덱스라족산

해독제 / 심장 보호제

**덱스라족산**은 주로 수의 종양학에서 사용되는 세포 내 철 킬레이트제 및 화학 보호제입니다. * **심장 보호**: 독성 징후를 보이거나, 기저 심장 질환이 있거나, 최대 누적 용량에 도달한 환자에서 안트라사이클린(예: 독소루비신)과 관련된 누적적이고 용량 의존적인 심장 독성 효과를 완화하는 데 사용됩니다. * **일출 관리**: 독소루비신의 우발적인 혈관 외 투여(일출)로 인해 발생하는 심각한 조직 괴사에 대한 중요한 해독제 역할을 합니다. **임상 포인트**: * 심장 보호에 매우 효과적이지만, 비용이 매우 비싸서 많은 보호자에게 부담이 될 수 있습니다. * 덱스라족산이 암 세포를 부분적으로 보호하여 항암제의 항종양 효능을 감소시킬 수 있다는 이론적인 우려와 인간에서의 증거가 있습니다.

작용 기전: Dexrazoxane is a cyclic derivative of EDTA that readily penetrates cell membranes. * Once intracellular, it is **hydrolyzed** into an active ring-opened chelating metabolite. * **Active Metabolite** → **Chelates intracellular iron** → Prevents the formation of the highly reactive **anthracycline-iron complex**. * This prevents the generation of destructive superoxide free radicals → **Protects the myocardium** from oxidative stress and irreversible anthracycline-induced cardiomyopathy. * *Mechanistic Note*: It also acts as a reversible inhibitor of **Topoisomerase II**, which is believed to contribute to its protective effects against severe tissue necrosis during extravasation injuries.

동물 종별 용량

Dogs

Treatment of anthracycline (doxorubicin, epirubicin, etc.) extravasation · 1000 mg/m2 · IV · within 6 hours and again on day 2. Infuse 500 mg/m2 on day 3 · 3 days · Terminate doxorubicin infusion immediately, and infuse intravenously in a separate infusion. Acute surgical evaluation is performed. Dosage recommendations are for human patients, but may apply to veterinary patients.
Treatment of anthracycline extravasation · 10 times the doxorubicin dose · IV · within 3 hours and again at 24 and 48 hours after extravasation · 48 hours · Anecdotally; significantly reduces local tissue injury.
Prevention of doxorubicin-induced cardiomyopathy · 10:1 ratio (e.g., 300 mg/m2 of dexrazoxane to 30 mg/m2 doxorubicin) · IV · starting 30 minutes of, and prior to the doxorubicin dose · Given as slow IV bolus (as a short, IV bolus).
Prevention of doxorubicin-induced cardiomyopathy · 10:1 ratio (e.g., 300 mg/m2 of dexrazoxane to 30 mg/m2 doxorubicin) · IV · starting 30 minutes before doxorubicin is administered · Given as slow IV bolus. Use can be considered in breeds at risk (Shelties, Collies, Australian Shepherds, etc.), dogs exceeding usual cumulative dose cutoff, and cases with preexisting cardiac disease where no effective chemo options exist.

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

투여 경로

금기

Should not be used unless an anthracycline antineoplastic agent is being used
Unknown based on monograph, but generally avoid in patients not receiving anthracyclines

이상반응

Additive myelosuppression
Potential reduction in efficacy of anthracycline antitumor agents
Testicular atrophy (observed in dogs)
Myelosuppression (documented in humans)
Decreased clinical efficacy of anthracycline antineoplastic agents

약물 상호작용

Myelosuppressive agents · Additive myelosuppression may occur when used concurrently.
Anthracycline antineoplastic agents · May decrease the clinical efficacy of the chemotherapy · moderate

모니터링

CBC
Echocardiogram (if used for cardioprotection)
ECG (if used for cardioprotection)
Complete blood count (CBC) for myelosuppression
Cardiac monitoring (ECG, echocardiogram) if used for cardiotoxicity
Extravasation site for healing or necrosis

과용량

Because of the method of administration and drug expense, overdoses are unlikely in veterinary medicine. As there is no known antidote, treatment would be supportive. Potentially, the drug could be removed via hemodialysis.

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