부토르파놀
Butorphanol
Butorphanol tartrate
다른 이름: Stadol · Torbutrol · Torbugesic · Dolorex · Equanol · Alvegesic · Butomidor · Torphasol · levo-BC-2627 · butorphanol tartrate
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
검토된 비계산 근거검토된 비계산 근거 (5)
근거 표시 전용 — 자동 계산 불가
Chelonians/minimal sedation
TABLE 127.5. Agent: Butorphanol. Dosage: 0.2 mg/kg IM118,275. Species/Comments: Chelonians/minimal sedation.
근거 표시 전용 — 자동 계산 불가
Most species/sedation; preanesthetic
TABLE 127.5. Agent: Butorphanol. Dosage: 0.4–1 mg/kg SC, IM295. Species/Comments: Most species/sedation; preanesthetic.
근거 표시 전용 — 자동 계산 불가
Most species/preanesthetic
TABLE 127.5. Agent: Butorphanol. Dosage: 0.5–2 mg/kg IM, or 0.2–0.5 mg/kg IV, IO23. Species/Comments: Most species/preanesthetic.
근거 표시 전용 — 자동 계산 불가
Butorphanol combinations follow; see ketamine for combinations; inadequate for analgesia
TABLE 127.5. Agent: Butorphanol. Dosage: —. Species/Comments: Butorphanol combinations follow; see ketamine for combinations; inadequate for analgesia.
근거 표시 전용 — 자동 계산 불가
Lizards/administer 30 min before isoflurane for smoother, shorter induction
TABLE 127.5. Agent: Butorphanol. Dosage: 1–1.5 mg/kg SC, IM295. Species/Comments: Lizards/administer 30 min before isoflurane for smoother, shorter induction.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
부토르파놀(Butorphanol)은 다양한 동물 종의 수의학에서 널리 사용되는 합성 오피오이드 부분 효능제입니다.
- 진통 작용: 경도에서 중등도의 내장 통증에 대한 진통 효과를 제공합니다. "천장 효과(ceiling effect)"로 인해 고용량을 투여해도 진통 효과가 증가하지 않으므로 심한 통증(예: 주요 정형외과 수술)에는 적합하지 않습니다.
- 진해 작용: 개의 만성 비생산성 기침(예: 전염성 기관기관지염, 기관 허탈)을 억제하는 데 매우 효과적입니다.
- 역전제: 펜타닐, 메타돈, 모르핀과 같은 순수 뮤(mu) 효능제로 인한 심각한 호흡 및 중추신경계 억제를 역전시키면서도 카파(kappa) 수용체 매개 진통 효과를 어느 정도 유지하는 독특한 유용성이 있습니다.
- 진정 작용: 시너지 효과가 있는 진정 및 화학적 보정을 위해 알파-2 효능제(예: 덱스메데토미딘 또는 자일라진) 및 벤조디아제핀과 자주 병용됩니다.
임상 요점: 부토르파놀은 소동물에서 훌륭한 진해제 및 경미한 진정제이지만, 작용 시간이 매우 짧아(개의 경우 진통 작용이 보통 1시간 미만) 일차 진통제로서의 유용성은 제한적입니다. 반면, 말(예: 산통)에서는 매우 효과적이고 흔히 사용되는 내장 진통제입니다.
작용 기전
Butorphanol exerts its effects by interacting with specific opioid receptors in the central nervous system:
- Kappa (κ) and Sigma (σ) Agonist: Activation of κ-receptors in the limbic system and spinal cord provides visceral analgesia and sedation.
- Mu (μ) Antagonist: Competitively binds to and blocks μ-receptors. This antagonism is responsible for its ability to reverse pure μ-agonist drugs and is the reason for its analgesic "ceiling effect."
- Antitussive Mechanism: Directly suppresses the medullary cough center, elevating the threshold to stimuli (like CO2) without depressing respiratory center sensitivity as profoundly as pure agonists.
- Cellular Pathway: Binds to κ-receptors → inhibits adenylate cyclase → decreases intracellular cAMP → closes voltage-gated calcium channels and opens potassium channels → hyperpolarization and reduced neuronal excitability.
안전성·주의사항
금기사항
- Known hypersensitivity to butorphanol
- Lower respiratory tract conditions with copious mucous production (suppressing cough prevents clearance)
- Caution in patients with head trauma, increased CSF pressure, or severe CNS dysfunction (e.g., coma)
- Caution in severe liver disease, renal insufficiency, hypothyroidism, or Addison's disease
- Caution in dogs with heartworm disease (safety not established)
부작용
- Sedation and ataxia
- Anorexia or diarrhea (rare in small animals)
- Respiratory depression (mild compared to pure agonists)
- CNS excitement, head tossing, and increased ambulation (especially in horses at high doses or rapid IV administration)
- Decreased gastrointestinal motility and potential ileus (horses)
- Nystagmus, salivation, seizures, and hyperthermia (at massive overdoses in horses)
주의
MDR1 (ABCB1) Mutation Warning: Dogs with the MDR1 mutation (e.g., Collies, Australian Shepherds) may develop pronounced and prolonged sedation. Reduce the dose by 25% in heterozygous dogs and by 30-50% in homozygous mutant dogs.
