펠바메이트

항경련제

**펠바메이트(Felbamate)**는 주로 반려견의 2차 또는 3차 항경련제로 사용되는 독특한 디카르바메이트계 **항경련제**입니다. * **복합 부분 발작** 및 전신 발작에 특히 유용합니다. * **임상 요점**: 다른 많은 항경련제와 달리, 펠바메이트는 페노바르비탈이나 브롬화칼륨과 병용할 때 일반적으로 추가적인 진정 작용을 일으키지 않아 매력적인 추가 요법이 됩니다. * 반감기가 짧기 때문에 하루 세 번(TID) 엄격한 투약이 필요합니다. * 비용 및 접근성이 수의학 환자에게 제한 요소가 될 수 있습니다. * 수의학에서의 사용이 제한적이기 때문에 전체적인 부작용 프로파일이 불완전할 수 있습니다.

작용 기전: Felbamate reduces excitatory neurotransmission and enhances inhibitory pathways. * Increases activation of **voltage-gated sodium channels** → decreases sustained high-frequency firing of action potentials. * **NMDA Receptor Antagonism**: Blocks the **NR2B subunit** of the **NMDA receptor** → prevents glutamate-mediated excitation. * **GABA_A Modulation**: Acts as a positive allosteric modulator at **GABA_A receptors** → enhances chloride influx and neuronal hyperpolarization.

동물 종별 용량

Dogs

Seizures (As either add-on therapy or monotherapy) · 15 mg/kg PO q8h. Dose can be increased in 15 mg/kg increments every 2 weeks until seizures are controlled. Doses as high as 70 mg/kg q8h are required and tolerated in some dogs. · PO · q8h · Starting dose is 15 mg/kg.
Seizures (As a third choice antiepileptic agent) · 15-65 mg/kg PO q8h · PO · q8h · Steady state reached after 4th oral dose. Monitor CBC and liver function tests as you would for phenobarbital. Therapeutic serum concentration reported to be 15-100 micrograms/mL.
Seizures (For patients on phenobarb and bromides and seizure activity unchanged or having intolerable side effects) · 5-20 mg/kg PO three times daily · PO · TID · If intolerable side effects, do levels and decrease the dose of the one that is in the high end of the range. Then add felbamate.

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

투여 경로

금기

Hypersensitivity to felbamate or other carbamates (e.g., meprobamate)

이상반응

Keratoconjunctivitis sicca (KCS)
Liver enzyme induction
Tremor
Limb rigidity
Salivation
Restlessness and agitation (at high doses)
Blood dyscrasias (thrombocytopenia, lymphopenia, leukopenia)
Sedation (usually when combined with other anticonvulsants)
Vomiting/nausea (usually when combined with other anticonvulsants)

약물 상호작용

Phenobarbital · Felbamate may increase phenobarbital levels. Phenobarbital may decrease felbamate levels.
Phenytoin · Felbamate may increase phenytoin levels. Phenytoin may decrease felbamate levels.
Valproate · Felbamate can cause increases in valproic acid levels.

모니터링

Liver function tests (q2-3 months recommended by some clinicians)
Complete Blood Count (CBC) (q2-3 months recommended by some clinicians)
Therapeutic drug levels (25-100 micrograms/mL range, though usefulness is questionable)
Seizure frequency and severity

과용량

Limited veterinary information is available. * In humans, a massive overdose (12 grams over 12 hours) resulted only in mild gastric distress and a slightly increased heart rate. * Treatment should be supportive and symptomatic. Consider gastric decontamination if ingestion is recent and the patient is neurologically stable.

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