수뇌증 치료제로 연구 중이나, 말에서 경구 생체이용률이 매우 낮아(<4%) 치료 효과를 거두기 어렵습니다. 인체에서는 매우 효과적이지만, 수의학적 사용은 종종 약동학적 차이, 특정 종(예: 말)에서의 불량한 경구 흡수율, 그리고 잠재적 독성(고양이의 신독성 및 골수 억제 등)으로 인해 제한됩니다.

작용 기전: Acyclovir is a prodrug that requires activation by viral enzymes, making it highly specific to infected cells. 1. **Viral Entry**: Acyclovir enters the virus-infected cell. 2. **Initial Phosphorylation**: It is preferentially phosphorylated by **viral thymidine kinase** into acyclovir monophosphate. 3. **Subsequent Phosphorylation**: Host cell kinases further convert it into the active form, **acyclovir triphosphate**. 4. **DNA Chain Termination**: Acyclovir triphosphate acts as a competitive inhibitor of **viral DNA polymerase**. It incorporates into the growing viral DNA chain → lacks the 3'-hydroxyl group needed for further elongation → causes **premature DNA chain termination** and halts viral replication.

동물 종별 용량

Cats

Herpesvirus-1 infections · 10-25 mg/kg PO twice daily · PO · q12h · Never begin therapy until diagnostic evaluation is completed. May be toxic in cats; monitor CBC every 2-3 weeks.

Horses

EHV-1 outbreaks (prevention or treatment) · 10 mg/kg PO 5 times daily or 20 mg/kg PO q8h · PO · 5 times daily or q8h · Although efficacy is undetermined, anecdotal use may have had some efficacy. However, the drug's very low oral bioavailability suggests that oral dosing is unlikely to be of much benefit.

Birds

Treatment of Pacheco's Disease · 80 mg/kg PO q8h or 40 mg/kg q8h IM · PO/IM · q8h · Maximum 72 hours for IM · Do not use parenterally for more than 72 hours as it can cause tissue necrosis at site of injection.
Treatment of Pacheco's Disease · 80 mg/kg in oral suspension once daily PO; mix suspension with peanut butter or add to drinking water 50 mg in 4 oz of water · PO · q24h · 7-14 days
Individual treatment · 80 mg/kg PO or IM twice daily · PO/IM · q12h
Prophylaxis (Exposed birds) · 25 mg/kg IM once, then acyclovir is added to drinking water at 1 mg/mL and to the food at 400 mg/quart of seed · IM, then PO · Once IM, then continuous PO · Minimum of 7 days · Give IM with caution as it is very irritating.
Prophylaxis (Quaker parrots) · 80 mg/kg q8h · PO (gavage) · q8h · 7 days

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

투여 경로

POIMIVtopical

금기

Dehydrated states
Pre-existing renal function impairment
Hypersensitivity to acyclovir or related antivirals
Pre-existing neurologic deficits
Previous neurologic reactions to other cytotoxic drugs

이상반응

Thrombophlebitis (with parenteral use)
Acute renal failure
Encephalopathologic changes (rare)
Gastrointestinal disturbances (vomiting, diarrhea)
Leukopenia (cats)
Anemia (cats)
Tissue necrosis (if given IM for >72 hours in birds)

약물 상호작용

Nephrotoxic medications (e.g., Amphotericin B, Aminoglycosides) · Concomitant administration with IV acyclovir may increase the potential for nephrotoxicity. Amphotericin B may potentiate antiviral effects but significantly increases nephrotoxic risk.
Zidovudine · Concomitant use may cause additional CNS depression.

모니터링

Renal function tests (BUN, Serum Creatinine) with prolonged or IV therapy
Complete Blood Count (CBC) every 2-3 weeks in cats to monitor for leukopenia and anemia
Hydration status

과용량

Acute oral overdosage is unlikely to cause significant toxicity. * **Clinical Signs**: Gastrointestinal signs (vomiting, diarrhea, lethargy) predominate. Renal failure is possible with higher doses due to drug crystallization in the renal tubules. Crystalluria and elevated renal values occurred at 188.7 mg/kg in a dog. * **Treatment**: Consider gastrointestinal decontamination at doses of **150 mg/kg or higher**. Below 150 mg/kg, manage symptomatically as GI signs will likely predominate. Ensure adequate hydration to maintain urine flow and prevent crystalluria.

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