디메르카프롤
Dimercaprol
2,3-dimercapto-1-propanol
다른 이름: BAL in Oil · Sulfactin Homburg · British anti-lewisite · dimercaptopropanol · dithioglycerol dimercaprolum · Dicaptol
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days; q8h on 3rd day; BID for next 10 days | Until recovery | 🌎 NA |
| Arsenic toxicity | 4 mg/kg IM | IM | q4-6h | Max 4 continuous days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM loading dose, then 2.5 mg/kg IM | IM | q3-4h for two days, then progressively lengthen to q12h | Until recovery | 🌎 NA |
- Arsenic toxicity: Intensive supportive care required. 5 mg/kg dose only for acute cases and only for the first day. Give with sodium thiosulfate: 40-50 mg/kg IV as a 20% solution 2-3 times daily.
- Arsenic toxicity: Do not give for more than 4 continuous days.
- Arsenic toxicity: Loading dose of 5 mg/kg for acute cases only.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days; q8h on 3rd day; BID for next 10 days | Until recovery | 🌎 NA |
| Arsenic toxicity | 2.5-5 mg/kg IM | IM | q4h for first 2 days, then q12h | Until recovery | 🌎 NA |
| Arsenic toxicity | 4 mg/kg IM | IM | q4-6h | Max 4 continuous days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM loading dose, then 2.5 mg/kg IM | IM | q3-4h for two days, then progressively lengthen to q12h | Until recovery | 🌎 NA |
- Arsenic toxicity: Intensive supportive care required. 5 mg/kg dose only for acute cases and only for the first day. Give with sodium thiosulfate.
- Arsenic toxicity: If ingestion was within 36 hours. Use emetics/gastric lavage if recent. Institute fluid therapy.
- Arsenic toxicity: Do not give for more than 4 continuous days.
- Arsenic toxicity: Loading dose of 5 mg/kg for acute cases only.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Arsenic toxicity | 5 mg/kg IM initially, followed by 3 mg/kg IM q6h for remainder of first day, then 1 mg/kg IM q6h | IM | q6h | 2 or more additional days | 🌎 NA |
| Arsenic toxicity | 5 mg/kg IM initially, followed by 3 mg/kg IM q6h for remainder of first day, then 1 mg/kg IM q6h | IM | q6h | Next 48 hours | 🌎 NA |
- Arsenic toxicity: Therapy is difficult due to large volumes required and painful IM route. Must be used acutely; delays significantly decrease effectiveness.
- Arsenic toxicity: Effective if administered within hours of ingestion. Wash off topical arsenic, empty digestive tract. Administer sodium thiosulfate PO and IV.
소
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Arsenic toxicity (no clinical signs) | 3 mg/kg IM | IM | q8h | — | 🌎 NA |
| Arsenic toxicity (clinical signs) | 6 mg/kg IM | IM | q8h | 3-5 days | 🌎 NA |
| Arsenic, lead or mercury poisoning | 2.5-5 mg/kg IM | IM | q4h | 2 days | 🌎 NA |
| Mercury toxicity | 3 mg/kg IM | IM | four times daily for 3 days, then twice daily | 13 days total | 🌎 NA |
- Arsenic, lead or mercury poisoning: Efficacy questionable unless given before signs appear or very early. Withdrawal info not available.
- Mercury toxicity: Treatment is often unsuccessful.
돼지
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Mercury toxicity | 3 mg/kg IM | IM | four times daily for 3 days, then twice daily | 13 days total | 🌎 NA |
- Mercury toxicity: Treatment is often unsuccessful.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
디메르카프롤(Dimercaprol, BAL 또는 영국 항루이사이트제로도 알려짐)은 수의학에서 주로 비소 중독 치료에 사용되는 중금속 킬레이트제입니다. 납, 수은, 금 중독에도 간혹 사용됩니다.
제2차 세계대전 중 루이사이트(비소 기반 화학무기)의 해독제로 처음 개발되었으며, 중금속과 결합하여 필수 세포 효소를 방해하는 것을 막는 수لف히드릴기를 포함하고 있습니다.
