시사프라이드

동물 종별 용량

투여 경로

금기

• Gastrointestinal perforation
• Gastrointestinal obstruction
• Gastrointestinal hemorrhage
• Hypersensitivity to cisapride

이상반응

• Vomiting
• Diarrhea
• Abdominal discomfort
• Prolonged QT intervals or cardiac arrhythmias (very rare in veterinary patients)

약물 상호작용

• Anticholinergic agents · May diminish the prokinetic effects of cisapride.
• Benzodiazepines · Cisapride may enhance the sedative effects of benzodiazepines.
• Warfarin · Cisapride may enhance anticoagulant effects; additional monitoring and dosage adjustments may be required.
• Oral drugs with a narrow therapeutic index · Cisapride decreases GI transit times, potentially altering the absorption of other oral drugs. Serum levels may need closer monitoring.
• CYP3A4 Inhibitors (Amiodarone, Ketoconazole, Itraconazole, Fluconazole, Chloramphenicol, Cimetidine, Fluvoxamine, Grapefruit juice, Macrolides except azithromycin) · Inhibit cisapride metabolism, leading to increased cisapride levels and an increased risk for cisapride cardiotoxicity.
• QT-prolonging drugs (Amiodarone, Clarithromycin, Moxifloxacin, Procainamide, Quinidine, Sotalol, Tricyclic Antidepressants) · May increase the risk of QT interval prolongation and fatal arrhythmias when used concurrently with cisapride.

모니터링

• Efficacy (resolution of GI stasis, constipation, regurgitation)
• Adverse effects profile (GI upset, signs of arrhythmias)

과용량

LD50 doses in various lab animals range from 160 - 4000 mg/kg. The reported oral lethal dose in dogs is 640 mg/kg. **Clinical Signs:** Most common adverse effects seen in dogs and cats are diarrhea, lethargy, ataxia, hypersalivation, muscle fasciculations, agitation, abnormal behavior, hyperthermia, and possibly seizures (dogs). **Treatment:** Significant overdoses should be handled using standard gut emptying protocols when appropriate. Supportive therapy should be initiated when required. **Activated charcoal** is effective in binding unabsorbed cisapride.