아스파라기나제

항종양제

아스파라기나제는 개와 고양이의 **림프계 악성 종양**(예: 림프종) 및 **백혈병**(특히 급성 림프구성 백혈병, ALL) 치료에 주로 사용되는 독특한 효소 기반 **항종양제**입니다. DNA를 직접 손상시키는 전통적인 화학요법 약물과 달리, 암세포의 필수 영양소를 고갈시켜 작용합니다. 골수 억제가 거의 없고 위장관 점막을 보존하기 때문에, 유도 요법이나 환자의 골수 기능이 이미 손상된 경우의 "구제(rescue)" 요법으로 탁월한 선택입니다. **임상 팁:** 대장균에서 유래한 거대 외부 단백질이기 때문에 과민 반응/아나필락시스가 주요 임상적 우려 사항입니다. 또한, 환자의 면역 체계가 효소에 대한 중화 항체를 생성함에 따라 시간이 지남에 따라 효능이 감소하는 경우가 많습니다.

작용 기전: Normal cells can synthesize their own asparagine using the enzyme **asparagine synthetase**. However, many lymphoid malignant cells lack this enzyme and rely entirely on exogenous asparagine from the bloodstream for protein and DNA synthesis. Asparaginase is an enzyme that circulates in the intravascular space and catalyzes the breakdown of circulating asparagine: **L-asparagine** + H2O → (via **L-asparaginase**) → **Aspartic acid** + **Ammonia** By rapidly depleting circulating asparagine, the drug halts protein synthesis in the tumor cells, leading to apoptosis. The antineoplastic activity is greatest during the post-mitotic (**G1**) phase of the cell cycle.

동물 종별 용량

Dogs

Lymphoid malignancies / Leukemia · 400 Units/kg or 10,000 Units/m2 IM or SC, with a maximum dose of 10,000 Units per patient · IM/SC · Protocol dependent · Protocol dependent · Many oncologists recommend administering diphenhydramine at 2 mg/kg SC 30 minutes prior to administration.
Treatment of lymphoid malignancies · 10,000 IU/m2 or 400 IU/kg · IM/SC · q7d or less frequently · As per chemotherapy protocol · See specialist texts for chemotherapy protocols and conversion of body weight to body surface area.

Cats

Lymphoid malignancies / Leukemia · 400 Units/kg or 10,000 Units/m2 IM or SC, with a maximum dose of 10,000 Units per patient · IM/SC · Protocol dependent · Protocol dependent · Many oncologists recommend administering diphenhydramine at 1 mg/kg SC 30 minutes prior to administration.
Treatment of lymphoid malignancies · 10,000 IU/m2 or 400 IU/kg · IM/SC · q7d or less frequently · As per chemotherapy protocol · See specialist texts for chemotherapy protocols and conversion of body weight to body surface area.

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

투여 경로

IMSC

금기

Patients with a history of anaphylaxis to asparaginase
Patients with pancreatitis or a history of pancreatitis

이상반응

Hypersensitivity reactions (vomiting, diarrhea, urticaria, pruritus, dyspnea, hypotension, collapse)
Hemorrhagic pancreatitis
Hepatotoxicity
Coagulation defects
Hyperglycemia (secondary to altered insulin synthesis)
Leukopenia (rare)

약물 상호작용

Methotrexate · Asparaginase may reduce methotrexate effectiveness against tumor cells until serum asparagine levels return to normal.
Prednisone · Concurrent use may increase the risk for hyperglycemia.
Vincristine · Increased toxicity (neuropathy and erythropoiesis disruption) and myelosuppression may occur. Some oncologists recommend separating the dosing by a few days to a week. · major

모니터링

Hepatic function
Renal function (BUN may be increased by drug action)
Pancreatic function (blood glucose, amylase)
Hematopoietic function
Patient observation for hypersensitivity during and immediately after administration
Serum ammonia (may be increased)

과용량

In dogs, the maximally tolerated dose is 10,000 IU/kg and the lethal dose is 50,000 IU/kg. Overdosage is expected to cause severe toxicity secondary to protein synthesis alteration (pancreatitis, hepatotoxicity, coagulopathy). Treatment is supportive.

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