데토미딘

알파-2 아드레날린 작용제 / 진정 진통제

> **데토미딘**은 강력한 알파-2 아드레날린 작용제로, 주로 말 의학에서 깊은 진정 및 진통 효과를 위해 사용됩니다. * **역가:** 자일라진보다 약 50~100배 더 강력합니다. * **임상 용도:** 말의 기립 진정, 소규모 수술 및 진통(특히 산통)에 널리 사용됩니다. 소, 소형 반추동물, 낙타과 동물 및 조류에도 허가 외 용도로 사용된 바 있습니다. * **중요 주의사항:** 말이 깊게 진정된 것처럼 보이더라도 외부 자극에 갑자기 반응(예: 발차기)할 수 있습니다. 오피오이드(예: 부토르파놀)를 추가하면 이러한 놀람 반응을 완화하고 진정의 질을 높이는 데 도움이 될 수 있습니다.

작용 기전: Detomidine acts as a potent and highly specific agonist at **alpha-2 adrenergic receptors** in the central and peripheral nervous systems. * **Sedation & Analgesia:** Activation of presynaptic alpha-2 receptors in the locus coeruleus and dorsal horn of the spinal cord → inhibition of norepinephrine release → decreased sympathetic outflow, resulting in profound sedation, muscle relaxation, and analgesia. * **Cardiovascular Effects:** Initial activation of peripheral postsynaptic alpha-2 receptors → transient vasoconstriction and **hypertension** → compensatory vagal reflex → profound **bradycardia** and potential AV block. Central sympatholytic effects then lead to a prolonged decrease in blood pressure.

동물 종별 용량

Sheep

Anesthesia · 0.01 mg/kg IM · IM · once · Followed by propofol at 3-5 mg/kg IV.
Analgesia · 0.005-0.05 mg/kg IV or IM q3-6 hours (once) · IV/IM · q3-6h · once

Goats

Anesthesia · 0.01 mg/kg IM · IM · once · Followed by propofol at 3-5 mg/kg IV.
Analgesia · 0.005-0.05 mg/kg IV or IM q3-6 hours (once) · IV/IM · q3-6h · once

Cattle

Sedation/analgesia · 30-60 micrograms/kg (0.03-0.06 mg/kg) IV or IM · IV/IM · once · Not FDA-approved.
Analgesia · 0.01 mg/kg IV · IV · once · 1/2 hour · Withdrawal times: Milk = 72 hours; Slaughter = 7 days.

Horses

Sedation/analgesia · 20-40 micrograms/kg (0.02-0.04 mg/kg) IV or IM · IV/IM · once · IV only for analgesia. Lower dose provides 30-90 min sedation/30-45 min analgesia. Higher dose provides 90-120 min sedation/45-75 min analgesia.
Sedation/analgesia (Sublingual Gel) · 0.04 mg/kg (0.018 mg/lb) (0.040 mg/kg) placed beneath the tongue · Sublingual · once · Not meant to be swallowed.
Marked abdominal pain (not surgical candidates or long transport) · 0.01-0.02 mg/kg (10-20 micrograms/kg) IV or IM · IV/IM · once

투여 경로

IVIMSublingual (Oromucosal)POEpidural

금기

Preexisting AV or SA heart block
Severe coronary insufficiency
Cerebrovascular disease
Severe respiratory disease
Chronic renal failure

이상반응

Initial blood pressure increase (hypertension)
Profound bradycardia and heart block (AV block)
Piloerection
Sweating
Ataxia
Salivation
Slight muscle tremors
Penile prolapse
Decreased gastrointestinal motility

약물 상호작용

Other Alpha-2 Agonists (e.g., xylazine, medetomidine, clonidine) · Not recommended to be used together as effects may be additive.
Anesthetics, Opiates, Sedative/Hypnotics · Effects may be additive; dosage reduction required. Increased risk for arrhythmias with thiopental, ketamine, or halothane.
Epinephrine · Do not use to treat cardiac effects caused by detomidine, as epinephrine possesses alpha agonist effects.
Phenothiazines (e.g., acepromazine) · Severe hypotension can result.
Potentiated Sulfonamides (e.g., trimethoprim/sulfa) · Fatal dysrhythmias may occur if used with intravenous potentiated sulfonamides.

모니터링

Level of sedation and analgesia
Cardiac rate and rhythm
Blood pressure (if indicated)

과용량

> **Toxicity Profile:** * Tolerated by horses at 5X the high dose level (0.2 mg/kg). * Doses of 10-40X recommended can cause severe respiratory and cardiovascular changes that can become irreversible and cause death. * **Reversal:** Alpha-2 antagonists such as **atipamezole** (50-100 micrograms/kg) or **yohimbine** can be successfully used to reverse some or all effects of inadvertent overdoses.

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