알팍살론
Alfaxalone
3-alpha-hydroxy-5-alpha-pregnane-11,20-dione
다른 이름: Alfaxan-CD RTU · Alfaxan Multidose · alfaksaloni · alfaxalona · alfaxalonum · alphaxalone · GR-2/234
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
검토된 비계산 근거검토된 비계산 근거 (10)
근거 표시 전용 — 자동 계산 불가
Crocodilians/induction, but unpredictable results
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 3 mg/kg IV252. Species/Comments: Crocodilians/induction, but unpredictable results.
근거 표시 전용 — 자동 계산 불가
Lizards, chelonians/induction, 35–40 min; duration, 15–35 min; good muscle relaxation; variable results
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 15 mg/kg IM229. Species/Comments: Lizards, chelonians/induction, 35–40 min; duration, 15–35 min; good muscle relaxation; variable results.
근거 표시 전용 — 자동 계산 불가
Most species/good muscle relaxation; variable results; drug requires more evaluation; may have violent recovery;198don’t use within 10 days of DMSO treatment
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 6–9 mg/kg IV, or 9–15 mg/kg IM182. Species/Comments: Most species/good muscle relaxation; variable results; drug requires more evaluation; may have violent recovery;198don’t use within 10 days of DMSO treatment.
근거 표시 전용 — 자동 계산 불가
Horsfield’s tortoises (males only)/light to moderate sedation with no to minimal analgesia; red-eared slider turtles/light sedation of short duration; PD turtles administered 10 mg/kg at low temperature more relaxed than warm, and turtles administered 20 mg/kg at warm temperature were most relaxed
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 10–20 mg/kg IM113,164,300. Species/Comments: Horsfield’s tortoises (males only)/light to moderate sedation with no to minimal analgesia; red-eared slider turtles/light sedation of short duration; PD turtles administered 10 mg/kg at low temperature more relaxed than warm, and turtles administered 20 mg/kg at warm temperature were most relaxed.
근거 표시 전용 — 자동 계산 불가
Turtles, tortoises/induction
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 5 mg/kg IV170. Species/Comments: Turtles, tortoises/induction.
근거 표시 전용 — 자동 계산 불가
Most species
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 6–15 mg/kg IM, IV298. Species/Comments: Most species.
근거 표시 전용 — 자동 계산 불가
Snakes, lizards/induction; not effective for blotched blue-tongued skinks
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 9 mg/kg IV290. Species/Comments: Snakes, lizards/induction; not effective for blotched blue-tongued skinks.
근거 표시 전용 — 자동 계산 불가
Red-eared slider turtles, Eastern painted turtles, yellow-spotted Amazon river turtles, other undocumented turtle species/anesthetic induction
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 20 mg/kg IM141. Species/Comments: Red-eared slider turtles, Eastern painted turtles, yellow-spotted Amazon river turtles, other undocumented turtle species/anesthetic induction.
근거 표시 전용 — 자동 계산 불가
Chelonians (red-eared sliders)/surgical anesthesia with good relaxation
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 24 mg/kg ICe111. Species/Comments: Chelonians (red-eared sliders)/surgical anesthesia with good relaxation.
근거 표시 전용 — 자동 계산 불가
Bearded dragons/effective for induction of anesthesia; respiratory depression noted
TABLE 127.5. Agent: Alfaxalone(Alfaxan, Jurox). Dosage: 12 mg/kg IV262. Species/Comments: Bearded dragons/effective for induction of anesthesia; respiratory depression noted.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
알팍살론 (Alfaxalone) 은 속효성 중추신경계 억제제 및 전신 마취제로 작용하는 신경활성 스테로이드 분자입니다. 주로 수의학 환자의 마취 유도 및 유지에 사용됩니다.
임상적 특징 및 약리학적 프로필:
- 제형의 발전: 현대의 제형(Alfaxan®)은 용해제로 2-히드록시프로필-베타-사이클로덱스트린(HPCD)을 사용합니다. 이는 폴리에톡실화 피마자유(Cremophor EL)를 포함하여 특히 고양이에서 심각한 히스타민 방출과 아나필락시스를 유발했던 과거 제품(Saffan®)에 비해 크게 개선된 것입니다.
- 심폐 기능에 미치는 영향: 일반적으로 안전역이 넓은 것으로 간주되지만, 특히 정맥으로 빠르게 투여할 경우 용량 의존적인 호흡 억제 및 유도 후 무호흡을 유발할 수 있습니다. 보상성 빈맥이 발생할 수 있으나 심혈관 지표는 일반적으로 잘 유지됩니다.
- 진통 효과: 알팍살론은 진통 효과가 거의 없습니다. 통증이 동반되는 시술의 경우 적절한 순수 진통제(예: 오피오이드)와 병용해야 합니다.
- 회복: 반감기가 짧고 축적되지 않아 회복이 일반적으로 빠르고 부드럽지만, 자극을 받거나 전처치/진통이 불충분한 경우 환자가 정신운동성 흥분(허우적거림, 발성, 경련)을 겪을 수 있습니다.
작용 기전
Alfaxalone exerts its anesthetic effects by interacting with GABA_A (gamma-aminobutyric acid type A) receptors in the central nervous system.
- Mechanism: It binds to specific transmembrane domains on the GABA_A receptor complex.
- Pathway: Binding → Enhances the binding of the inhibitory neurotransmitter GABA to the receptor → Increases the frequency and duration of chloride (Cl⁻) ion channel opening → Influx of chloride ions into the neuron → Hyperpolarization of the postsynaptic cell membrane → Inhibition of neural action potential transmission → Dose-dependent CNS depression (ranging from sedation to general anesthesia).
