데페록사민 메실산염

해독제 - 철 킬레이트제

**데페록사민 메실산염(Deferoxamine mesylate)**은 수의학에서 주로 급성 철 중독(예: 철분 보충제 또는 산소 흡수제 섭취)의 구명 해독제로 사용되는 매우 특이적인 **철 킬레이트제**입니다. 알루미늄 중독 및 급성 심근 허혈의 보조 치료제로도 간혹 평가되지만, 재관류 손상에 대한 효능은 실망스러운 편입니다. 주요 임상 포인트: * **높은 친화력**: 혈류 및 조직의 유리 철을 특이적으로 표적화하고 결합하여 철로 인한 산화 손상을 방지합니다. * **소변 변색**: 성공적인 킬레이트화의 특징은 연어 핑크색 또는 '로제 와인(vin rosé)' 색의 소변이 생성되는 것이며, 이는 철-킬레이트 복합체가 배설되고 있음을 나타냅니다. * **투여**: 반드시 비경구(일반적으로 IM 또는 느린 IV 지속 점적)로 투여해야 합니다. 경구 투여는 위장관의 철분 흡수를 역설적으로 증가시킬 수 있으므로 일반적으로 금기입니다.

작용 기전: Deferoxamine acts by directly binding to free iron to neutralize its toxicity: * The drug possesses three hydroxamic groups that have a high affinity for **ferric (Fe³⁺) ions**. * Deferoxamine + Fe³⁺ → **Ferrioxamine** (a stable, water-soluble chelate complex). * By sequestering the iron, it prevents the metal from participating in the **Fenton reaction**, thereby halting the production of damaging reactive oxygen species (hydroxyl radicals). * The ferrioxamine complex is then readily excreted by the kidneys into the urine. It does not significantly chelate other essential trace metals or electrolytes (except aluminum).

동물 종별 용량

Cats

Severe iron toxicosis · 40 mg/kg IM q4-8 hours · IM · q4-8h · Until urine clears or serum iron levels return to normal · Cat dosages are not well established; extrapolated from general animal doses.
Severe iron toxicosis · 15 mg/kg/hour · IV · CRI · 2-3 days · Cat dosages are not well established; extrapolated from general animal doses.
Severe iron toxicosis · 10 mg/kg IM or IV q8h for 24 hours · IM/IV · q8h · 24 hours · Cat dosages are not well established.

Dogs

Severe iron toxicosis · 40 mg/kg IM q4-8 hours · IM · q4-8h · Until urine clears or serum iron levels return to normal · Most effective within the first 24 hours. IM route is preferred as too rapid IV administration can cause hypotension and pulmonary edema.
Severe iron toxicosis · 15 mg/kg/hour · IV · CRI · 2-3 days (until serum iron < 300 microliters/dL or below TIBC) · Initiate ASAP or at least within 12 hours of ingestion. Give as a constant rate infusion. If CRI not possible, give 40 mg/kg IM q4-8h.
Severe iron toxicosis · 10 mg/kg IM or IV q8h for 24 hours · IM/IV · q8h · 24 hours
Ferric ion chelator during treatment of cardiac arrest (experimental) · 5-15 mg/kg IV , IM or SC · IV/IM/SC · Single dose or as directed
Ferric ion chelator during treatment of cardiac arrest (experimental) · 10 mg/kg IV , IM q2h twice, then three times daily for 24 hours · IV/IM · q2h twice, then TID · 24 hours

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

투여 경로

IMIVSC

금기

Severe renal failure (unless dialysis is used to remove the ferrioxamine complex)

이상반응

Allergic reactions (hives, wheezing)
Auditory neurotoxicity (with chronic, high-dose therapy)
Pain or swelling at injection sites
Gastrointestinal distress
Hypotension, tachycardia, and convulsions (if given IV too rapidly)
Pulmonary edema (associated with rapid IV administration)

약물 상호작용

Prochlorperazine · Concurrent use may cause temporary impairment of consciousness.
Vitamin C (Ascorbic Acid) · May be synergistic in removing iron, but could lead to increased tissue iron toxicity, especially in cardiac muscle. Use with extreme caution in patients with preexisting cardiac disease.

모니터링

Serum iron levels
Total iron-binding capacity (TIBC)
Serum ferritin
Urine color (monitor for clearing of the 'vin rosé' color)
Blood pressure and heart rate (especially during IV infusion)
Ophthalmic examinations (if used chronically)

과용량

Acute overdosage or excessively rapid IV administration can lead to severe hypotension, tachycardia, convulsions, hives, wheezing, and pulmonary edema. Chronic high-dose use may lead to hypocalcemia, thrombocytopenia, and auditory/visual neurotoxicity. Treatment is supportive and symptomatic.

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