Geriatric/Debilitated Patients: Use with caution and consider dose reductions.
Hepatic/Renal Impairment: The manufacturer advises against use in dogs with a history of liver disease. Use cautiously in renal insufficiency.
Pregnancy/Nursing: Category C (human). Safe for use if used cautiously in dogs/cats, but manufacturer does not recommend use in pregnant bitches, foals, weanlings, or breeding horses.
약물 상호작용
May cause increased CNS or respiratory depression; dosage may need to be decreased.
Could potentially decrease the metabolism of butorphanol, prolonging its effects.
Butorphanol may antagonize analgesic effects, but will also reverse sedative and respiratory depressant effects.
May cause increased conjunctival changes when used concurrently.
Could potentially decrease the metabolism of butorphanol.
Reduces the doses of other drugs required for induction and maintenance of anaesthesia
Addition of butorphanol will reduce analgesia produced from the full mu agonist; combination is not recommended for analgesia
Synergistic sedation
Synergistic sedation and analgesia
Butorphanol's mu-antagonist properties may block or partially reverse the analgesic effects of full mu-agonists. Higher doses of full mu-agonists may be required.
모니터링
- Analgesic and/or antitussive efficacy
- Respiratory rate and depth
- Appetite and bowel function
- CNS effects (sedation vs. excitement)
약동학
반감기
흡수
Completely absorbed in the gut when administered orally, but due to a high first-pass effect, only about 16% (1/6th) reaches systemic circulation. Completely absorbed following IM administration.
분포
Well distributed. Highest levels found in liver, kidneys, and intestine. Approximately 80% bound to plasma proteins. Crosses the placenta (neonatal levels roughly equivalent to maternal) and distributes into maternal milk.
대사
Metabolized in the liver, primarily by hydroxylation, as well as N-dealkylation and conjugation. Metabolites do not exhibit analgesic activity.
배설
Metabolites and parent compound are mainly excreted into the urine (only 5% unchanged). 11-14% is excreted into the bile and eliminated in feces.
과다투여
Acute life-threatening overdoses are unlikely (LD50 in dogs is 50 mg/kg). However, because veterinary injection comes in two highly different strengths (0.5 mg/mL and 10 mg/mL), inadvertent overdoses can occur in small animals.
Clinical Signs: CNS effects (profound sedation or excitement), cardiovascular changes, and respiratory depression.
Treatment:
- Administer intravenous naloxone immediately to reverse opioid effects.
- Provide supportive measures: IV fluids, oxygen therapy, vasopressors, and mechanical ventilation if required.
- If seizures occur and persist, use diazepam for control.
제품
제형
- Veterinary Injection: 0.5 mg/mL, 2 mg/mL, 10 mg/mL
- Veterinary Tablets: 1 mg, 5 mg, 10 mg
- Human Injection: 1 mg/mL, 2 mg/mL
- Human Nasal Spray: 10 mg/mL
동물용의약품
- Butorphanol Tartrate Injection: 0.5 mg/mL (Torbutrol)
- Butorphanol Tartrate Injection: 2 mg/mL (Torbugesic-SA)
- Butorphanol Tartrate Injection: 10 mg/mL (Torbugesic, Dolorex, Butorject, Torphaject, Equanol)
- Butorphanol Tartrate Tablets: 1 mg, 5 mg, and 10 mg (Torbutrol)
인용의약품
- Butorphanol Tartrate Injection: 1 mg/mL, 2 mg/mL (Stadol)
- Butorphanol Nasal Spray: 10 mg/mL
규제 현황
Subject to specific member state controlled drug regulations.
Classified as POM-V (Prescription Only Medicine - Veterinarian).
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
The injectable product should be stored out of bright light and at room temperature; avoid freezing.
보호자 정보
이 약은 무엇인가요? 부토르파놀은 기침을 완화하거나, 가벼운 통증을 줄여주거나, 수의학적 처치 전 진정제로 사용되는 약물입니다.
어떤 변화를 예상해야 하나요?
- 반려동물이 졸려하거나 약간 비틀거릴 수 있습니다. 이는 정상적인 반응이지만, 약효가 사라질 때까지 안전하고 조용한 환경(예: 계단 피하기)에 머물게 해주세요.
- 기침약으로 처방받은 경우, 기침 발작이 눈에 띄게 줄어드는 것을 확인할 수 있습니다.
중요한 경고:
- 처방된 용량보다 많이 투여하지 마세요. 약을 많이 준다고 해서 진통 효과가 커지는 것은 아니며 부작용만 증가할 수 있습니다.
- 반려동물의 기침이 "마른 기침"에서 "가래가 끓는 습성 기침"으로 변하면 수의사에게 연락하세요. 습성 기침을 억제하면 폐에 점액이 갇힐 수 있습니다.
- 행동에 큰 변화가 있거나, 식욕이 떨어지거나, 심한 변비/설사가 발생하면 수의사에게 알리세요.
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