암프롤리움

항원충제 / 항콕시듐제

암프롤리움은 널리 사용되는 **항콕시듐제**로, 구조적으로 티아민(비타민 B1)과 유사합니다. FDA에서는 주로 가금류와 소의 아이메리아(*Eimeria*) 감염 치료 및 예방용으로 승인되었으나, 반려동물, 소형 포유류 및 특수동물의 콕시듐증(예: 개와 고양이의 낭포등포자충 *Cystoisospora* spp.) 치료를 위해 허가 외(off-label)로 자주 사용됩니다. **임상 요점:** * 티아민 경쟁적 억제제로 작용하기 때문에 단기 사용 시 안전역이 일반적으로 넓지만, 장기 사용 시 티아민 결핍증(반추동물의 뇌회백연화증 또는 소동물의 신경 증상)을 유발할 수 있습니다. * 치료 기간은 일반적으로 12-14일을 초과하지 않아야 합니다. * 액상 제제는 쓴맛이 매우 강하므로 식수에 섞어 투여할 경우 환자가 수분을 충분히 섭취하는지 면밀히 모니터링해야 합니다.

작용 기전: Amprolium is a **thiamine (Vitamin B1) analog**. It competitively inhibits the active transport and utilization of thiamine by the parasite. * **Mechanism:** Amprolium → blocks thiamine uptake → disrupts carbohydrate metabolism in the parasite (specifically inhibiting **thiamine pyrophosphate (TPP)**-dependent enzymes) → parasite death. * It primarily targets the **first-generation schizont** in the cells of the intestinal wall, preventing differentiation into merozoites. It may also suppress the sexual stages and sporulation of oocysts. * Because the host's thiamine transport mechanisms have a lower affinity for amprolium than the parasite's, toxicity to the host is minimized during short-term therapy.

동물 종별 용량

Sheep

Coccidiosis (Lambs) · 55 mg/kg daily · PO · q24h · 19 days
Eimeria macusaniensis (Camelids - New World) · 10 mg/kg · PO · q24h · 5 days · Dosed for camelids
Eimeria macusaniensis (Camelids - New World) · 10 mg/kg as a 1.5% solution · PO · q24h · 10-15 days · Give thiamine at 10 mg/kg SC once daily every 5 days during treatment. Dosed for camelids.

Dogs

Coccidiosis (Small Pups < 10 kg adult weight) · 100 mg (total dose) · PO · q24h · 7-12 days · Using the 20% powder in a gelatin capsule
Coccidiosis (Large Pups > 10 kg adult weight) · 200 mg (total dose) · PO · q24h · 7-12 days · Using the 20% powder in a gelatin capsule
Coccidiosis (Pups or bitches, in food) · 250-300 mg total dose · PO · q24h · 7-12 days · Using the 20% powder on food
Coccidiosis (Pups or bitches, in water) · 30 mL of the 9.6% solution in one gallon of water · PO · ad libitum · 7-10 days · No other water provided
Prophylaxis · 0.075% solution as drinking water · PO · ad libitum
Coccidiosis (Combination therapy) · 150 mg/kg of amprolium and 25 mg/kg of sulfadimethoxine · PO · q24h · 14 days
Control of coccidiosis · 1.5 tablespoonsful (22.5 mL) of the 9.6% solution per one gallon of water · PO · ad libitum · Not to exceed 10 days · Sole drinking water source. Monitor water consumption; rarely some dogs may not drink due to bitter taste.

투여 경로

POSCIMIV

금기

Prolonged use (>12-14 days) especially in puppies
Concurrent high-dose thiamine supplementation (reduces efficacy)

이상반응

Neurologic disturbances (rare, dose-related)
Depression
Anorexia
Diarrhea
Thiamine deficiency (polioencephalomalacia) with prolonged high doses

약물 상호작용

Thiamine · Exogenously administered thiamine in high doses may reverse or reduce the anticoccidial efficacy of amprolium.
Thiamine (Vitamin B1) · Exogenously administered thiamine may reduce the efficacy of amprolium. · major

모니터링

Clinical efficacy (resolution of diarrhea, negative fecal floats)
Hydration status (especially if administered in drinking water)
Neurologic signs (ataxia, depression) indicating potential thiamine deficiency

과용량

Amprolium has induced **polioencephalomalacia (PEM)** in sheep when administered at 880 mg/kg PO for 4-6 weeks and at 1 gram/kg for 3-5 weeks. Erythrocyte production also ceased in lambs receiving these high dosages. In dogs, overdoses of amprolium will produce neurologic clinical signs. **Treatment:** * Discontinue amprolium therapy immediately. * Administer parenteral thiamine (1-10 mg/day IM or IV).

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