ํ์ํด๋ก๋น๋ฅด
**ํ์ํด๋ก๋น๋ฅด(Famciclovir)**๋ ์์ํ์์ ์ฃผ๋ก **๊ณ ์์ด ํค๋ฅดํ์ค๋ฐ์ด๋ฌ์ค-1(FHV-1)** ๊ฐ์ผ ์น๋ฃ์ ์ฌ์ฉ๋๋ ๊ฒฝ๊ตฌ์ฉ ํญ๋ฐ์ด๋ฌ์ค์ ์ ๋๋ค. * ์ฒด๋ด์์ ํญ๋ฐ์ด๋ฌ์ค ํ์ฑ์ ๊ฐ์ง **ํ์ํด๋ก๋น๋ฅด(penciclovir)**๋ก ๋ณํ๋๋ ์ ๊ตฌ์ฝ๋ฌผ์ ๋๋ค. * ๊ณ ์์ด๋ ์ด ๋ณํ์ ๋ด๋นํ๋ ํจ์์ธ **๊ฐ ์๋ฐํ๋ ์ฐํํจ์**์ ์์น๊ฐ ๋งค์ฐ ๋ฎ๊ธฐ ๋๋ฌธ์ ์น๋ฃ ๋๋์ ๋๋ฌํ๋ ค๋ฉด ์ฌ๋์ด๋ ๋ค๋ฅธ ์ข ์ ๋นํด ํจ์ฌ ๋ ๋์ ์ฉ๋์ด ํ์ํ ๊ฒฝ์ฐ๊ฐ ๋ง์ต๋๋ค. * ๊ณ ์์ด์๊ฒ ๋จ๊ธฐ๊ฐ(2~3์ฃผ) ์ฌ์ฉํ ๋ ์ผ๋ฐ์ ์ผ๋ก ๋ด์ฝ์ฑ์ด ์ข์ง๋ง, ์ฅ๊ธฐ์ ์ธ ์์ ์ฑ ๋ฐ์ดํฐ๋ ์์ง ์ ํ์ ์ ๋๋ค. * **์์ ์์ **: ๋น๊ต์ ๊ณ ๊ฐ์ด์ง๋ง ์ ๋ค๋ฆญ ์์ฝํ์ด ์ถ์๋๋ฉด์ ์ค์ฆ ๋๋ ๋์น์ฑ FHV-1 ํ๋ฌ์๊ฒ ๋ ์ ๊ทผํ๊ธฐ ์ฌ์ด ์น๋ฃ ์ต์ ์ด ๋์์ต๋๋ค.
์์ฉ ๊ธฐ์ : Famciclovir is a prodrug that undergoes biotransformation to become active: Famciclovir โ **hepatic aldehyde oxidase** โ Penciclovir Once inside a virus-infected cell: Penciclovir โ **viral thymidine kinase** โ Penciclovir monophosphate โ **cellular kinases** โ Penciclovir triphosphate * The triphosphate form competes with deoxyguanosine triphosphate to inhibit **herpes virus DNA polymerase**. * This selectively and effectively halts **herpes viral DNA synthesis** and replication. * Viral resistance can occur via mutation.
๋๋ฌผ ์ข ๋ณ ์ฉ๋
- Feline herpes virus (FHV-1) ยท 125 mg (total dose) ยท PO ยท 2-3 times a day ยท Author's choice. Wide range of doses used.
- Adjunctive treatment of FHV-1 rhinotracheitis ยท 31.25 mg (1/4 of one 125 mg tablet) ยท PO ยท q12h ยท 14 days ยท Has not been evaluated for longterm therapy.
- Chronic, recurrent and/or severe herpes viral infection ยท Kittens: 1/8th of one 125 mg tablet; adult cats: 1/4 of one 250 mg tablet ยท PO ยท once daily (q24h) ยท Kittens: 2 weeks; adult cats: 3 weeks ยท Dose range is variable!
- Feline herpes virus (FHV-1) ยท 1/4 of one 125 mg tablet ยท PO ยท twice daily (q12h) ยท 10-14 days; may continue once daily for up to 30 days
- Adjunctive treatment (with interferon and lysine) of herpes virus-associated ulcerative facial dermatitis & stomatitis ยท 125 mg ยท PO ยท q12h
- Management of feline herpesvirus (FHV-1) infections ยท 90 mg/kg ยท PO ยท q12h ยท Dose recommendations have varied because of complex and non-linear pharmacokinetics in cats.
์ฉ๋์ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์ฐธ๊ณ ์๋ฃ์ ๋๋ค. ํญ์ ์ต์ ๋ผ๋ฒจ๊ณผ ๊ฐ๋ณ ํ์์ ๋ํด ํ์ธํ์ญ์์ค.
ํฌ์ฌ ๊ฒฝ๋ก
๊ธ๊ธฐ
- Known hypersensitivity to famciclovir or penciclovir
์ด์๋ฐ์
- Cats: Anorexia and polydipsia (noted at high doses of 90 mg/kg PO q8h)
- Humans: Nausea, vomiting, diarrhea, headache, neutropenia, renal failure
- Gastrointestinal signs (vomiting, diarrhea, anorexia)
์ฝ๋ฌผ ์ํธ์์ฉ
- Probenecid ยท Can reduce the amount of penciclovir excreted by the kidneys, leading to increased penciclovir plasma levels
๋ชจ๋ํฐ๋ง
- Clinical efficacy (resolution of ocular/respiratory signs)
- Adverse effects (most likely GI upset, anorexia, polydipsia)
- Consider occasional CBCs and serum creatinine to monitor for neutropenia or renal dysfunction if using the drug chronically
- Haematology
- Biochemistry
- Urinalysis (especially in cats with concurrent disease or on long-term therapy)
๊ณผ์ฉ๋
Little information is available regarding acute toxicity. **Supportive treatment** is recommended. Penciclovir can be removed by hemodialysis.
VetSheet ์ฝ๋ฌผ ๋ ํผ๋ฐ์ค๋ ๋ฉดํ ์์ ์ ๋ฌธ๊ฐ๋ฅผ ์ํ ์์ ์์ฌ๊ฒฐ์ ๋ณด์กฐ ๋๊ตฌ์ด๋ฉฐ, ์ ๋ฌธ์ ํ๋จ์ด๋ ์ ์กฐ์ฌ์ ์ต์ ๋ผ๋ฒจ์ ๋์ ํ์ง ์์ต๋๋ค.