์ค๋ผ๋ ธํ
์ค๋ผ๋ ธํ(Auranofin)์ ์ฃผ๋ก ๋ฉด์ญ ์กฐ์ ํน์ฑ(**๊ธ ์๋ฒ, chrysotherapy**)์ ์ํด ์์ํ์์ ์ฌ์ฉ๋๋ ๊ฒฝ๊ตฌ์ฉ ๊ธ์ผ ์ ์ ์ ๋๋ค. * **์์ ์ฉ๋**: ์ญ์ฌ์ ์ผ๋ก ๊ฐ์ ๊ณ ์์ด์ ๋์ฝ์ฑ ์ฒํฌ์ฐฝ ๋ฐ ํน๋ฐ์ฑ ๋ค๋ฐ์ฑ ๊ด์ ์ผ๊ณผ ๊ฐ์ ๋ฉด์ญ ๋งค๊ฐ ์งํ์ ์ฌ์ฉ๋์์ต๋๋คใ * **ํจ๋ฅ ๋ฐ ๋ ์ฑ**: ์ฃผ์ฌ์ฉ ๊ธ ํํฉ๋ฌผ(์: ์ค๋กํฐ์ค๊ธ๋ฃจ์ฝ์ค)๋ณด๋ค ๋ ์ฑ์ ๋ํ ๊ฒ์ผ๋ก ๊ฐ์ฃผ๋์ง๋ง ํจ๋ฅ๋ ๋จ์ด์ง๋๋คใ * **ํ๋์ ๋ฐฐ๊ฒฝ**: ์ต๊ทผ์๋ ๋ ์์ ํ๊ณ ํจ๊ณผ์ ์ธ ์๋ก์ด ๋ฉด์ญ์ต์ ์ (์: ์ฌ์ดํด๋ก์คํฌ๋ฆฐ, ๋ง์ด์ฝํ๋๋ ์ดํธ)๋ก ๋์ฒด๋๋ ์ถ์ธ์ ๋๋คใ * **์ฌ์กฐ์ ํ์**: ์ธ์ฒด์ฉ ์์ ์ฉ ์บก์ ํฌ๊ธฐ(3mg) ๋๋ฌธ์ ์๋๋ฌผ์๊ฒ ์ ํํ ์ฉ๋์ ํฌ์ฌํ๋ ค๋ฉด ๊ฑฐ์ ํญ์ ์ฌ์กฐ์ ๊ฐ ํ์ํฉ๋๋คใ
์์ฉ ๊ธฐ์ : The exact mechanism of gold salts is not fully elucidated, but they possess anti-inflammatory, antirheumatic, and immunomodulating effects. * **Macrophage Inhibition**: Auranofin is taken up by macrophages โ inhibits **phagocytosis** and suppresses **lysosomal enzyme activity**. * **Mediator Suppression**: Inhibits the release of **histamine** and the production of **prostaglandins**. * **T-Cell Modulation**: Selectively suppresses **helper T-cells (CD4+)** without significantly affecting suppressor T-cell populations, thereby dampening the autoimmune response.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Rescue drug for feline pemphigus and for idiopathic dermatoses and plasma cell pododermatitis/stomatitis ยท 0.2-0.3 mg/kg ยท PO ยท twice daily ยท Must be reformulated for accurate dosing.
- Immune-mediated arthropathies and dermatopathies ยท 0.05-0.2 mg/kg (up to 9 mg/day total dose) ยท PO ยท q12h
- Treatment of pemphigus complex (with corticosteroids) ยท 0.12-0.2 mg/kg ยท PO ยท twice daily
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Systemic Lupus Erythematosus (SLE) - may exacerbate signs
- Pregnancy (known teratogen and maternotoxic)
์ด์๋ฐ์
- Immune-mediated thrombocytopenia (dose-dependent)
- Hemolytic anemia
- Leukopenia
- Gastrointestinal disturbances (particularly diarrhea, dose-dependent)
- Renal toxicity (proteinuria)
- Hepatotoxicity (increased liver enzymes)
- Dermatosis
- Corneal ulcers
์ฝ๋ฌผ ์ํธ์์ฉ
- Cytotoxic agents (including high dose corticosteroids) ยท Safety when used with these agents has not been established; use with caution.
- Penicillamine ยท Increased potential for hematologic or renal toxicity; use with gold salts is not recommended.
- Antimalarial drugs ยท Increased potential for hematologic or renal toxicity; use with gold salts is not recommended.
๋ชจ๋ํฐ๋ง
- Hepatic function tests (baseline, monthly for 2-3 months, then every other month)
- Renal function tests including urinalysis (baseline, monthly for 2-3 months, then every other month)
- CBC with platelet counts (baseline, monthly for 2-3 months, then every other month). Note: eosinophilia may denote impending reactions.
๊ณผ์ฉ๋
Very limited data is available. The minimum lethal oral dose in rats is 30 mg/kg. * **Decontamination**: Gut-emptying protocols should be employed after an acute overdose when applicable. * **Antidotes**: Chelating agents (e.g., penicillamine, dimercaprol) have been used for severe toxicities, but their use is controversial.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.