๋จํธ๋กค๋ ๋ํธ๋ฅจ
๋จํธ๋กค๋ ๋ํธ๋ฅจ์ ๋ ํนํ ์ง์ ์์ฉํ **๊ณจ๊ฒฉ๊ทผ ์ด์์ **์ ๋๋ค. ์ค์ถ์ฑ ๊ทผ์ก ์ด์์ (๋ฉํ ์นด๋ฅด๋ฐ๋ชฐ์ด๋ ๋์์ ํ ๋ฑ)์ ๋ฌ๋ฆฌ ๋ง์ด ๊ทผ์ก ์ฌ์ ์ ์ง์ ์์ฉํฉ๋๋ค. ์์ํ์์์ ์ฃผ์ ์ ์์ฆ์ ๋ค์๊ณผ ๊ฐ์ต๋๋ค: * **์ ์ฑ ๊ณ ์ด์ฆ(MH):** ํนํ ๋ผ์ง์ ๊ฐ์์ ์ ์ฑ ๊ณ ์ด์ฆ ๋ฐ ๋ผ์ง ์คํธ๋ ์ค ์ฆํ๊ตฐ์ ๋ํ ๊ตฌ๋ช ์ฝ์ ๋๋ค. * **๋ง์ ๊ทผ์ก ๋ณ์ฆ:** ๋ง์ **์ด๋์ฑ ํก๋ฌธ๊ทผ ์ตํด์ฆ** ๋ฐ **๋ง์ทจ ํ ๊ทผ์ผ(PAM)** ์๋ฐฉ ๋ฐ ์น๋ฃ์ ๋๋ฆฌ ์ฌ์ฉ๋ฉ๋๋ค. * **์๋๋ฌผ ๋น๋จ๊ธฐ๊ณผ:** ๊ฐ์ ๊ณ ์์ด์ ์ธ๋ถ ์๋ ๊ด์ฝ๊ทผ ๊ธด์ฅ์ ๋ฎ์ถฐ **๊ธฐ๋ฅ์ฑ ์๋ ํ์**๋ฅผ ๊ด๋ฆฌํ๋ ๋ฐ ์์ฃผ ํ์ฉ๋ฉ๋๋ค. * **๋ ์ ๊ต์:** ๋๋์ ์์ธํธ์ฝ๋ฆฐ ๋ฐฉ์ถ๊ณผ ์ฌํ ๊ทผ์ก ๊ฒฝ๋ จ์ ์ ๋ฐํ๋ **๊ฒ์๊ณผ๋ถ๊ฑฐ๋ฏธ ๊ต์**์ ๋ณด์กฐ ์น๋ฃ์ ๋ก ๊ถ์ฅ๋ฉ๋๋ค. **์์ ์์ :** ์ฃผ์ฌ์ ๋ ๋งค์ฐ ๋น์ธ๊ณ ์ฌ๊ตฌ์ฑ ํ ์ ํต๊ธฐํ์ด ์งง๊ธฐ ๋๋ฌธ์ ์ฃผ๋ก ์ฌ๊ฐํ๊ณ ๊ธ์ฑ์ธ ์๊ธฐ(์: MH)์๋ง ์ฌ์ฉ๋๋ฉฐ, ๊ฒฝ๊ตฌ์ ๋ ๋ง์ฑ ๊ด๋ฆฌ๋ ์๋ฐฉ ๋ชฉ์ ์ผ๋ก ์ฌ์ฉ๋ฉ๋๋ค.
์์ฉ ๊ธฐ์ : Dantrolene acts intracellularly to uncouple the excitation-contraction process in skeletal muscle. * It binds specifically to the **ryanodine receptor (RyR1)** located on the **sarcoplasmic reticulum (SR)**. * This binding **blocks the release of calcium (Caยฒโบ)** from the SR into the myoplasm. * Decreased intracellular calcium โ prevents the interaction of actin and myosin โ produces **skeletal muscle relaxation**. Because it specifically targets the RyR1 isoform (found primarily in skeletal muscle) rather than RyR2 (cardiac muscle), it has minimal direct effects on cardiac or smooth muscle at standard therapeutic doses. The exact mechanism for its mild CNS effects (drowsiness, dizziness) remains poorly understood.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Treatment of functional urethral obstruction due to increased external urethral tone ยท 0.5-2 mg/kg PO q12h OR 0.5-1 mg/kg IV ยท PO/IV ยท q12h ยท IV product very expensive.
- Treatment of functional urethral obstruction due to increased external urethral tone ยท 0.5-2 mg/kg PO three times daily ยท PO ยท TID
- Treatment of functional urethral obstruction due to increased external urethral tone ยท 2-10 mg (total dose) PO three times daily ยท PO ยท TID ยท Given with either prazosin (0.5 mg/cat once to twice daily) or phenoxybenzamine (2.5-7.5 mg/cat once to twice daily).
- Treatment of functional urethral obstruction due to increased external urethral tone ยท 0.5-1 mg/kg PO q12h ยท PO ยท q12h
- Treatment of acute rhabdomyolysis ยท 15-25 mg/kg slow IV four times daily ยท IV ยท QID
- Treatment of acute rhabdomyolysis ยท 2-4 mg/kg PO via nasogastric tube once daily ยท PO ยท SID
- Prevention of recurrent exertional rhabdomyolysis in Thoroughbreds ยท 4 mg/kg PO in horses fasted (12-hour fast in study) prior to administration. ยท PO ยท Once
- Prevention of rhabdomyolysis ยท 2 mg/kg PO once daily for 3-5 days and then every 3rd day for a month ยท PO ยท SID then q3d ยท 1 month ยท Drug is diluted in normal saline and given via stomach tube. Monitor hepatic function.
- Prevention of rhabdomyolysis ยท 300 mg (total dose) PO once daily ยท PO ยท SID ยท May be preferable because the drug is hepatotoxic.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Preexisting liver disease (use with extreme caution)
- Severe cardiac dysfunction (use with caution)
- Pulmonary disease (use with caution)
์ด์๋ฐ์
- Weakness
- Sedation
- Dizziness
- Headache
- Nausea
- Vomiting
- Constipation
- Increased urinary frequency
- Hypotension
- Hepatotoxicity (especially with chronic use)
์ฝ๋ฌผ ์ํธ์์ฉ
- Benzodiazepines & other CNS depressants ยท Increased sedation may be seen if tranquilizing agents are used concomitantly.
- Calcium-Channel Blockers ยท Rare reports of cardiovascular collapse in humans; concomitant use during malignant hyperthermia crises is not recommended. ยท major
- Estrogens ยท Increased risks of hepatotoxicity have been seen in women >35 years of age; veterinary significance is unknown.
- Warfarin ยท Dantrolene may be displaced from plasma proteins by warfarin, resulting in increased effects or adverse reactions.
๋ชจ๋ํฐ๋ง
- Baseline and periodic liver function tests (ALT, AST, Alk Phos, etc.) if projecting to be used chronically or using high dosages
- Body temperature (especially for malignant hyperthermia)
- Urine volume, frequency, continence
๊ณผ์ฉ๋
There is no specific antidotal therapy for dantrolene overdoses. * **Decontamination:** Remove the drug from the gut if possible (e.g., emesis induction, activated charcoal) if exposure was recent and oral. * **Supportive Care:** Treat supportively, monitoring respiratory, cardiovascular, and hepatic function.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.