아포모르핀
Apomorphine
Apomorphine hydrochloride
다른 이름: Apokyn · APO-go · Apofin · Apokinon · Apomine · Britaject · Ixense · Taluvian · Uprima · Apometic · apomorphini hydrochloridum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Induction of emesis | 0.03 mg/kg IV or 0.04 mg/kg IM (IV route preferred); alternatively a portion of tablet may be crushed in a syringe, dissolved with few drops of water and administered into the conjunctival sac. After sufficient vomiting occurs, rinse conjunctival sac free of unabsorbed apomorphine. | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | 0.04 mg/kg IV, 0.07 mg/kg IM, or 0.25 mg/kg into the conjunctival sac | IV/IM/Topical | Once | — | 🌎 NA |
| Induction of emesis | 0.2 mg/kg | SC | single dose | single dose | 🌍 EU |
| Induction of emesis | 20-40 μg/kg | IV | single dose | single dose | 🌍 EU |
- Induction of emesis: IV route preferred.
- Induction of emesis: Authorized dose. Do not repeat if ineffective.
- Induction of emesis: Non-authorized dose and route but some evidence suggests it is at least as effective.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Induction of emesis | 0.04 mg/kg IV or 0.08 mg/kg IM or SC | IV/IM/SC | Once | — | 🌎 NA |
| Induction of emesis | Not recommended | IM | single dose | single dose | 🌍 EU |
- Induction of emesis: Use of apomorphine in cats is controversial and many recommend not using in this species.
- Induction of emesis: Xylazine is a potent emetic in cats and at least as safe.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
아포모르핀은 합성 아편양제제 유도체이지만 모르핀과 달리 유의미한 진통 효과는 없습니다. 수의학에서 섭취한 독성 물질을 신속하게 제거하기 위해 개에게 가장 우선적으로 선택되는 최토제로 널리 알려져 있습니다.
- 신속한 작용: 비경구(정맥/근육 주사) 또는 결막낭에 점안할 경우 매우 빠르게 구토를 유발합니다.
- 종 특이성: 개에게 매우 효과적입니다. 고양이의 경우 효과가 낮고 안전성 우려가 있어 사용에 논란이 있으며 일반적으로 권장되지 않습니다.
- 한계점: 다른 최토제와 마찬가지로 일반적으로 위 내용물의 40-60%(최대 80%)만 제거합니다. 구토 유발에 성공했다고 해서 추가적인 독성학적 모니터링이나 치료(예: 활성탄 투여)가 필요 없는 것은 아닙니다.
작용 기전
Apomorphine acts as a non-selective dopamine agonist.
It directly stimulates D2-dopaminergic receptors in the chemoreceptor trigger zone (CRTZ) located in the area postrema of the medulla oblongata.
Mechanism Pathway: Apomorphine administration → Crosses the blood-brain barrier → Stimulates D2 receptors in the CRTZ → Activates the central vomiting center → Initiates the emetic reflex.
Clinical Pearl: The CRTZ in dogs is highly sensitive to dopamine, making apomorphine highly effective. In contrast, the feline CRTZ is mediated primarily by alpha-2 adrenergic receptors, which is why alpha-2 agonists (like xylazine or dexmedetomidine) are the preferred emetics for cats, while apomorphine is often ineffective.
안전성·주의사항
금기사항
- Rodents and rabbits (unable to vomit or lack stomach wall strength)
- Hypoxia, dyspnea, or shock
- Lack of normal pharyngeal reflexes (risk of aspiration)
- Seizuring, comatose, or severely CNS-depressed patients
- Patients who have already vomited repeatedly
- Ingestion of strong acids, alkalis, or other caustic agents (risk of esophageal/gastric rupture)
- Ingestion of petroleum distillates (unless toxicity risk outweighs aspiration risk)
- Ingestion of strychnine or other CNS stimulants (may precipitate seizures)
- Oral opiate or other CNS depressant (e.g., barbiturates) toxicity
- Hypersensitivity to morphine
부작용
- Protracted vomiting
- CNS depression (lethargy, sedation)
- CNS stimulation (excitement, restlessness)
- Respiratory depression
- Corneal ulcers (anecdotal, associated with conjunctival administration)
주의
If vomiting does not occur within the expected time after apomorphine administration, repeated doses are unlikely to induce emesis and may cause clinical signs of toxicity. Use with extreme caution, if at all, in cats. When using the conjunctival route, the eye must be thoroughly rinsed with sterile saline after emesis is achieved to prevent protracted vomiting and potential corneal irritation.
약물 상호작용
May negate the emetic effects of apomorphine by blocking dopamine receptors in the CRTZ.
May cause severe hypotension; concurrent use is contraindicated in humans.
Additive CNS or respiratory depression may occur.
May reduce the emetic effects of apomorphine
Additive CNS or respiratory depression
모니터링
- CNS status (depression or excitement)
- Respiratory rate and effort
- Heart rate and rhythm
- Vomitus (quantify volume, examine for toxic contents, and save for possible later analysis)
약동학
흡수
Slowly absorbed after oral administration with unpredictable efficacy. Rapidly absorbed after IM administration (vomiting generally within 5 minutes). Topical administration to the conjunctival sac is usually effective but less so than IV or IM.
분포
Readily crosses the blood-brain barrier to access the chemoreceptor trigger zone.
대사
Primarily conjugated in the liver.
배설
Excreted in the urine.
과다투여
Excessive doses of apomorphine may result in:
- Respiratory and/or cardiac depression
- CNS stimulation (excitement, seizures) or severe CNS depression
- Protracted vomiting
Treatment:
- Naloxone may reverse the CNS and respiratory depressant effects of the drug, but it cannot be expected to halt the vomiting.
- Atropine has been suggested to treat severe bradycardias associated with overdose.
- If protracted vomiting occurs from conjunctival administration, thoroughly flush the eye with sterile saline.
제품
제형
- Injection
- Soluble tablets (often used for conjunctival administration or compounding)
동물용의약품
- Pharmaceutical dosage forms of apomorphine have been occasionally difficult to obtain; compounding pharmacies may be required to obtain the drug.
인용의약품
- Apomorphine HCl Injection: 10 mg/mL in 2 mL amps and 3 mL cartridges (Apokyn)
규제 현황
POM-V
POM-V
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store soluble tablets in tight containers at room temperature (15-30°C) and protect from light. Upon exposure to light and air, apomorphine gradually darkens in color. Do not use discolored tablets or solutions (green to turquoise). Solutions are more stable in acidic than in alkaline environments. Compounded sterile solutions (with sodium metabisulfite) can retain potency for two months at 25°C if protected from light. Do not autoclave solutions, as this causes a green discoloration.
보호자 정보
아포모르핀은 반려동물이 잠재적으로 위험한 물질을 섭취했을 때 구토를 유발하기 위해 수의사의 감독 하에 전문적으로 사용되는 속효성 약물입니다.
- 예상되는 상황: 반려견은 약물을 투여받은 후 몇 분 이내에 구토를 할 가능성이 높습니다.
- 사후 관리: 위가 비워진 후 반려동물에게 약간의 메스꺼움, 졸음 또는 무기력증이 남아있을 수 있습니다.
- 중요 사항: 구토 유발은 중독 치료의 첫 번째 단계일 뿐입니다. 수의사는 반려동물이 섭취한 물질에 따라 활성탄 투여나 정맥 수액과 같은 추가 치료를 권장할 수 있습니다.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.