베나제프릴

안지오텐신 전환 효소(ACE) 억제제

베나제프릴은 개와 고양이의 심부전, 전신 고혈압, 만성 신부전 및 단백상실성 신증 관리에 수의학에서 널리 사용되는 **안지오텐신 전환 효소(ACE) 억제제**입니다. **임상적 특징:** * 거의 전적으로 신장을 통해 배설되는 에날라프릴과 달리, 베나제프릴의 활성 대사체(베나제프릴라트)는 개에서 **간(55%)과 신장(45%) 양쪽 경로**를 통해 배설됩니다. 이러한 이중 배설 경로 덕분에 신기능 장애가 동반된 환자에게 더 선호되는 ACE 억제제입니다. * 사구체 내 고혈압을 낮추는 데 특히 유익하여 만성 신장 질환에서 단백뇨를 감소시킵니다. * (캡토프릴과 달리) 설프히드릴기가 없기 때문에 면역 매개성 부작용을 일으킬 가능성이 적습니다.

작용 기전: Benazepril is a **prodrug** that is hydrolyzed in the liver to its active metabolite, **benazeprilat**. It competitively inhibits **Angiotensin-Converting Enzyme (ACE)**. * **Pathway:** Angiotensin I → (blocked by ACE) → **Angiotensin II** * **Hemodynamic Effects:** By preventing the formation of Angiotensin II (a potent vasoconstrictor), benazepril promotes vasodilation, reducing both preload and afterload in heart failure patients. * **Renal Effects:** It dilates the efferent arterioles of the glomerulus more than the afferent arterioles, reducing intraglomerular capillary pressure and subsequently decreasing proteinuria. * **Endocrine Effects:** Decreased Angiotensin II leads to reduced secretion of **aldosterone** from the adrenal cortex, minimizing sodium and water retention.

동물 종별 용량

Dogs

Adjunctive treatment of heart failure · 0.25-0.5 mg/kg PO once daily · PO · q24h
Adjunctive treatment of heart failure · 0.25-0.5 mg/kg PO once to twice daily · PO · q12-24h
Adjunctive treatment of hypertension and/or proteinuria (first step) · 0.5 mg/kg q12h · PO · q12h · As a first step drug for systolic hypertension >160 mmHg, diastolic >120 mmHg
Adjunctive treatment of hypertension and/or proteinuria · 0.25-0.5 mg/kg q12-24h · PO · q12-24h · Co-administration with a calcium channel antagonist may lower blood pressure when monotherapy is not sufficient.
Hypertension associated with protein-losing renal disease · 0.5 mg/kg PO once daily (q24h) · PO · q24h
Proteinuria, hypertension · 0.25-1 mg/kg PO q12-24h · PO · q12-24h · Potentially could worsen preexisting azotemia; lower dose and monitoring recommended.
Heart failure · 0.25-0.5 mg/kg · PO · q24h · Long-term · Adjunctive treatment. Often used in conjunction with diuretics, pimobendan, spironolactone, or digoxin.
Adjunctive treatment of hypertension/proteinuria · 0.25-0.5 mg/kg · PO · q12-24h · Long-term · May reduce blood pressure; more potent in dogs than cats.

Cats

Adjunctive treatment of heart failure · 0.25-0.5 mg/kg PO once daily · PO · q24h

투여 경로

금기

Known hypersensitivity to ACE inhibitors

이상반응

Anorexia
Vomiting
Diarrhea
Hypotension
Renal dysfunction (worsening azotemia)
Hyperkalemia

약물 상호작용

Aspirin · May potentially negate the decrease in systemic vascular resistance induced by ACE inhibitors (though low-dose aspirin may not significantly affect hemodynamics).
Antidiabetic Agents (insulin, oral agents) · Possible increased risk for hypoglycemia; enhanced monitoring recommended.
Diuretics (e.g., furosemide, hydrochlorothiazide) · Potential for increased hypotensive effects. Reducing furosemide doses by 25-50% is often recommended when initiating ACE inhibitors for heart failure.
Potassium-Sparing Diuretics (e.g., spironolactone, triamterene) · Increased risk of hyperkalemia; enhanced monitoring of serum potassium is required.
Lithium · Possible increased serum lithium levels; increased monitoring required.
Potassium Supplements · Increased risk for hyperkalemia. · major
Spironolactone · Potential for hyperkalemia due to additive potassium-sparing effects, though concurrent use is generally safe in practice. · moderate
NSAIDs · Increased risk of nephrotoxicity and decreased clinical efficacy of benazepril. · major
Diuretics (e.g., Furosemide) · Increased risk of hypotension and prerenal azotemia. · moderate
Vasodilators (e.g., Amlodipine, Anesthetic agents) · Additive hypotensive effects. · moderate
Beta-blockers · Increased risk of hypotension due to negative inotropic effects. · moderate

모니터링

Clinical signs of Congestive Heart Failure (CHF)
Serum electrolytes (especially potassium)
Renal panel (Creatinine, BUN)
Urine protein (UPC ratio)
Blood pressure (especially if treating hypertension or if signs of hypotension arise)

과용량

In overdose situations, the primary concern is **hypotension**. * **Treatment:** Supportive treatment with volume expansion using normal saline is recommended to correct blood pressure. * **Monitoring:** Because of the drug's long duration of action, prolonged monitoring and treatment may be required. * **Decontamination:** Recent massive overdoses should be managed using standard gut-emptying protocols (emesis, activated charcoal) as appropriate.

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