데옥시코르티코스테론 피발레이트 (DOCP)

무기질코르티코이드

**데옥시코르티코스테론 피발레이트(DOCP)**는 주로 개와 고양이의 전형적인 부신피질기능저하증(애디슨병) 관리에 사용되는 장기 지속형 주사용 **무기질코르티코이드**입니다. * **임상 요점:** 플루드로코르티손과 달리 DOCP는 당질코르티코이드 활성이 **전혀 없습니다**. 따라서 DOCP를 투여받는 환자는 특히 스트레스나 질병 시기에 당질코르티코이드(예: 생리적 용량의 프레드니손 또는 히드로코르티손)를 반드시 함께 보충해야 합니다. * 미세 결정 데포 현탁액으로 제조되어 천천히 용해되며 작용 시간이 길게(일반적으로 21~30일) 유지됩니다.

작용 기전: DOCP acts as an exogenous analog of aldosterone. * **Target Site:** Acts primarily at the **renal distal tubule** and collecting ducts. * **Mechanism:** Binds to mineralocorticoid receptors → upregulates **Na+/K+ ATPase** pumps and epithelial sodium channels (ENaC) → increases the absorption of **sodium (Na+)** and enhances **potassium (K+)** and **hydrogen (H+)** ion excretion. * **Requirement:** To be effective, mineralocorticoids require a functioning kidney.

동물 종별 용량

Cats

Maintenance therapy of hypoadrenocorticism · 2.2 mg/kg IM every 25 days plus prednisolone (0.25-1 mg/cat PO twice daily; if daily oral dosing not feasible, may give 10 mg of methylprednisolone acetate once a month IM) · IM · q25d
Maintenance therapy of hypoadrenocorticism · 10-12.5 mg (total dose) IM per month. Adjust dose based-upon follow-up serum electrolyte concentrations monitored every 1-2 weeks during initial maintenance period. Normal electrolyte values 2 weeks following injection, suggests adequate dosing, but does not provide information regarding duration of action. Prednisone at 1.25 mg PO once a day or IM methylprednisolone acetate 10 mg once a month can provide long-term glucocorticoid supplementation. · IM · monthly

Dogs

Hypoadrenocorticism · 2.2 mg/kg IM every 25 days · IM · q25d · Dosage requirements are variable and should be individualized to the patient.
Hypoadrenocorticism · Initially, inject 2.2 mg/kg IM or SC every 25 days. Reevaluate at 12 and 25 days after initial injection. If hyponatremia and/or hyperkalemia are noted at 12 days, increase dose by 10%. If they are noted at 25 days (but not on day 12), shorten dosing interval by 2 days. · IM/SC · q25d
Hypoadrenocorticism · 1.5-2.2 mg/kg IM q20-30 days · IM · q20-30d
Hypoadrenocorticism · Initially, 2.2 mg/kg IM q25 days. If electrolytes remain in normal range at 30 days, reduce dose by 10% a month. In our clinic, we have used a dose of DOCP as low as 1 mg/kg q30 days with good control of hypoadrenocorticism. · IM · q25-30d

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

투여 경로

IMSC

금기

Congestive heart failure
Severe renal disease
Edema

이상반응

Injection site irritation
Polyuria (PU)
Polydipsia (PD)
Hypernatremia
Hypokalemia
Hypertension
Edema
Weight gain (fluid retention)

약물 상호작용

Amphotericin B · Patients may develop hypokalemia if mineralocorticoids are administered concomitantly.
Aspirin · DOCP may reduce salicylate levels.
Digoxin · Because DOCP may cause hypokalemia, it should be used with caution and increased monitoring when used in patients receiving digitalis glycosides.
Insulin · Potentially, DOCP could increase the insulin requirements of diabetic patients.
Potassium-depleting diuretics (e.g., furosemide, thiazides) · Patients may develop hypokalemia if administered concomitantly; as diuretics can cause a loss of sodium, they may counteract the effects of DOCP.

모니터링

Serum electrolytes (Na+, K+)
BUN and Creatinine (initially every 1-2 weeks, then once stabilized, every 3-4 months)
Body weight
Physical examination for edema

과용량

Overdosage may cause polyuria, polydipsia, hypernatremia, hypertension, edema, and hypokalemia. Cardiac enlargement is possible with prolonged overdoses. Excessive weight gain may be indicative of fluid retention secondary to sodium retention. **Treatment:** * Electrolytes should be aggressively monitored. * Potassium may need to be supplemented. * Discontinue the drug in patients until clinical signs associated with overdosage have resolved, then restart the drug at a lower dosage.

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