안전성·주의사항
금기사항
- Concurrent use with other injectable general anesthetic agents (e.g., propofol, thiopental)
- Situations where endotracheal intubation, positive pressure ventilation, and oxygen support are unavailable
- Animals less than 12 weeks of age (safety not established)
부작용
- Respiratory depression
- Post-induction apnea
- Hypotension (dose-dependent)
- Cardiac arrhythmias (primarily secondary to hypoxemia/hypercapnia)
- Psychomotor excitement during recovery (especially if unstimulated or lacking premedication)
주의
Critical Warning: Post-induction apnea is common (up to 44% in dogs, 19% in cats). Alfaxalone should only be used when endotracheal intubation and oxygen supplementation/ventilation are immediately available.
- Administration Rate: Give slowly IV (over 60 seconds or titrated to effect) to minimize the risk of severe apnea.
- Hepatic Dysfunction: Use with caution; lower dosages or increased dosing intervals may be required as the drug undergoes extensive hepatic metabolism.
- Recovery Environment: Keep patients in a quiet, unstimulating environment during recovery to minimize psychomotor excitement. Avoid handling unless necessary.
- Analgesia: Always provide concurrent appropriate pain control, as alfaxalone offers no analgesia.
약물 상호작용
Potentiates the CNS and respiratory depressant effects. Significantly reduces the required induction and maintenance doses of alfaxalone.
Should not be used concurrently according to the manufacturer label.
Should not be used concurrently according to the manufacturer label.
Increased risk of severe CNS and respiratory depression
Synergistic CNS depression; significantly reduces the required induction dose of alfaxalone
Synergistic CNS depression; reduces the required induction dose of alfaxalone.
Profound synergy; significantly reduces alfaxalone dose requirements and may exacerbate cardiovascular and respiratory depression.
Enhanced sedation and increased risk of hypotension.
Synergistic CNS depression; significantly reduces the required induction dose of alfaxalone.
Synergistic CNS depression; reduces alfaxalone dose requirements.
모니터링
- Level of anesthesia / CNS depression (jaw tone, palpebral reflex)
- Respiratory rate, rhythm, and depth (capnography and pulse oximetry highly recommended due to apnea risk)
- Cardiovascular status (heart rate, ECG rhythm, blood pressure)
- Body temperature (monitor for hypothermia during anesthesia)
약동학
반감기
흡수
Rapid onset following intravenous administration. Well absorbed following deep intramuscular injection in cats.
분포
Widely distributed. Volume of distribution (Vd) in dogs is approximately 2.5 L/kg; in cats, approximately 2 L/kg.
대사
Undergoes extensive hepatic metabolism via Phase I (cytochrome P450 dependent) and Phase II (conjugation dependent) pathways. Cats form alfaxalone sulfate and alfaxalone glucuronide; dogs form only alfaxalone glucuronide.
배설
Metabolites are eliminated via hepatic/fecal and renal routes. Clearance in dogs is ~54 mL/kg/min. Clearance in cats is dose-dependent (25.1 mL/kg/min at 5 mg/kg; 14.8 mL/kg/min at 25 mg/kg). No clinically relevant accumulation occurs with multiple doses.
과다투여
Overdoses up to 25 mg/kg primarily result in severe cardiorespiratory depression.
Clinical Signs of Toxicity:
- Severe hypoventilation and prolonged apnea
- Hypotension
- Cardiac arrhythmias
Treatment:
- Immediate endotracheal intubation and positive pressure ventilation with 100% oxygen.
- Cardiovascular support (IV fluids, vasopressors/inotropes if hypotension is severe).
- Continuous monitoring until the drug is metabolized and cleared.
제품
제형
- 10 mg/mL injection (10 mL and 20 mL vials)
동물용의약품
- Alfaxan® 10 mg/mL injection (10 mL and 20 mL vials)
규제 현황
Approved for induction and maintenance of anesthesia.
Prescription Only Medicine - Veterinarian.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store at room temperature (<30°C) and protect from light. Do not freeze. According to the New Zealand label, broached (punctured) vials should preferably be used within 24 hours, but may be stored at 4°C for up to 7 days provided contamination is avoided. Discard if the solution is not clear, colorless, or contains particulate matter.
보호자 정보
알팍살론이란 무엇인가요? 알팍살론은 수술 전 수면을 유도하거나 간단한 시술을 위해 깊은 진정 상태를 제공하는 데 사용되는 빠르고 매우 안전한 주사용 마취제입니다.
예상되는 상황:
- 빠른 작용: 반려동물은 주사 후 매우 빠르고 부드럽게 잠들게 됩니다.
- 모니터링: 일시적으로 호흡이 느려질 수 있으므로, 수의료진은 시술 내내 반려동물의 호흡, 심박수, 산소 수치를 면밀히 모니터링합니다.
- 회복: 시술이 끝나면 반려동물은 보통 빨리 깨어납니다. 하지만 회복 단계에서는 소음, 빛, 접촉에 예민해질 수 있습니다. 깜짝 놀라면 경련을 일으키거나 다리를 허우적거리거나 소리를 낼 수 있습니다.
- 사후 관리: 수의료진은 반려동물이 완전히 깨어나고 걸음걸이가 안정될 때까지 조용하고 따뜻하며 어두운 환경에서 안정을 취하게 합니다. 퇴원 후 이 약물과 관련하여 집에서 특별히 해줄 관리는 없습니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.