클로니딘

중추성 알파-2 아드레날린 수용체 작용제

클로니딘은 **중추성 알파-2 아드레날린 수용체 작용제**로, 수의학에서는 전통적으로 개의 성장 호르몬(GH) 결핍증이나 갈색세포종을 진단하는 약물로 사용됩니다. 또한 난치성 **염증성 장질환(IBD)**(특히 고양이)의 보조 치료제 및 심한 통증이나 수술 마취를 위한 경막외 보조제로도 사용됩니다. > **임상 요점 (약리학적 보충):** > * 약물 전문에서는 진단 및 위장관 용도를 강조하지만, 현대 수의 행동 의학에서 클로니딘은 개의 **공포 기반 불안, 소음 공포증 및 상황적 패닉**을 관리하기 위해 허가 외(off-label)로 점점 더 많이 사용되고 있습니다. > * 교감신경 각성을 억제하여 항불안 및 진정 효과를 제공하며, 다른 진정제에서 흔히 볼 수 있는 심각한 운동 실조를 동반하지 않는 경우가 많습니다. > * 심혈관계에 미치는 영향 때문에 신중한 환자 선택과 용량 조절이 필요합니다.

작용 기전: Clonidine acts centrally at the **brain stem**, stimulating **alpha-2 adrenoreceptors**. * **Cardiovascular/Sympathetic:** Stimulation of presynaptic **alpha-2 receptors** (e.g., in the **locus coeruleus**) → decreases norepinephrine release → reduces sympathetic outflow from the CNS → decreased peripheral resistance, heart rate, and blood pressure. * **Endocrine:** Stimulates **GHRH (Growth Hormone Releasing Hormone)** → transient release of **Growth Hormone (GH)**. * **Analgesia:** Stimulates presynaptic and postjunctional **alpha-2 adrenoreceptors** in the dorsal horn of the spinal cord → blocks pain signal transmission to the brain. * **Gastrointestinal:** Alpha-2 stimulation alters enteric nervous system tone, increasing fluid absorption and decreasing motility, aiding in refractory IBD.

동물 종별 용량

Cats

Adjunctive antidiarrheal therapy for refractory cases of inflammatory bowel disease · 5-10 micrograms/kg · SC or PO · two to three times a day · As fourth line therapy after prostaglandin synthetase inhibitors, opioid agonists, and 5-HT3 serotonergic antagonists are being used.

Cattle

Epidural analgesia/analgesia · 2-3 micrograms/kg diluted to 8 mL with sterile normal saline · epidurally · Single dose · Onset/duration of analgesia = 19 minutes/192 minutes with 2 mcg/kg dose and = 9 minutes/311 minutes with 3 mcg/kg dose; peak effects from 60-180 minutes.

Dogs

Diagnosing hyposomatotropism · 10 micrograms/kg · IV · Single dose · Obtain plasma for GH levels prior to dosing and at 15, 30, 45, 60, and 120 minutes. Healthy dogs should demonstrate GH levels of 10 ng/mL after administration.
Adjunctive antidiarrheal therapy for refractory cases of inflammatory bowel disease · 5-10 micrograms/kg · PO or SC · two to three times a day · Can activate alpha2-receptors in the CRT and cause vomiting.
Control panic-like responses and fear-based behavioural problems · Dose not specified in monograph; use tactically (prn) or over longer term · PO · prn or daily · prn (lasts 3-4 hours) or long-term (takes 1-2 weeks for full response) · Effect develops in about 30 minutes. Withdrawal must be gradual.
Diagnostic test for pituitary dwarfism (hyposomatotropism) · Dose not specified in monograph · IV · Single dose · N/A · Specialist texts should be consulted for the clonidine stimulation test protocol.

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

투여 경로

IVPOSCEpiduralIM

금기

Known hypersensitivity to clonidine
Severe cardiovascular disease (use with extreme caution)
Renal disease (use with extreme caution)

이상반응

Transient hyperglycemia
Dry mouth
Constipation
Sedation
Aggressive behavior
Hypotension
Collapse
Bradycardia
Transient sedation
Rebound hypertension (if withdrawn abruptly)

약물 상호작용

Antihypertensive drugs · Possible additive hypotensive effects
Beta-adrenergic blocking agents (e.g., propranolol) · May enhance bradycardia. If discontinuing, beta-blocker should be stopped first, then clonidine tapered to avoid rebound hypertension.
CNS depressant drugs (opiates, barbiturates) · May exacerbate the actions of other CNS depressant drugs
Digoxin · Possible additive bradycardia
Prazosin · May decrease the antihypertensive effects of clonidine
Tricyclic antidepressants (e.g., amitriptyline) · May block the antihypertensive effects of clonidine
Barbiturates · Increased central nervous system depression and hypotension · major
Opiates · Additive sedation, bradycardia, and respiratory depression · major
Beta-blockers · Additive hypotensive and bradycardic effects; may exacerbate rebound hypertension upon withdrawal · major
Hypotensive agents · Additive lowering of blood pressure · moderate

모니터링

Growth Hormone (GH) levels and adverse effects (when used for diagnostics)
Blood pressure
Heart rate
Efficacy and adverse effect profile (when used for ongoing diarrhea treatment)
Degree of sedation
Behavioral response
Plasma IGF-1 or GH levels (when used diagnostically)

과용량

Clonidine has a **narrow margin of safety**. * **Clinical Signs:** Hypotension, bradycardia, vomiting, weakness, depression, lethargy, tachycardia, ataxia, and hypertension. Rarely, seizures or respiratory depression. * **Toxicity Values:** LD50 for oral clonidine in rats is 465 mg/kg; mice 206 mg/kg. * **Treatment:** For large overdoses, gut evacuation using standard protocols (use emetics cautiously as consciousness may deteriorate rapidly). Symptomatic and supportive care. Fluids and pressors (e.g., dopamine) for hypotension. IV atropine for bradycardia. **Atipamezole or yohimbine** may be used to reverse cardiovascular effects, but multiple doses may be required as signs can last up to 48 hours.

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