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μν¬μν΄ μνλ μ¬μ‘°ν© μΈκ° μ리μ€λ‘ν¬μ΄μν΄(rHuEPO)μΌλ‘, μ£Όλ‘ κ°μ κ³ μμ΄μ λ§μ± μ λΆμ κ³Ό κ΄λ ¨λ λΉμ¬μμ± λΉνμ μΉλ£νλ λ° μ¬μ©λ©λλ€. μμνμμλ μκ°ν체 νμ± μνμ΄ λκΈ° λλ¬Έμ(20-70%) μ¬κ°ν λμΉμ± λΉνμ μ λ°ν μ μμ΄ μΌλ°μ μΌλ‘ 'μ΅νμ μλ¨'μΌλ‘ κ°μ£Όλ©λλ€. μΉλ£ μ€μλ μΌλ°μ μΌλ‘ μ² λΆ λ³΄μΆ©μ΄ νμν©λλ€.
μμ© κΈ°μ : Erythropoietin is an endogenous hormone primarily produced by the kidneys that regulates erythropoiesis. * **Receptor Binding:** Epoetin alfa binds to **erythropoietin receptors** on the surface of committed erythroid progenitor cells in the bone marrow. * **Proliferation & Differentiation:** This binding activates intracellular signaling pathways (such as JAK2/STAT5) β stimulates the survival, proliferation, and differentiation of red cell precursors. * **Reticulocyte Release:** It also accelerates the release of reticulocytes from the bone marrow into the systemic circulation, ultimately increasing the hematocrit and hemoglobin levels.
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- Adjunctive therapy for anemia associated with endstage renal disease Β· Initially, 100 Units/kg SC 3 times weekly (or 48.4-145 Units/kg SC 3 times a week). Β· SC Β· 3 times weekly Β· Ongoing Β· Target hematocrit is 30-40%.
- Anemia associated with endstage renal disease (PCV <20%) Β· 75-100 Units/kg SC three times a week until PCV is in the low normal range (35%), then reduce dose and frequency to 50-75 Units/kg two times per week. Β· SC Β· 3 times a week initially Β· Ongoing Β· Administer iron at start of regime and until appetite is good.
- Problematic clinical signs and PCV <20% Β· Initially, 100 Units/kg SC 3 times per week. Β· SC Β· 3 times per week Β· Ongoing Β· Provide oral supplementation with ferrous sulfate (5-50 mg per cat per day). Reduce to twice per week when target PCV (30-40%) is reached.
- Anemia Β· 50-150 Units/kg IM 3 times weekly; may decrease to once weekly if RBC indices are significantly improved Β· IM Β· 3 times weekly Β· Ongoing
- Anemia (Rabbits) Β· 50-150 Units/kg SC every 2-3 days until PVC is normal; then once weekly (q7 days) for at least 4 weeks Β· SC Β· every 2-3 days initially Β· at least 4 weeks maintenance
- Adjunctive therapy for anemia associated with endstage renal disease Β· Initially, 100 Units/kg SC 3 times weekly, until the bottom of the target hematocrit range of 37-45% is attained. Once attained, change to twice weekly. As hematocrit approaches upper target, reduce to once weekly. Maintenance generally 75-100 Units/kg SC 1-2 times weekly. Β· SC Β· 3 times weekly initially Β· Ongoing Β· A lower initial dosage of 50-100 Units/kg 3 times weekly may be used. Iron supplementation required.
- Adjunctive therapy for anemia associated with endstage renal disease Β· Initially, 48.4-145 Units/kg SC three times a week. Most dogs should be started at 97 Units/kg SC 3 times a week. Β· SC Β· 3 times a week Β· Ongoing Β· Monitor hematocrit weekly until target 37-45% is reached, then decrease to two times weekly. Oral iron supplements recommended.
μ©λμ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μ°Έκ³ μλ£μ λλ€. νμ μ΅μ λΌλ²¨κ³Ό κ°λ³ νμμ λν΄ νμΈνμμμ€.
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κΈκΈ°
- Uncontrolled hypertension
- Hypersensitivity to epoetin alfa
- Formation of significant autoantibodies with prior treatment
- Equines (not recommended for use)
μ΄μλ°μ
- Autoantibody formation (leading to refractory anemia)
- Systemic hypertension
- Vomiting
- Seizures
- Uveitis
- Iron depletion
- Local reactions at injection sites
- Fever
- Arthralgia
- Mucocutaneous ulcers
- Polycythemia (with chronic overdosage)
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- Androgens Β· May increase the sensitivity of erythroid progenitors; safety of this combination is not fully determined.
- Desmopressin Β· Concurrent use with EPO can decrease bleeding times.
- Probenecid Β· Has been demonstrated to reduce the renal tubular excretion of EPO; clinical significance remains unclear.
- Iron supplements Β· Synergistic/Required; EPO increases demand for iron to synthesize hemoglobin for new RBCs Β· minor
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- Hematocrit / PCV (weekly to every other week initially, then every 1-2 months)
- Blood Pressure (at least monthly initially)
- Renal Function Status
- Iron status (serum iron, TIBC)
- RBC indices
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Acute overdoses appear to be relatively free of adverse effects. Single doses of up to 1600 Units/kg in humans demonstrated no signs of toxicity. **Chronic overdoses** may lead to polycythemia or other adverse effects. Cautious phlebotomy may be employed should polycythemia occur.
VetSheet μ½λ¬Ό λ νΌλ°μ€λ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μμ¬κ²°μ 보쑰 λꡬμ΄λ©°, μ λ¬Έμ νλ¨μ΄λ μ μ‘°μ¬μ μ΅μ λΌλ²¨μ λμ νμ§ μμ΅λλ€.