임상 요점: 디메르카프롤은 땅콩 기름에 조제되어 깊은 근육 주사로 투여해야 하며, 상당히 고통스러울 수 있습니다. 셀레늄과 같은 특정 금속에는 비교적 효과가 없으며, 철, 카드뮴, 셀레늄 중독에는 절대 금기입니다(생성된 복합체가 금속 단독보다 더 강한 독성을 띠기 때문입니다).
작용 기전
Heavy metals exert their toxic effects by binding to sulfhydryl (-SH) groups on essential cellular enzymes, leading to enzyme inactivation. Dimercaprol contains two sulfhydryl groups that act as "decoys."
- Dimercaprol + Heavy Metal → Heterocyclic Ring Complex
- This complex is more stable than the metal-enzyme bond, allowing the metal to be pulled away from the tissues and excreted via the kidneys and feces.
Mechanistic Note: The chelation is not irreversible. The complex can dissociate as dimercaprol concentrations decrease, if oxidized, or in an acidic environment. Therefore, alkalinizing the urine is crucial to prevent the complex from dissociating in the kidneys and causing nephrotoxicity.
안전성·주의사항
금기사항
- Impaired hepatic function (unless secondary to acute arsenic toxicity)
- Iron poisoning
- Cadmium poisoning
- Selenium poisoning
부작용
- Pain at injection site
- Vomiting
- Seizures (at higher dosages)
- Transient increases in blood pressure
- Tachycardia
- Nephrotoxicity
주의
Dimercaprol is potentially nephrotoxic; use cautiously in patients with impaired renal function. To protect the kidneys, the urine should be alkalinized to prevent the chelated drug from dissociating in the urine. Animals with diminished renal function or who develop renal dysfunction while on therapy should have the dosage adjusted or therapy discontinued. IM injections must be administered deeply to minimize pain. May decrease Iodine I 131 thyroidal uptake values.
약물 상호작용
Forms a highly toxic complex. Do not administer with iron salts; wait at least 24 hours after the last dimercaprol dose before starting iron therapy.
Forms a highly toxic complex. Do not administer with selenium salts; wait at least 24 hours after the last dimercaprol dose before starting selenium therapy.
Forms a highly toxic complex.
Forms a highly toxic complex.
Forms highly toxic complexes
모니터링
- Liver function
- Renal function
- Hemogram
- Hydration and perfusion status
- Electrolytes and acid/base status
- Urinary pH (maintain alkaline pH)
약동학
흡수
Peak blood levels occur in 30-60 minutes after IM injection. Slowly absorbed through the skin after topical administration.
분포
Distributed throughout the body, including the brain. Highest tissue levels are found in the liver and kidneys.
대사
Non-metal bound drug is rapidly metabolized to inactive compounds.
배설
Excreted in the urine, bile, and feces. In humans, completely eliminated within 6-24 hours.
과다투여
Clinical signs of dimercaprol overdosage in animals include vomiting, seizures, tremors, coma, and death. No specific doses were located to correspond with these clinical signs. Treatment should be supportive and symptomatic.
제품
제형
- Injection: 100 mg/mL (10%) in peanut oil and benzyl benzoate
인용의약품
- Dimercaprol Injection: 100 mg/mL (10%) (for IM use only) in 3 mL ampules (BAL in Oil)
규제 현황
POM status.
POM (Prescription Only Medicine).
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store below 40°C; preferably at room temperature (15-30°C). Unstable in aqueous solutions. The commercially available injection is a peanut oil and benzyl benzoate solution. Turbidity or small amounts of flocculent material/sediment do not indicate deterioration.
보호자 정보
- 엄격한 감독 필요: 이 약물의 잠재적 독성과 중금속 중독의 생명 위협적인 특성 때문에, 일반적으로 입원 환경에서 수의사의 철저한 감독 하에 사용해야 합니다.
- 특이한 냄새: 디메르카프롤은 반려동물의 호흡에서 마늘이나 스컹크 같은 강하고 불쾌한 메르캅탄 냄새를 유발할 수 있습니다. 이는 약물의 정상적인 반응입니다.
- 주사 통증: 이 약물은 깊은 근육 주사로 투여되며 반려동물에게 상당히 고통스러울 수 있습니다.
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